By Yonette Joseph, Malika Khurana and Adam Pasick
President Donald Trump’s executive order freezing most U.S. foreign aid for 90 days has thrown into turmoil programs that fight starvation and deadly diseases, run clinical trials and seek to provide shelter for millions of displaced people across the globe.
The U.S. Agency for International Development, or USAID, is the main government organization that provides humanitarian aid, such as food, medical assistance and disaster relief. It has been hit the hardest by the freeze.
Trump has accused the agency of rampant corruption and fraud, without providing evidence. Billionaire Elon Musk, who has been given the task of cutting federal budgets and programs, boasted online of “feeding USAID into the wood chipper.”
The Trump administration ordered thousands of the agency’s workers to return to the United States from overseas, put them on on indefinite administrative leave and shifted oversight of the agency to the State Department.
On Thursday, the administration also announced plans to gut the agency’s staff, reducing USAID’s workforce of more than 10,000 to perhaps a few hundred. On Friday, a judge temporarily blocked elements of the Trump administration’s plan to shut down the agency, though the aid freeze remains in effect.
Critics say Trump’s executive order will cause a humanitarian catastrophe and undermine America’s influence, reliability and global standing.
How much foreign aid does the U.S. provide?
In total, the United States spent nearly $72 billion on foreign assistance in 2023, which includes spending by USAID, the State Department and programs managed by agencies like the Peace Corps.
As a percentage of its economic output, the United States — which has the world’s largest economy — gives much less in foreign aid than other developed countries.
USAID spent about $38 billion on health services, disaster relief, anti-poverty efforts and other programs in fiscal year 2023 — about 0.7% of the federal budget. In 2021, before the war in Ukraine, it accounted for 0.4%.
Who are the recipients?
Trump’s freeze on U.S. foreign aid does not apply to weapons support for countries like Israel and Egypt. Emergency food assistance is supposed to be exempt, but many such programs have suffered because of disruptions to the government’s payment systems.
In 2023, the last year for which full data is available, Ukraine, which has been waging a war against Russia since Moscow’s full-scale invasion in February 2022, received $16.6 billion, the most U.S. assistance of any country or region. The bulk of that went to economic development, followed by humanitarian aid and security.
Israel — which was attacked by Hamas-led militants on Oct. 7, 2023, setting off a 16-month war in the Gaza Strip — received the second-highest amount of U.S. assistance: $3.3 billion in 2023, mainly for security.
How is the money spent?
U.S. foreign aid can be structured as direct financial assistance to countries through nongovernmental organizations; military support; food and medical aid; or technical expertise.
Foreign aid can be a form of soft power, serving a country’s strategic interests, strengthening allies and helping to prevent conflicts.
In the case of USAID, money has gone toward humanitarian aid, development assistance and direct budget support in Ukraine; peace-building in Somalia; disease surveillance in Cambodia; vaccination programs in Nigeria; HIV prevention in Uganda; and maternal health assistance in Zambia. The agency has also helped to contain major outbreaks of Ebola and funded conservation and environmental programs.
Contrary to a claim by Trump, U.S. money has not been used to send condoms to Gaza for use by Hamas, health officials say. In a statement late last month, the International Medical Corps said that it had received more than $68 million from USAID since October 2023 for its work in the enclave but that “no U.S. government funding was used to procure or distribute condoms.”
Instead, the group said, the money was used to operate two field hospitals, treat and diagnose malnutrition, deliver more than 5,000 babies and perform 11,000 surgeries.
Why was the freeze ordered?
For years, conservative critics have questioned the value of U.S. foreign aid programs.
“Every dollar we spend, every program we fund and every policy we pursue must be justified with the answer to three simple questions,” Secretary of State Marco Rubio said in a recent statement. “Does it make America safer? Does it make America stronger? Does it make America more prosperous?”
The Trump administration and allies in Congress argue that the halt to foreign aid is necessary to investigate any waste. Many of their claims are misleading or have lacked context.
Rubio, who previously spoke out in support of the agency, blamed its employees for “deciding that they’re somehow a global charity separate from the national interest.”
He has insisted, however, that the takeover was “not about getting rid of foreign aid.” He said during a recent Fox News interview, “We have rank insubordination” in the agency, adding that USAID employees had been “completely uncooperative.”
As organizations across the globe reeled, the Trump administration switched gears. Rubio announced that “lifesaving humanitarian assistance” could continue but that the reprieve would be “temporary.”
But by then, hundreds of senior officials and workers who help distribute U.S. aid had been fired or put on leave, and many aid efforts remain paralyzed.
What have been the effects of the aid freeze?
The immediate disruptions caused by Trump’s foreign aid freeze have rippled across health care, security and humanitarian programs worldwide. The long-term consequences could reshape global health, research and political stability in many countries.
Health: Many global clinical trials rely on USAID funding. The abrupt stop-work order has left thousands of people in vulnerable medical conditions without care, and with no system in place to monitor for adverse effects.
Doctors now face a legal and ethical dilemma: Comply with the Trump freeze or risk harm to patients.
— In South Africa, researchers were forced to shut down an HIV prevention trial, leaving women with experimental implants inside their bodies and without ongoing medical oversight.
— A malaria vaccine study in Britain has stranded volunteers who had received doses but now lack medical follow-ups for potential complications.
— In Uganda, children enrolled in a tuberculosis treatment trial were cut off from potentially lifesaving medication.
— In Bangladesh, a cholera treatment trial has been abandoned, leaving patients with no plan for next steps.
The damage is compounded by Trump’s announcement that the United States would withdraw from the World Health Organization, which then announced its own cost-cutting measures.
What was the reaction to the Trump order?
Democratic lawmakers said the moves to dismantle USAID or merge it with the State Department were illegal.
Two unions representing USAID employees on Thursday filed a lawsuit arguing that the reduction in personnel and the cancellation of global aid contracts were unconstitutional and violated the separation of powers. It argued that USAID cannot be unwound without the approval of Congress.
On Friday afternoon, Judge Carl Nichols of U.S. District Court for the District of Columbia issued a temporary restraining order pausing the administrative leave of 2,200 USAID employees and a plan to withdraw nearly all the agency’s overseas workers within 30 days.
The agency has funded election-monitoring groups, anti-corruption watchdogs and independent news outlets — exactly the kind of oversight that authoritarian leaders detest. Leaders in Russia, Hungary and El Salvador welcomed the Trump administration’s assault on USAID.
Nayib Bukele, president of El Salvador, who has embraced strongman tactics to crack down on gang violence, said in a post on the social platform X that the agency’s funds had been “funneled into opposition groups, NGOs with political agendas and destabilizing movements.”
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