With aid cutoff, Trump takes millions of lifelines

Funding from the world's wealthiest countries flowed from the largest global aid institutions in the past to a complex network of small, medium and large organizations that provided assistance. Over 20 million HIV drugs. Nutritional supplements for hungry children. Supporting refugees, orphaned children, and women who have been attacked by violence.

The network is now clear. The Trump administration plans to freeze foreign aid for 90 days and block the U.S. International Development Agency to just 5% of its workforce, but a federal judge suspended the plan on Friday. Given the war and the bound economy, other governments and charities rarely make up for the shortage. Also, recipient states are too difficult to manage themselves in debt.

Even the largest tissues are unlikely to appear unharmed. In the interview, more than 25 aid workers, former USAID employees, and staff from the aid organization described the system that was thrown into massive disruption and chaos.

Block towers can take hours to build, but “it takes one of these blocks and collapses,” says Mitchell Warren, executive director of HIV prevention organization AVAC, who relies on 38% of USAID. I did.

“You've stripped away all your staff, all your institutional memories, all your trust and trust not only in the United States but in dozens of countries where USAID works,” Warren said. “These things took decades to accumulate, but they took two weeks to destroy them.”

Some, with only 10 employees, are folded. Some medium-sized organizations have abandoned up to 80% of their employees. Even large organizations, including Catholic Relief Services and the FHI 360, have announced large layoffs or Farrows, among the largest recipients of USAID funds.

One study said about one in four nonprofits could last for a month. Over half said they had enough reserves to survive for at most three months.

The damage is exacerbated by President Trump's announcement that the US will withdraw from the World Health Organization, forcing leaders to announce their own cost-cutting measures.

Global health experts said the future seemed suddenly uncertain, even dystopias could be seen, and they struggled to clarify alternatives.

“It's clear that the future looks different,” said Christine Stegling, assistant executive director of UNAIDS, UN HIV division. But “None of us yet has a real photo of what that means.”

The damage extends not only to the health of people overseas, but also to Americans and American businesses. In addition to approximately 100,000 positions being cut overseas, an estimated 52,000 Americans from 42 states have been lost.

The global healthcare supply chain market was valued at nearly $3 billion in 2023 and was expected to grow. About $2 billion in American agricultural products are purchased annually as food aid. A sudden halt is at risk for more than $450 million in corn, lentils, rice, and other products in transit or in warehouses or ports.

“This economic impact will be astounding in people's lives and businesses,” says Lisa Hilmi, executive director of Core Group, a large global consortium of health practitioners.

Hirumi, who worked as a nurse in many conflicts and disaster zones, said the lack of health services could promote health, malnutrition, epidemics, civil unrest and “a much broader meltdown in society around the world.” He said it was sexual.

“If America is the biggest superpower, we need to act that way,” she said. “And part of that is acting with humanity.”

“Whimsical Chaos”

A week after aid was suspended, Secretary of State Marco Rubio issued life-saving humanitarian assistance and drug exemptions. However, orders for suspension of some programs, including food aid, continued even after the announcement of the exemption.

Last week, one large organization got some of its programs. However, that same day, the Trump administration put dozens of USAID officers on leave, leaving the organization to decide whether the department that issued the exemption is still viable, and the officer who wrote the notification was still employed. Ta.

“This is another example of the chaos this administration has to offer us,” said a senior official at the organization.

Leaders of most organizations that rely on USAID funding will not talk about the record, fearing retaliation from the Trump administration.

Even if the organization receives approval to continue, the money is not flowing. One large organization received less than 5% of its expected budget during this period, while the others received nothing.

“We are clearly welcoming that the secretary has approved the exemption and posted the post online, but we cannot pay the bills via post,” a senior official from the large organisation said of Rubio. .

Some groups feel that they are morally obligated to continue providing lifesaving services, hoping to be refunded in the end. However, dozens of small organizations are closed every day, causing damage to some of the world's most vulnerable groups, some experts warn.

Global health ecosystems are so closely woven together that the suspension freezes work for organizations that don't receive money from the US government.

The non-profit IPA works with hundreds of organizations in dozens of countries to provide access to birth control, abortion and other reproductive health services. The organization's president, Anu Kumar, said forever that many of the clinics have been closed.

At the speed of confusion, she said, the clinics were unable to plan emergency situations or rely on fundraising in mind, adding, “This definitely has a ripple effect.”

According to the Guttmacher Institute, more than 900,000 women and girls are denied reproductive care after a week of freezing. “It's more than the entire population of North Carolina,” Dr. Kumar said.

As a result, the institute estimated that 4.2 million girls and women experienced unintended pregnancy, with 8,340 people going to die from pregnancy and complications during childbirth.

Many HIV programs include the most risky “major population” including trans people and men who have sex with men and even crimes in some countries. It was focused on.

In Uganda, for example, strict anti-gay laws for people with HIV can be administered the death penalty for consensual homosexual activities. The US-funded nonprofits were important sources of financial and medical assistance.

“It's something that every American should be proud of, but I don't think they know that,” said the coalition for health promotion and social development that monitors the quality of other HIV programs in Uganda. said Kenneth Mwenge, executive director of the company.

“I don't think you know how much they contributed and the lives they saved. They don't celebrate it enough,” he said. His organization had to let go of 105 full-time staff and community workers.

Childhood vaccinations, malaria prevention and treatment, and malnutrition programs are also stagnating. So are programs relating to education, economic empowerment, preventive health services and family planning.

“This is the perfect storm for poor health outcomes and we won't avoid them,” said Elisha Dan Jojou, executive director of Global Health Council, a member organization for health groups. Ta.

Some USAID-funded organizations provided clean water and sanitation, particularly to the refugee population. Others have helped the government protect against diseases such as polio and measles among conflict zones and nomadic groups. Still others provided expertise to contain the outbreak of dangerous pathogens such as Ebola and Marburg smoldering in Uganda and Tanzania.

Even if any of these threats are not contained, they could potentially cross the boundaries and land on the US coast, said Rebecca Wolf, who worked for a USAID-funded nonprofit for 15 years. Ta.

The world is “very interconnected and we're trying to divide it into “America-first,” so the rest will no longer work in today's era,” she said.

“It feels like sadness.”

Some USAID employees and aid organizations said unplugging the sudden plug of fundraising is against the goal.

For the past few years, USAID has been working to train midwives, nurses, doctors, labs and hospitals.

Self-sufficiency requires small, local nonprofit organizations to provide services, but the smallest organizations are least likely to survive the current storm.

“Ironically, their priorities for Project 2025 are to stay away from localization from big partners,” said Jeremiah Centrella, former general advisor at Mercy Corps. “But the large international partners are the only partners with a strong enough balance sheet to access and overcome private donors.”

It is unclear what will happen to tens of thousands of workers who are not working all of a sudden and have no industry to find them.

In Kenya, Mercy Gichinji cared for 100 households in Nairobi's Kayor district. Githinji, a 52-year-old single mother of four daughters, is currently unsure how she will pay rent and tuition.

The clinic provided medical care, but residents supported rent, food and hygiene pads. “Now there's no checks and nothing,” Gichinji said. “It's so bad. People are suffering.”

Even if aid resumes next week, clinics and offices are already closed, people are moving, and trust is broken, former USAID employee said.

Others said they were desperately saddened – not for their own sake, but for those whom they have vowed to serve.

“The only way I could explain it is to feel like sadness,” said the former USAID employee.

“Our mission is to save lives and reduce suffering,” she said. “It was so heartbreaking to be called a criminal or radical madman without notice or reason, even if we had no opportunity to contribute to it and were taken away from it overnight.”

Stephanie Nolen contributed the report.