Africa: Meet the Woman Fighting to Protect Africa’s Girls After Global Health Funding Collapse

“We’re doing right by girls… even when systems fail them”

The U.S. withdrew $377 million in funding from the United Nations Population Fund (UNFPA), the United Nations’ lifeline for sexual and reproductive health. Across Africa, the fallout is immediate – clinics are closing, contraceptive and PrEP supplies are dwindling, and adolescent girls, already at the mercy of fragile health systems, face a future of heightened risk from unintended pregnancies, HIV, and gender-based violence.

Serah Malaba, Chief Impact Officer at Tiko, said the shockwaves from sweeping cuts to U.S. and European government aid, including the U.S. government’s decision to deny all future funding to UNFPA, the abrupt end to most USAID programs, and major reductions in European development assistance, are “deeply alarming”. According to UNFPA, the loss of U.S. support will negatively affect efforts to prevent maternal deaths, especially in conflict-affected and crisis-hit regions.

“In sub-Saharan Africa, we are witnessing clinics shutting down, uncertain guidance on implementation of PrEP for girls who need it, critical stockouts of contraceptives, and a breakdown in sexual and reproductive health services for adolescent girls,” said Malaba. “These girls, already the most vulnerable demographic, are losing access to essential care, putting them at higher risk of unintended pregnancy, HIV infection, and sexual and gender-based violence.”

As global aid falters, Tiko focuses on girl-centred health in Sub-Saharan Africa, uses technology and data to improve access to sexual and reproductive health services for adolescent girls in urban and peri-urban Africa, working in close partnership with governments to strengthen public health systems.

Malaba said Tiko is working to keep sexual and reproductive health services available for adolescent girls by using a data-driven, tech-enabled model that prioritises the most at-risk communities despite these funding shocks. In the face of clinic closures and supply shortages, Tiko prioritises directing resources to the public and private sector clinics, focused on critical urban informal settlements where adolescent girls are most vulnerable.

Their ‘Triple Threat’ model – tackling unintended pregnancy, HIV, and gender-based violence – is rewriting the script for girls’ health. Malaba leads efforts that are on track to reach their target of 5 million girls across Sub-Saharan Africa by late 2035. She said these are not separate problems in a girl’s life – they’re “interconnected, and they often show up together and addressing them in isolation misses the complexity of what girls are actually going through and limits the impact we can have”.

Health systems are failing girls

Malaba said global health systems are “failing girls” because aid too often funds fragmented, short-term programmes that fail to address the full spectrum of adolescent girls’ needs or build resilient systems. She said that too often programmes are siloed and lack sustainability, leaving girls without continuous support.

Tiko counters this gap, she said, by partnering closely with community-based organisations, governments to strengthen public health systems, using data-driven approaches for accountability, and deploying innovative financing to ensure long-term impact. She said the organization’s focus on free, integrated, girl-centred solutions helps create sustainable change rather than temporary fixes.

In Kenya alone, Tiko exceeded HIV service delivery targets by over 300%

“Our integrated approach tackles teen pregnancy, HIV, and gender-based violence concurrently, so girls receive holistic care. Through our digital platform and strong grassroots delivery partnerships, we reach girls directly, coordinate across health systems, and use innovative financing tools like Development Impact Bonds to sustain service delivery,” she said.

Malaba shared Emily’s story as a powerful example of how the organisation’s integrated approach is transforming lives.

“When Emily* completed her Form 4 in 2023, she was full of hope for the future. But just a year later, everything changed. She found out she was pregnant. “It broke me,” Emily recalls.

“I was depressed and stressed, constantly wondering how I would raise a baby on my own.”

Emily’s situation worsened when her boyfriend denied responsibility for the pregnancy and violently forced her out of his house. Alone, confused, and heartbroken, she found herself with nowhere to go. She gave birth while living on the streets, facing one challenge after another.

Through Tiko, Emily was connected to youth-friendly clinics where she received comprehensive counselling on contraception, HIV prevention, mental health, and child support. Malaba said the combination of these services, offered free of charge and in a safe, non-judgmental space, helped Emily reclaim her future.

“Today, she is on her way to becoming a certified cosmetologist, with dreams of one day owning her own salon,” Malaba said.

“Tiko’s model removed financial and social barriers: services were free, accessible, and delivered in a non-judgmental environment. Using Tiko’s digital platform, Emily accessed reliable information and ongoing support, empowering her to take control of her health and share knowledge with her peers.”

However, challenges remain significant.

“Supply chain disruptions, clinic closures, health worker shortages, and reduced funding for peer care models and declining international development assistance,” Malaba said.

“We must work harder to fill the gaps and advocate for sustained funding. Strengthening resilient communities and health systems and securing reliable resources are critical next steps.”

“Our integrated ‘Triple Threat’ model is critical because it provides free, comprehensive, girl-centred care that tackles all these risks together, improving health outcomes and empowerment,” she said.

“At a time when resources are less, we need to be doing right by girls, which means keeping them connected and protected, responding to their health and wellbeing needs so they can shape their own futures.”

Malaba said her personal journey deeply informs her mission to transform adolescent health systems across Africa. “Losing both my parents to HIV at a young age gave me firsthand insight into the vulnerabilities adolescent girls face and the devastating consequences when health systems fail them,” she said.

This loss, she said, became the foundation for a leadership vision rooted in empathy, equity, and lasting impact.

“This personal loss fuels my passion and commitment to ensure that no girl is left behind or forced to navigate these challenges alone. My experience has shaped a vision centred on resilience, empathy, and systemic change, building girl-centred health programs that are accessible, integrated, and sustainable.

“It drives me to create solutions grounded in real-world needs and to work tirelessly to transform the systems that once failed me and so many others,” said Malaba.

Malaba faced challenges while establishing Tiko, such as deeply entrenched gender norms, political resistance, and resource constraints.

Driving systemic change is often about navigating complex power dynamics, she said, and operating in environments where women’s leadership is undervalued. “However, these obstacles have strengthened my resolve to build alliances and demonstrate through results that investing in girls and women is essential for sustainable development,” she said.

Looking ahead, Malaba said the organisation will help build resilient, digitally enabled, and accountable health systems across Africa that put adolescent girls at the centre. Tiko wants scalable, evidence-based solutions embedded in national health strategies, supported by sustained financing and strong government leadership. The global community should step up by investing in impact-focused integrated approaches, prioritising adolescent health in funding decisions, and ensuring girls’ voices shape the programmes designed to serve them.

Malaba issued an urgent call for global leaders to create protected funding streams specifically for girls’ SRHR services.

“Global leaders immediately ring fence and increase funding specifically for adolescent girls’ sexual and reproductive health services, with an emphasis on integrated and girl-centred approaches. Failure to act decisively will have devastating consequences,” she said.

“Protecting and empowering adolescent girls is not only a moral imperative but foundational to global health, equality, and development goals.”

“Without urgent action, we risk losing a generation of girls to preventable health challenges,” said Malaba.

By Melody Chironda