The funds of the richest nation in the world once flowed from the largest global aid agency to a complex network of small, medium and large organizations that provided aid: drugs for HIV for over 20 million people; Nutritional supplements for hungry children; Support for refugees, orphaned children and women affected by violence.
Now, that network is revealing. The Trump administration has frozen foreign aid for 90 days and planned to sell off the US agency for international development just 5 percent of its workforce, although a federal judge paused the plan on Friday. Given the wars and the financial economies, it is unlikely that other governments or philanthropies are compensated for deficiency and the nations intended are too hindered by the debt to manage on their own.
The largest organizations is also unlikely that unknown emerge. In interviews, over 25 aid assistants, former Usaid employees and officials of aid organizations have described a system thrown into mass confusion and chaos.
A tower of blocks can take hours to build, but “pull out one of those blocks and collapses,” said Mitchell Warren, executive director of the HIV Avac prevention organization, which was based on USAID for 38 percent of his own loans.
“You got rid of all the staff, all institutional memory, all trust and trust, not only in the United States but in the dozens of countries where Usaid works,” said Warren. “These things took decades to accumulate, but two weeks to destroy.”
Small organizations, some with only 10 employees, folded. Some medium -sized organizations have unleashed up to 80 % of their employees. Even the great organizations – including Catholic Relief Services and FHI 360, among the major recipients of the USAID funding – have announced great layoffs or Furlough.
In a survey, about 1 out of 4 non -profit said he could last a month; More than half said he had enough reserves to survive for three months.
The damage is aggravated by the announcement of President Trump that the United States would retire from the World Health Organization, forcing its leaders to announce its measures to reduce costs.
Global health experts said that the future suddenly seemed uncertain, even dystopian and fought to articulate the alternatives.
“We are quite clear that the future seems different,” said Christine Stegling, executive deputy director of Unids, the United Nations HIV division. But “none of us still has a true image of what it means”.
The damage extends not only to the health of people abroad but to Americans and American companies. Together with the approximately 100,000 positions cut abroad, about 52,000 Americans in 42 states have lost their jobs.
The global market of the health supply chain has been evaluated at almost $ 3 billion in 2023 and is expected to grow. Every year, about $ 2 billion in American agricultural products have been purchased as food aid. Brusca Halt risks over 450 million dollars of corn, lentils, rice and other raw materials that are in transit or in warehouses and ports.
“The economic impact of this will be surprising for people’s life and businesses,” said Lisa Hilmi, executive director of the main group, a consortium of great global health practitioners.
Mrs. Hilmi, who worked as a nurse in many areas of conflict and disasters, said that the lack of health services could guide bad health, malnutrition, epidemics, civil disorders and “a much wider collapse in society in the whole world “.
“If America is the greatest superpower, then we have to behave like this,” he said. “And part of this is acting with humanity.”
‘Dizzying chaos’
A week after the help was paused, the secretary of state Marco Rubio issued a renunciation for humanitarian assistance and humanitarian drugs. But the stop-works orders for some programs, including food assistance, followed even after the announcement of the renunciation.
Last week, a great organization obtained the green light for some of its programs. But later that same day the Trump administration put on leave of the USAID officers, leaving the organization asking for whether the division that issued the renunciation was still a practicable entity and the officer who wrote the notice was still employee.
“It is another example of the dizzying chaos that this administration has inflicted on us,” said a high official of the organization.
The leaders of most of the organizations that depend on the USAID funding would not speak on the record, fearing retaliation from the Trump administration.
Even when the organizations received approvals to continue, no money was flowed. A large organization received less than 5 percent of the budget scheduled for the period, but others have not received anything.
“Obviously it welcomes that the secretary approved a renunciation and put a post on the internet, but we cannot pay our bills with the place,” said a high official of a large organization of Mr. Rubio.
Some groups feel morally obliged to continue to provide rescue services, hoping that they are in the end to be reimbursed. But with dozens of small organizations that goes off day by day, the damage to some of the most vulnerable groups in the world has matured, some experts have warned.
The global health ecosystem is so closely intertwined that the break has frozen the work of organizations that do not receive money from the United States government.
The IPA non profit works with hundreds of dozen organizations of countries to provide access to contraception, abortion and other reproductive health services. Many clinics have closed others permanently, said Anu Kumar, president of the organization.
The speed of the interruption did not allow the clinics the time to make emergency plans or to rake their dependence on the financing, added, adding: “This certainly has a chain effect”.
After a week of freezing, over 900,000 women and girls will have been denied reproductive care, a figure that will grow to 11.7 million during the 90 -day break, according to the Guttmacher Institute. “It is more than the entire population of the North Carolina,” said Dr. Kumar.
Consequently, the institute has estimated, 4.2 million girls and women will experience unintentional pregnancies and 8,340 will die from complications during pregnancy and childbirth.
Many HIV programs have focused on “key populations” at higher risk, including transgender people and men who have sex with men, who are marginalized and even criminalized in some countries.
In Uganda, for example, in which a hard anti-gay law can bring the death penalty for consensual homosexual activities for people with HIV, non-profit groups financed by the United States have been crucial sources of financial and medical support.
“It’s something that every American should be proud, but I don’t think they know it,” said Kenneth Mwehonge, executive director of the Coalition for Health Promotion and Social Development, which monitors the quality of other HIV programs in Uganda.
“I don’t think they know how much they contributed and the lives they saved, and they don’t celebrate it enough,” he said. His organization had to let 105 full -time staff and the community workers have to go.
Child immunizations, malaria prevention and care and malnutrition are also blocked. So they are programs on education, economic empowerment, preventive health services and family planning.
“This is a perfect storm for poor health results, not to circumvent it,” said Elisha Dunn-Georgiou, executive director of the Global Health Council, an organization of belonging to the health groups.
Some organizations financed by the USAID have provided clean water and toilet-sanitary services, in particular for refugee populations. Others have helped governments to protect from diseases such as polio and measles in conflict areas and between nomadic groups. Still others have provided experience in containing outbreaks of dangerous pathogens such as Ebola and Marburg, who are steaming in Uganda and Tanzania.
One of these threats, if not contained, could easily cross the boundaries and land on the American coasts, said Rebecca Wolfe, who has worked at the Mercy Corps No Profit funded by the USAID for 15 years and is now a development expert at the University of Chicago.
The world “is so interconnected and try to divide it into” America First “and the rest no longer works in today’s age,” he said.
‘It seems a pain’
Some Usaid employees and help organizations have said that the sudden disconnection of funding was antithetical to the objective: helping countries become independent enough to take care of their citizens.
In recent years, Usaid has worked on a formation of obstetricians, nurses, doctors, workshops and hospitals to start transferring responsibility.
Self -sufficiency would require small non -profit organizations locally to provide services, but smaller organizations are also less likely to resist the current storm.
“The irony is that their priority in the 2025 project is locating and moving away from the great partners,” said Jeremiah Centrella, former General Consultant of Mercy Corps. “But the great international partners are the only ones with access to private donors and quite strong budgets to overcome this.”
It is not clear what will happen to the tens of thousands of workers who suddenly have no work and industry in which to find one.
In Kenya, Mercy Githinji took care of 100 families in the Kayole district of Nairobi when the clinic where she worked, managed by the Usaid Tumukia Mtoto project, abruptly closed. Now Mrs. Githinji, a single mother of four 52 -year -old daughters, is not sure how the rent or school taxes will pay.
The clinic provided medical care, but also helped residents with money for rent, food and health. “There is no control now, there is nothing,” said Mrs. Githinji. “It’s very bad. People suffer. “
Even if the help had to resume next week, clinics and offices have already closed, the people have moved and the trust has been broken, some former Usaid employees said.
Others said they were desperately saddened, not for themselves, but for the people who had committed themselves to serving.
“The only way I was able to describe it is, it seems a pain,” said a former Usaid employee.
“Our mission is to save human lives and relieve suffering,” he said. “Do not have the opportunity to contribute to this, and to be taken away from today, arbitrarily, without notice or reason, being called a crazy criminal or radical, was deeply heartbreaking.”
Stephanie Nolen Contributed relationships.