How Trump administration’s foreign aid cuts can spark global health crisis

Donald Trump

The Trump administration's move to freeze foreign aid and disassemble the United States Agency for International Development (USAID) will unleash a humanitarian catastrophe, causing millions of preventable deaths, The New York Times has reported.

USAID's internal memos project that the reduction will result in horrific global health ramifications. As many as 18 million more cases of malaria annually would lead to an additional 166,000 deaths. 200,000 children may be paralyzed each year by polio, and hundreds of millions more could become infected. A million children with severe acute malnutrition might remain untreated, which is usually lethal. The memos also estimate more than 28,000 new cases of lethal infectious diseases like Ebola and Marburg per year.

Nicholas Enrich, the acting assistant administrator for global health at USAID, presented these estimates in memos that were obtained by The New York Times. Enrich was put on administrative leave on Sunday after issuing the reports.

Internal resistance and bureaucratic hurdles

The Enrich memos assert that the demise of USAID's programs directly stems from political meddling by the State Department's top brass, the Department of Government Efficiency (DOGE), and USAID itself. Those leaders allegedly prevented payment systems, established ineffective funding procedures, and constantly modified policies on what is considered lifesaving aid. A second memo describes how USAID's global health staff has been reduced from 783 in January to fewer than 70.

Sudden cancellation of thousands of aid programs

Although the administration had initially granted a waiver that permitted some humanitarian assistance programs to keep going, 5,800 USAID projects were suddenly cancelled last week, including many that were covered by the waiver. "It was finally clear that we were not going to be implementing under that waiver," Enrich explained. "I needed records to show what had happened."

Far-reaching effects outside health care

The effects of these cuts reach well beyond overtly medical assistance. Enrich's memo identifies other ramifications, such as uncontained outbreaks of infectious diseases like mpox and bird flu, with 105 million cases projected in the US alone. The rate of maternal deaths and child fatalities is likely to increase in 48 countries, while drug-resistant tuberculosis (TB) is forecast to grow 30% globally, causing increased numbers of patients to travel into the US for care. It takes more than $154,000 per TB patient in medical expenditures. Economic interference is also anticipated to hit American agriculture, international trade, as well as internal health care spending.

Possible constitutional and legal issues

Experts contend that the cuts are illegal under US law, as Congress has constitutional power over foreign aid expenditures, not the president. Matthew Kavanagh, director of the Georgetown University Center for Global Health Policy and Politics, said that dismantling USAID and ending its programs not only puts millions of marginalized individuals around the world at risk of death but also provokes a constitutional crisis in the name of cruelty.

The uncertain future of US humanitarian assistance

The move by the Trump administration to undermine foreign aid sent shockwaves in the international community. Global health authorities, development organisations, and politicians are currently clamouring to overturn the cut in a bid to avoid continued loss of lives. With millions being threatened and the courts fighting it out in the courts of law, the future of America's foreign aid is uncertain. Whether the White House will walk back its plans—or double down—remains uncertain.