The consequences of the Trump administration’s broad-based cuts to United States foreign assistance continue to grow, and the magnitude of the damage is breathtaking.
Around the world, thousands of health clinics and food programs have closed, as have safe houses for refugees and at-risk human rights defenders in authoritarian countries. Funding cuts to independent media and fact-finding groups are eroding the quality and quantity of information about human rights abuses, war crimes, corruption, and public health emergencies. Researchers and journalists investigating government wrongdoing in Myanmar, North Korea, China, and elsewhere have stopped many projects.
Authoritarian leaders are already celebrating.
In Afghanistan, cuts have resulted in the cancellation of online university classes for women and girls, their only accredited access to higher education. Groups broadcasting information into North Korea and gathering information about its government’s crimes are collapsing.
Grave macroeconomic impacts are also likely to occur soon in several countries, with attendant effects on health and livelihoods.
The impacts on public health are massive. Despite supposed waivers to allow vital lifesaving work, the President’s Emergency Plan for AIDS Relief (PEPFAR) programs countering HIV/AIDS, malaria, and tuberculous remain paused worldwide due to continued disruptions in US government staffing and payment systems. An aid official in Africa told me on February 24, “Even where waivers were granted, the payment system isn’t working. All programs remain suspended.” My Human Rights Watch colleagues have heard the same from US officials around the world.
In Bangladesh, facilities providing health care and protection for Rohingya refugees have laid off staff. In Afghanistan, hundreds of maternal health clinics, often the only locations providing health care to women and girls, remain closed. On the Myanmar-Thailand border, emergency hospitals were closed for weeks. A refugee there told my colleague that his wife, dependent on dialysis, died soon after the closures.
In Indonesia, many PEPFAR programs remain suspended and outreach staff have been dismissed. Fewer than a third of HIV positive Indonesians typically seek care due to heightened stigma, meaning outreach efforts are especially important in lowering infection and mortality rates, which can be expected to rise.
The cumulative impacts of PEPFAR shortfalls could be horrific. The Joint United Nations Programme on HIV/AIDS now projects over six million additional deaths from HIV by 2029 if cuts to PEPFAR are not reversed, and spiking deaths from malaria, tuberculous, and yet-unknown future outbreaks.
Suddenly cutting all this vital funding without consulting partners, staff, recipients, or other governments was reckless and inhumane. Other donors – and the US Congress, which voted to authorize the funding – should forcefully demand the Trump administration reverse course.
It is unlikely, however, that much funding will be restored, which places a burden on others to step up. Other governments and donors now need to reprioritize funding to better address gaps and increase funding where they can to counter the Trump administration’s staggering cruelty.
