In just a matter of three months, the Trump administration significantly undermined foreign aid, endangering countless lives and livelihoods globally. Following an initial 90-day halt on all US foreign aid expenditures, President Donald Trump transferred control to Elon Musk’s Department of Government Efficiency (DOGE).
The damage inflicted as DOGE aimed to dismantle the US Agency for International Development (USAID) was rapid and far-reaching. Health facilities across Afghanistan to Burundi closed their doors. Oxygen tanks, medications for HIV and malaria, and various medical supplies worth at least $240 million are stranded at ports or warehouses worldwide. Despite Musk’s claims at the end of February that Ebola funding was restored with “no interruption” during the freeze, public health experts assert those funds remain inactive. Whether addressing malnutrition, clean water access, or outbreak responses, even a short delay can reverse years of progress.
The Trump administration made cuts of at least $54 billion to foreign aid contracts. Globally, approximately 60,000 aid workers lost their positions, including around 2,000 from USAID. Many nations have seen their main health support disappear, and it is unlikely to return swiftly. Secretary of State Marco Rubio, who assumed interim leadership of USAID in early February, announced that 83 percent of the agency’s programs had been terminated, while those that were restored have been significantly reduced.
A comprehensive list of the impacted programs and projects has yet to be released by the administration. Nevertheless, former USAID staff and contractors are compiling lists of canceled efforts based on termination notices received. Many essential global health initiatives addressing malnutrition, preventing newborn and maternal fatalities, or combating infectious diseases such as HIV, malaria, tuberculosis, and polio have been adversely affected. Furthermore, projects aimed at enhancing infectious disease monitoring in other countries and preventing future pandemics—which could threaten American health and security—were also eliminated.
These reductions, coupled with the US’s recent exit from the World Health Organization, add to a prolonged decline in global health funding. The timing is exceptionally poor: five years after the onset of the Covid pandemic, the world is now experiencing a wave of infectious disease outbreaks, from dengue and malaria to Ebola, along with a new and deadly disease emerging in Congo.
The consequences recorded thus far are severe and extensive, yet they represent just a fraction of how billions of lives and livelihoods will be affected currently and in the future. Here’s what we know regarding the global health impacts of US foreign aid in three informative charts.
Millions of patients stranded
Until very recently, USAID operated in 160 countries, working to foster democracy, alleviate poverty, enhance health, combat infectious disease outbreaks, and provide food, clean water, and education to rural, underserved, refugee, and conflict-affected communities. Since its establishment in 1961 under President John F. Kennedy, USAID has become a well-known entity in numerous countries. US foreign aid during that time has been a crucial and frequently examined tool of global diplomacy, traditionally enjoying bipartisan support.
In terms of aid, the US remains indispensable. In 2024, US contributions to the United Nations accounted for 40 percent of all humanitarian funding. The US provided nearly half of all global food aid and made significant contributions to the World Health Organization in response to health crises and emergencies.
In total, the US allocated over $10 billion in health aid globally in 2024. Nations in sub-Saharan Africa received the majority of that assistance, yet developing countries everywhere have felt the ramifications of US funding reductions. Here are some significant consequences of the US foreign assistance freeze thus far:
- Approximately 3.8 million women have lost access to contraception on a global scale.
- In Afghanistan, 9 million individuals—almost a quarter of the population—will no longer benefit from US-funded healthcare services.
- Nearly 700,000 people in Burkina Faso and Mali have been deprived of water, food, or health services.
- The World Food Programme, the largest single donor of which is the US, ceased operations in South Africa, where 27 million individuals face hunger amid the worst drought in decades.
- In Nigeria, by April, 25,000 severely malnourished children will no longer receive food assistance.
One program particularly impacted is the President’s Emergency Plan for AIDS Relief (PEPFAR), which provides testing and treatment to manage HIV, credited with saving approximately 25 million lives. While the entire program wasn’t eliminated, several key contracts were significantly reduced or canceled. This has led to 20.6 million individuals, including nearly 600,000 children, losing access to HIV treatment that was previously funded by the US. Experts predict that the burden of HIV could increase sixfold over the next four years.
The disarray surrounding the Trump administration’s dismantling of USAID and associated agencies has been notable. Numerous lawsuits are currently pending, alleging the administration’s actions against USAID and its contractors are unlawful. However, a federal judge recently declined to mandate the restoration of canceled contracts.
China is already seizing the opportunity created by this vacuum. Media outlets from Nepal to Colombia have reported that Chinese representatives have made offers to enhance their assistance in various sectors, including agriculture, disaster relief, healthcare, and poverty reduction. After significant flooding in parts of Madagascar, Chinese officials initiated their first humanitarian response in the region, setting up aid tents along the Ikopa River within days.
The extent to which China will aim to leverage this situation remains uncertain. While the US foreign aid freeze and budget cuts have already created substantial challenges, the long-term effects will not be fully understood for months or even years. For instance, USAID-funded agricultural initiatives were unable to distribute seeds in time for planting, which could result in farmers missing an entire growing season, as noted by a spokesperson from a US nonprofit receiving USAID contracts. This will exacerbate food insecurity and potentially drive families into poverty.
In various regions, crucial mosquito control programs—such as applying insecticide to eliminate larvae before they mature into mosquitoes—have been overlooked, which is likely to lead to a surge in dengue, malaria, and other mosquito-borne diseases in the coming months.
The absence of US funding for polio eradication could result in an additional 200,000 cases of polio each year. Additionally, without US foreign aid resources, approximately 10.6 million tuberculosis cases could go untreated, leading to around 2.2 million preventable deaths.
If one is an optimist, there may be hope for the restoration of some of these programs and for rebuilding the bipartisan agreement that once supported foreign aid. Yet, as time passes, this possibility appears increasingly bleak. The stark reality is that the actions taken by the Trump administration have resulted in substantial voids in global aid that will ultimately be quantified in lost lives.
