January 20, President Donald Trump cast a long shadow across the day-to-day activities of the United States Agency for International Development (USAID). This administrative stop of things extended for 90 days out. This should have been decided upon, pending the kind of review—program by program—that should have been done in the first place. Just a week later, the US State Department issued a waiver. As a result of this action, we have protected funding for critical humanitarian assistance. While this is a positive step, the pause has caused widespread panic among international public health experts.
The Trump administration made matters even worse in late February, by canceling close to 10,000 contracts. This action affected several organizations previously protected under the waiver. The effect has been global and devastating, pushing back progress on health and other initiatives to build resilient communities for years.
Impact on Global Health Initiatives
Deborah Ikeh, the executive director of the Debriche Health Development Centre in Nigeria, echoed her concerns for what lies ahead. She has been especially horrified by the proposed cuts to US foreign aid. The Debriche Health Development Centre, involved in community-initiated monitoring of the government’s action on tuberculosis (TB) – Nigeria.
“What has happened has the potential to bring about massive retrogression. I’m very, very scared for the future,” said Deborah Ikeh.
Johns Hopkins University would have been hit particularly hard by these funding cancellations. In turn, they were forced to lay off workers and halt critical health initiatives. The university had been exceedingly dependent on USAID funding. It benefitted from a more than $20 million infusion in grants from the National Institutes of Health.
Broader Ramifications
During his tenure, USAID had been on the cutting edge in rolling out everything from maternal and child health initiatives to disaster relief efforts. Some of these included the President’s Emergency Plan for AIDS Relief (PEPFAR), the President’s Malaria Initiative, and various maternal and child health programs. These efforts were instrumental in addressing health outcomes in many countries.
“USAID was the implementing agency for a wide array of health and humanitarian programmes, including PEPFAR, the President’s Malaria Initiative, programmes for maternal and child health, and …” stated Chris Beyrer, director of the Global Health Institute at Duke University.
Duke University’s Global Health Institute experienced major failures due to the funding loss. This odd circumstance serves as a reminder of the often unseen but broad power and influence USAID wields.
Looking Ahead
This unexpected stop to USAID funding raises broader questions about the future of global health that have animated discussions since. Today, countless organizations are wrestling with this unexpected windfall and what it might mean for their current work being funded. While our stakeholders anxiously await more details from the program reviews being conducted by the Trump administration, the global health community can’t afford to be anything but terrified.
