The vague but influential program that provided detailed public health information for about half of the world's countries will collapse as a result of the Trump administration's freeze on foreign aid.
Funded by the US International Development Agency, demographics and health surveys have been the only source of information in many countries, including health and mortality in many countries, nutrition, reproductive health, and HIV infection.
The study collected data from 90 low- and middle-income countries, and then used the information to set health benchmarks at local, national and global levels, including the 2030 Sustainable Development Goals adopted by UN Member States.
On Tuesday, the program administrators learned that “we've finished for the convenience of the US government,” according to an email viewed by The New York Times. They were ordered to “stop all work, finish the subcontractors and not issue any further orders.”
The Trump administration is dismantling USAID. Thousands of layoffs are expected in the coming days. Without future research, it is nearly impossible to measure the impact of foreign aid reductions on citizens of countries with no substantial health infrastructure.
Some global health experts responded with disappointment at the end of this program.
“We've seen a lot of people who have had a lot of trouble with their lives,” said Win Brown, a demographic scientist at the University of Washington.
“We can't track what's going on, we can't form a strategy. We can't adjust based on how our data is changing,” he added.
It was unclear what would happen to research collected over the past decades or ongoing research projects in 25 countries. “We need to find a way to save that data, and I think it's feasible,” said Libya Montana, technical director of the program.
The survey has been conducted since 1984. The funds were about $500 million over five years, about half of which came from USAID and half from other donors, including countries.
Some countries like India have almost completely taken over funding for their own investigations. This research is widely seen as essential.
“The effects of these disruptions echo at local, regional, national and global levels,” a group of dozens of experts warned on February 13th.
Some UN organizations evaluate child and adolescent health or census data in some countries, while others measure household income and agricultural production.
However, demographic and health surveys collected every five years documented all important aspects of home health, including child and adult death data, height and weight, nutritional status, education and literacy, access to clean water and cell phones.
“Malnutrition indicators are one of the most important,” Dr. Montana said. The study also assessed malaria indicators and health facilities individually.
Estimating maternal and child mortality rates is very important in countries that do not have a good death registration system. This study also measured family size. This can demonstrate the availability of family planning, but reflects a wider range of social factors, including access to education for girls.
Dr. Brown, for example, uses this study to compare the use of birth control in women in countries such as Egypt, Pakistan and India over decades. “In a survey like DHS, you're on the ground talking to real people and their real homes in the real community,” he said.
Like other projects funded with foreign aid, the program was under a halt order before it was finished. All but 11 of the 80 staff took leave unpaid, and relationships with the contractor ended a few weeks ago.
Notified of the suspension, some central governments expressed concern and sympathy, and some asked if they could pay to finish the job. Dr. Montana said others have made it rough.
“It's like I've experienced more of this kind of thing that changes political winds right away,” she said.
