Critical supplies of life-saving medicines have been blocked and children left without food and battling malnutrition as multiple effects were reported across the globe after Elon Musk resolved to shut down the US government’s pre-eminent international aid agency.
Chaotic scenes were seen in scores of countries as aid organisations warned of the risk of escalating disease and famine along with disastrous repercussions in areas such as family planning and girls’ education, after President Donald Trump’s decision to freeze funding to USAid. In 2023, the agency managed more than $40bn (£32bn).
Countless aid organisations have already been forced to close down or lay off staff.
Analysis confirms that several thousand women and girls are likely to die from complications during pregnancy and childbirth as a direct result of Trump’s order to freeze aid to the agency for 90 days.
Trump has tasked the billionaire Musk – who has falsely accused USAid of being a “criminal” organisation – with scaling down the US government’s lead agency for humanitarian assistance.
The impact on the global aid sector has been profound and immediate. US foreign aid accounts for four out of every $10 spent globally on humanitarian aid.
One former senior USAid official described Musk’s crackdown as an “extinction-level event” for the international humanitarian sector.
The initial repercussions include the abandonment in warehouses of supplies of crucial drugs in Sudan, the site of what is currently the world’s worst humanitarian crisis, as well as in the Democratic Republic of the Congo (DRC), where recent fighting in the east has further destabilised the fragile region.
Across Africa, hundreds of thousands of children who rely on school meals have been left without sustenance after food was left to rot in the wake of Musk’s declaration that he wanted the US aid agency to “die”.
“Partners on the ground [are saying] that in DRC and Sudan, medical supplies are stuck in warehouses,” said a spokesperson for a leading international aid organisation.
Like many aid workers the Guardian interviewed, the spokesperson requested anonymity, amid claims that officials from the Trump administration have put pressure on those in the humanitarian sector not to speak out. Many were also reluctant to talk on the record over fears of future funding,
Among the projects already forced to close is a girls’ education project in Nepal, raising the risk of a rise in child marriage and trafficking.
“All payments are frozen for these projects. There’s a lot of misinformation. Organisations are having to make decisions in a vacuum,” said one humanitarian official.
In Bangladesh, the International Centre for Diarrhoeal Disease Research, which coordinates pioneering research into one of the most prolific killers of children, has laid off some of the world’s most respected scientists working on malaria programmes.
In Africa, malaria-control programmes in Uganda have been forced to adopt equally draconian measures with reports that dozens of vital projects for frontline care have been closed.
Farther south in Malawi, where many rely on donor-funded programmes for survival, fears are mounting that the aid freeze could redraw the country’s entire economy.
Within farming communities – the backbone of Malawi’s economy – Mike Dansa, chair of the Nsanje Civil Society Organisation, warned it could upend agricultural aid programmes that support smallholders with improved seeds, irrigation and climate-resilience projects, threatening food security in a country reeling from extreme weather events.
In Johannesburg, projects that have relied for more than 20 years on funding from the US HIV/Aids response programme, known as Pepfar, have had to lock their doors.
Dawie Nel, director of a Johannesburg LGBTQ+ clinic called Out, said his organisation, which looks after 6,000 clients, had suspended its treatment. “The US is a totally unreliable partner,” he said.
Across the Atlantic, similar scenes of chaos were playing out. In Colombia, which has been plagued by six decades of internal conflict and drug-related violence, large numbers of organisations rely on USAid funding.
Programmes providing emergency relief to families fleeing violence between armed groups and encouraging farmers to swap coca – the base ingredient of cocaine – for legal alternatives have ceased operating.
Colombia’s former president and Nobel peace prize laureate, Juan Manuel Santos, told the Guardian: “I have seen the massive benefit these programmes funded by USAid have generated for people across the country. To cut it, suddenly, is going to have a terrible humanitarian effect.”
Elsewhere, the director of a major international aid organisation in Colombia – who also requested anonymity – feared the impact on those who most needed help. “The people who this is going to affect the most are those already without a safety net. Precisely those who are least able to find another source of food, shelter or income,” they said.
However, some have argued that the disruption has exposed the fragility of development programmes that are reliant on external aid.
The former Kenyan president Uhuru Kenyatta urged African countries to view the aid freeze as a “wake-up call” for the continent to prioritise its own development.
“Nobody is going to continue holding out a hand to give you. It is time for us to use our resources for the right things,” he said.
Most, though, are adamant that the intention of Trump and Musk – who heads an unofficial cost-cutting agency – to close USAid is disastrous.
“Without naming countries or areas, we have had to close life-saving services, for children with acute malnutrition, and also testing and treatment sites for health facilities, nutrition facilities and wash facilities,” said one aid worker.
Jeremy Konyndyk, president of Refugees International and a former official at USAid, described Musk’s wish to close the agency as posing an existential threat to the humanitarian sector.
“If this goes forward, it really is an extinction-level event for the global aid sector in the US and for much of the global relief and development sector around the world.”
Konyndyk added that it would also “destabilise” budgets of many large aid and United Nations organisations around the world. “It threatens really the collapse not just of what USAid does, but of this huge ecosystem of relief and development organisations that are doing good around the world every day,” he said.
Research from the Guttmacher Institute underlined such warnings, revealing that 11.7 million women and girls will be denied access to contraceptive care over the course of the 90-day aid freeze, which they predict means 8,340 women and girls would die from complications during pregnancy and childbirth.
Elsewhere, concern over the fate of the humanitarian sector was laid bare in a survey of 342 international development organisations, which concluded that without US funding, more than half were likely to close before May.
Attempts by the US government to soften the impact of its freeze by unveiling a waiver for projects offering “life-saving assistance” appears to have done little except prompt further confusion.
“Is Plumpy’Nut [a paste used to feed severely malnourished children] life-saving? Is a vaccine life-saving? What is a life-saving part of a project? What qualifies under the waiver?” an aid worker asked.
A “global aid freeze” tracker has been set up to look at the collective impact of the orders, inviting civil society organisations to input data.
