USAID's dissolution and the human cost of US foreign aid cuts
The end of USAID, once the world's largest humanitarian donor, has been linked to deaths and rising hunger, while the US says its aid is now more targeted and efficient.
The global aid landscape has shifted sharply since the administration of US President Donald Trump dissolved the United States Agency for International Development (USAID), which had been the world's largest humanitarian donor.
USAID was established in the early 1960s by President John F. Kennedy and Congress. Beyond a stated moral obligation to help the world's most desperate populations, supporters viewed the agency as a key instrument of soft power. They argue it generated global goodwill toward the United States, helped curb the spread of diseases that could threaten Americans, and fostered stability in countries that might otherwise pose security risks. US foreign assistance typically accounted for about 1% of the federal budget.
A study published in The Lancet credited USAID programmes with preventing 91 million deaths in the first two decades of this century, including 30 million deaths of children under five. Critics, including Trump, have described the agency as wasteful and poorly managed.
The funding cuts have had severe consequences for millions of vulnerable people. Widespread hunger, shortages of lifesaving medicine, and increases in child marriage, kidnapping and child trafficking have all been documented and linked to the reductions. Experts caution that the full impact will not be measurable for years, since the effects of malnutrition and untreated disease take time to surface. The complete picture may never emerge, partly because the cuts eliminated the jobs of many frontline workers who collected mortality data.
While the US government has repeatedly maintained that no one has died as a result of USAID's dissolution, deaths linked to the funding cuts have been documented in several countries. In Nepal, cuts to programmes that provided proper nutrition and prenatal care to uneducated, impoverished pregnant women have led to more deaths among babies and pregnant women. Children in Myanmar, Nigeria and Somalia have also died after reductions to food rations and nutrition programmes.
The Gates Foundation has predicted that 2025 will be the first year this century in which child deaths increase, owing to global cuts to foreign aid.
In a statement, the US State Department said the Trump administration had reinvigorated its assistance programmes to focus on efficiency, effectiveness and partnership, adding that the US spends more on health and humanitarian assistance than any other country. "The rest of the world needs to contribute more and share the burden," the department said.
The administration's new foreign aid strategy is more limited and targets initiatives that officials say will advance US interests. In health aid, for example, the US is increasingly bypassing NGOs in favour of bilateral agreements with foreign governments. Under this model, money goes directly to governments in exchange for concessions such as access to a country's health data, which could help detect outbreaks of infectious diseases. Washington says this approach is more efficient, but some countries have pushed back, particularly over privacy concerns regarding their citizens' medical records.