‘we’re Headed For Disaster’: America’s Foreign Aid Cuts Expected To Devastate Global Health

The Trump administration has decided that hundreds of programs aimed at helping people in the world’s poorest countries stay alive are no longer in the national interest.

The sweeping cuts in foreign aid announced Wednesday will slash HIV treatment, prevention and research, health services to treat malaria, and care for new mothers and their babies, among other lifesaving programs, say global health and humanitarian groups whose contracts were cut. It will also halt basic health services for people displaced by conflict, such as those in Sudan or Gaza.

“This reckless and unilateral move will cost millions of lives around the world,” the Global Health Council, an alliance of nonprofits and companies which receive U.S. foreign aid funding, said in a statement. The council is one of the plaintiffs that’s challenged the foreign aid cuts in court.

President Donald Trump froze foreign aid shortly after taking office, saying his administration would review the funding to ensure it aligned with Trump’s “America First” policy. Soon thereafter, Secretary of State Marco Rubio said lifesaving aid would continue under a waiver.

But the administration said Wednesday the review was over. The list of programs cut included many aimed at saving lives. Among them were funds provided by the President’s Emergency Plan for AIDS Relief, better known as PEPFAR, a program credited with saving 25 million lives globally since former President George W. Bush started it in 2003.

Supreme Court Chief Justice John Roberts granted the administration a respite Wednesday from a decision by a lower-court judge who had ordered the administration to release frozen funds since it had not conducted “a good-faith, individualized assessment” of the grants and contracts it had halted.

In its appeal to Roberts, the administration said it had completed the assessment, and it told the lower court it was ending more than 90 percent of 6,300 USAID awards, worth $54 billion, and 60 percent of the State Department’s 6,800 awards, worth $4.4 billion.

“Secretary [of State Marco] Rubio has now made a final decision with respect to each award, on an individual basis, affirmatively electing to either retain the award or terminate it … as inconsistent with the national interests and foreign policy of the United States,” the court document stated.

Global health researchers and providers worry that cutting access to prevention and treatment services for HIV and malaria will lead to resistance to the drugs that treat them, rendering those drugs mostly ineffective in the future.

“With HIV prevention programs halting immediately, we are headed for disaster,” said Yvette Raphael, the executive director at Advocacy for Prevention of HIV and AIDS in South Africa.

PEPFAR provides nearly a fifth of HIV/AIDS funding in the country, which has more than 7 million people living with HIV, the highest in the world.

A State Department spokesperson said USAID “retained critical awards, including food assistance; life-saving medical treatments for HIV, tuberculosis, and malaria; and critical support for nations like Lebanon, Haiti, Venezuela, Cuba, and others.”

The spokesperson and the State Department did not immediately respond to questions about why programs covered by Rubio’s waiver were terminated.

Since midday Wednesday, the administration canceled at least seven awards for lifesaving humanitarian needs such as food assistance, shelter and emergency health care it had given to partners to support the Gaza relief effort, including to Catholic Relief Services and International Medical Corps, according to a USAID official familiar with the matter granted anonymity for fear of reprisal. The awards totaled at least $100 million, according to the official.

Those awards had gotten waivers from Rubio on Jan. 31, although the partners carrying out the aid work haven’t been paid since the start of the administration. Other awards are still active for the conflict, but it’s unclear what will happen to them.

Los Angeles-based International Medical Corps said in a statement that it had received cancellation notices for the majority of its U.S. government-funded programs and “this loss of funding will significantly impact our lifesaving global operations.” A spokesperson for Baltimore-based Catholic Relief Services declined to comment.

The Elizabeth Glaser Pediatric AIDS Foundation in Washington, which has provided HIV treatment services in several African countries, said Thursday that agreements with USAID supporting more than 350,000 people, including nearly 10,000 children and more than 10,000 HIV-positive pregnant women, were terminated. The programs had previously received approval to resume limited work under Rubio’s waiver, the organization said.

Alight, a Minneapolis nonprofit that works with displaced people around the world, said it received termination notices for programs in Sudan, Somalia and South Sudan, which were providing emergency health care services, including for severely malnourished children and women suffering from pregnancy complications in remote areas.

The program in Sudan, which was serving about 2.1 million people displaced by the civil war in the country, had continued during the foreign aid freeze as part of the waiver, said Jocelyn Wyatt, Alight’s CEO.

“We closed 33 primary health clinics in Sudan, and 12 health facilities in Somalia and water and sanitation services across three camps in Darfur,” she said.

The organization also runs six stabilization centers for severely malnourished children in Sudan that it will keep open, hoping to raise private funding to finance them, Wyatt said.

A program providing tests and medicines for malaria for more than 1 million people in Myanmar was also terminated, according to documents seen by POLITICO. The number of malaria cases has increased by nearly 800 percent in some parts of the country over the last few years, since the conflict there began, according to one former USAID contractor who worked on the program speaking anonymously for fear of reprisals.

The United Nations HIV program, called UNAIDS, also had its U.S. funding terminated. The U.S. provided most of the organization’s funding in 2023: nearly $96 million, according to a UNAIDS document.