The chapters from the richest nation in the world once flows from the largest global aid service to a complex network of small, medium and large organisms that have provided help: HIV medication for more than 20 million people. Nutrition supplements for hungry children. Support for refugees, orphaned children and women abused by violence.
Now, this network unfolds. The Trump administration frozen external assistance for 90 days and has planned to locate the US service for international development in just 5 percent of its workforce, although a federal judge stopped the plan on Friday. Taking into account wars and temporary economies, other governments or charities are unlikely to offset the deficit and the recipient nations are overly irregular to debt to manage on their own.
Even the largest organizations are unlikely to occur without lesions. In interviews, more than 25 aid workers, former USAID employees and assistance officials described a system that was thrown into mass confusion and chaos.
A block tower can take hours to build, but “pull one of these squares out and collapses,” said Mitchell Warren, executive director of HIV Avac’s prevention organization, who was based on USAID for 38 % of his funding .
“You have been rid of all the staff, all the institutional memory, all the confidence and trust, not only in the United States but in the dozens of countries in which USAID works,” Mr Warren said. “These things have taken decades to build, but two weeks to be destroyed.”
Small organizations, some with 10 employees, have been folded. Some medium -sized organizations have reached up to 80 % of their employees. Even large organizations – including universal relief services and the FHI 360, among the largest recipient of USAID funding – have announced large redundancies or Furloughs.
In a survey, about 1 in 4 non -profit organizations said they could last one month. More than half said they had enough reserves to survive for a maximum of three months.
The damage is exacerbated by President Trump’s announcement that the United States will withdraw from the World Health Organization, forcing its leaders to announce their own cost cutting measures.
World health experts said the future suddenly seemed uncertain, even dystopian, and struggled to formulate alternatives.
“We are quite clear that the future seems different,” said Christine Semling, Deputy Chief Executive Officer of UNAIDS, the United Nations HIV department. But “None of us has a real picture of what it means.”
The damage extends not only to people’s health abroad, but also to Americans and American businesses. Along with about 100,000 seats cut abroad, about 52,000 Americans in 42 states have lost their jobs.
The global health care chain market was estimated at about $ 3 billion in 2023 and is expected to increase. Each year, about $ 2 billion in American agricultural products were purchased as food. The sharp stance is in danger of more than $ 450 million worth of corn, lenses, rice and other goods in transit or in warehouses and ports.
“Its financial impact will be amazing for human life and businesses,” said Lisa Hilmi, Core Group, a consortium of large world health professionals.
Ms Hilmi, who worked as a nurse in many conflict and disaster zones, said that the lack of health services could lead to poor health, malnutrition, epidemics, political upheavals and “a much wider collapse of society around the world”.
“If America is the largest superpower, then we have to act like this,” he said. “And part of it acts with humanity.”
‘Stunned chaos’
A week after cease help, Foreign Minister Marco Rubio issued a resignation for humanitarian aid and rescue medicines. However, interruption orders for certain programs, including food aid, followed even after the announcement of the resignation.
Last week, a large organization got the green light for some of its programs. But later on the same day, Trump’s administration put dozens of USAID officers, letting the organization wonder if the division that issued the resignation was still a viable entity and the officer who wrote the notice was still employed.
“It is another example of the stunned chaos that this administration has caused us,” said a senior employee of the organization.
The leaders of most organizations depending on USAID funding would not speak in the archive, fearing retaliation by Trump’s administration.
Even when organizations have received approvals to continue, they have no money. A large organization received less than 5 % of its expected budget for the period, but others have received nothing.
“Obviously I welcome that the secretary approved a resignation and put a place on the internet, but we cannot pay our bills with the position,” a senior official told a large organization for Mr Rubio.
Some groups feel morally obliged to continue to provide life services, hoping that they will eventually return. But with dozens of small organizations that are waving up to the day, the damage to some of the world’s most vulnerable groups is gathered, some experts warned.
The global health ecosystem is so closely intertwined that the cessation has even frozen the work of even the organizations that do not receive money from the US government.
Non -profit IPAs work with hundreds of organizations in dozens of countries to provide access to contraception, abortion and other reproductive health services. Many of the clinics have been closed, some permanently, said that Anu Kumar, the president of the organization.
The speed of the disorder did not allow the clinics to make emergency plans or reduce their dependence on funding, he said, adding: “This has a ripple phenomenon.”
After a week of freezing, more than 900,000 women and girls will have refused reproductive care, a figure that will rise to 11.7 million during a 90 -day cessation, according to the Guttmacher Institute. “This is more than the whole population of North Carolina,” Dr. Kumar said.
As a result, the Institute is estimated, 4.2 million girls and women will experience inadvertent pregnancy and 8,340 will die of complications during pregnancy and childbirth.
Many HIV programs focused on “basic populations” at higher risk, including transsexuals and men who have sexual intercourse with men who are marginalized and even criminalized in some countries.
In Uganda, for example, where a harsh law against homosexuals can bring the death penalty for consensual homosexual activity for people with HIV, non -profit groups funded by the United States were critical sources of financial and medical support.
“It’s something that every American must 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 have contributed the lives they have saved and do not celebrate it enough,” he said. Its organization had to leave 105 full -time staff members and community workers.
Childhood immune effects, malaria prevention and treatment and malnutrition programs are also determined. Programs for education, financial empowerment, preventive health services and family planning.
“This is a perfect storm for bad health results without getting around,” said Elisha Dunn-Georgiou, executive director of the World Health Organization, Health Organization.
Some organizations funded by USAID provided clean water and drainage, especially for refugee populations. Others have helped governments protect against diseases such as polio and measles in conflict zones and between nomadic groups. Others also provided expertise on the restaurants of dangerous pathogens such as Ebola and Marburg, which crumpy in Uganda and Tanzania.
Any of these threats, if not contained, could easily cross the border and land on the coast of America, said Rebecca Wolfe, who has worked on the non -profit Mercy Corps funded by USAID for 15 years and is now a specialist in development at the University of Chicago.
The world “is so interconnected and try to divide it into” America first “and the rest are no longer working in today’s age,” he said.
‘Feels like sadness’
Some USAID employees and assistance organizations said that the sudden decomposition of funding was opposed to the goal: helping countries become independent enough to take care of their citizens.
In recent years, USAID has been working for the preparation of maids, nurses, doctors, laboratories and hospitals to begin to take responsibility.
Self -sufficiency would require small non -profit organizations locally to provide services, but smaller organizations are also less likely to exceed the current storm.
“The irony is that their priority in the project 2025 is detecting and moving away from the big partners,” said Jeremiah Centrella, a former Mercy Corps general adviser. “But the big international partners are the only ones who have access to private donors and adequate balance sheets to get through it.”
It is not clear what will happen to the tens of thousands of workers who suddenly have no jobs and no industry to find one.
In Kenya, Mercy Githinji cared about 100 households in the Kayole neighborhood of Nairobi, when the clinic where it worked, run by the USAID Tumukia Mtoto project, was shut down. Now Mrs Githinji, a 52 -year -old single mother of four daughters, is not sure how she will pay rents or school fees.
The clinic provided medical care, but also helped residents with rental money, food and hygiene pillows. “Now there is no control. There is nothing,” said Ms. Githinji. “It’s very bad. People suffer. ”
Even if the aid has repeatedly repeated next week, the clinics and offices are already closed, people have moved and confidence has been broken, some former USAID employees said.
Others said they were desperately sad – not for themselves, but for the people who were committed to serving.
“The only way I managed to describe it is, it feels like sadness,” said a former USAID employee.
“Our mission is to save lives and relieve the suffering,” he said. “He does not have the opportunity to contribute to it, and to be removed a night, arbitrarily, without warning or reason, called criminal or radical noisy. It was just a deep jerk.”
Stephanie Noolen They contributed reports.
