The Trump administration’s decision to close the U.S. Agency for International Development (USAID) has drawn widespread criticism from congressional Democrats and raised questions and concern about the influence billionaire ally Elon Musk wields over the federal government.
The United States is by far the world’s largest source of foreign assistance, although several European countries allocate a much bigger share of their budgets to such aid. USAID funds programs in some 120 countries with projects aimed at fighting epidemics, educating children, providing clean water, and supporting other areas of development.
The stop-work order has upended many of those projects, and has seen nurses laid off and clinics closed in more than 25 countries where two-thirds of all child deaths occur globally, said Janeen Madan Keller, policy fellow and deputy director of global health policy at the Center for Global Development.
Here is a look at USAID’s impact around the world.
Disease response, girls’ education, and free school lunches in Africa
Last year, the U.S. gave the sub-Saharan region more than $6.5 billion in humanitarian assistance, but since Trump’s announcement, HIV patients in Africa found locked doors at clinics funded by a U.S. program that helped rein in the global AIDS epidemic.
The President’s Emergency Plan for AIDS Relief (PEPFAR), known as one of the world’s most successful foreign aid programs, has been credited with saving more than 25 million lives, largely in Africa.
“The world is baffled,” said Aaron Motsoaledi, health minister of South Africa, the country with the largest number of people living with HIV, after the U.S. freeze on aid.
Motsoaledi said the U.S. funds nearly 20% of the $2.3 billion needed each year to run South Africa’s HIV/AIDS program through PEPFAR, and now the biggest response to a single disease in history is under threat.
Halting U.S. aid also could have a dire impact on the humanitarian situation in eastern Congo, where American aid funds access to food, water, electricity, and basic health care for 4.6 million people displaced by years of conflict. European nations are discussing increasing aid, but a European diplomat told the AP that will not make up for the loss of the U.S., the country’s largest donor.
In Ghana, the Chemonics International development group said it’s pulling logistics for programs in maternal and child health, malaria response, and HIV.
Education programs have been halted in Mali, a conflict-battered West African nation where USAID has become the country’s main humanitarian partner after others left after a 2021 coup.
In civil-war-torn Sudan, which is grappling with cholera, malaria, and measles, the aid freeze means 600,000 people will be at risk of catching and spreading those diseases, said an official who spoke on condition of anonymity because they were not authorized to speak publicly about the matter.
Countering Russian influence
USAID supports governance and media projects in countries where Russia exerts a large influence, such as Georgia and Armenia. Last year, it sharply increased support for programs in Armenia as the government of Prime Minister Nikol Pashinyan sought to reduce links with Russia and strengthen ties with the United States and the European Union. The aid freeze means several independent broadcasters have been forced to cut some of their programs.
Boris Navasardian, president of the Yerevan Press Club, said independent media “could face a forced choice: End their existence or seek sponsorship from political parties or big business.”
Hospitals in war-ravaged Syria
Doctors of the World Turkey said it has been forced to lay off 300 staff and shutter 12 field hospitals it runs across northern Syria, a region devastated by years of war and a huge 2023 earthquake. Hakan Bilgin, president, said the organization relies on USAID for 60% of its funding and has had to cut its daily consultations from 5,000 to 500.
“As a medical organization providing life-saving services, you’re basically [being told], ‘Close all the clinics; stop all your doctors; and you’re not providing services to women, children, and the elderly,” Bilgin said.
Bilgin said the impact on northern Syria, where millions rely on outside medical aid, could be catastrophic. “The real impact is bigger than we can measure right now,” he said in the group’s Istanbul office, surrounded by half-unpacked boxes and worried colleagues.
Support for marginalized communities from the Balkans to Uganda
In Kosovo, which has received more than $1 billion from USAID since 1999, women’s groups fear the impact of losing American funding for gender- and diversity-related projects in the conservative country.
“This might leave women’s groups stranded and unsupported,” said Ariana Qosaj Mustafa of the Kosovo Women’s Network.
Emina Bosnjak of the Sarajevo Open Center said USAID promotes awareness of discrimination, violence, and hate speech, and marginalized groups would suffer if that stops. “Stronger narratives that stand against human rights and stand against democracy and rule of law will actually become more visible,” she said.
A nonprofit organization supporting LGBTQ people in Uganda also feels under threat. Pius Kennedy, a program officer with the Kampala-based nonprofit Africa Queer Network, said he and five other permanent employees had been ordered by USAID to stop work. He said the funding freeze could erase years of gains made in protecting sexual minorities in Uganda, one of more than 30 African countries where homosexuality is criminalized.
“We would always look at the United States as something that we would always run to in case you are facing a number of insecurities in the country,” Kennedy said — but that may no longer be the case.