From Haiti to Sudan, from Syria to Ukraine, emails pleading for support and donations started pouring in after United States President Donald Trump stopped the operations of the United States Agency for International Development, or USAID.
Trump’s executive order on Jan. 20 has halted for 90 days the provision of foreign aid that is not “aligned with American interests.” The decree is now dangerously hurting humanitarian assistance across the globe. The cuts affect not only funding for a range of nongovernmental programs but also for various crucial United Nations operations.
In 2024 alone, the USAID and other US foreign assistance organizations spent roughly $40 billion in total aid to emergency and other similar assistance programs, according to the latest State Department data. The amount was less than 1 percent of US gross national income.
The White House contends that the ban on “lifesaving” aid has been lifted since the Jan. 20 edict but many organizations say this is not the case as confusion reigns. Limited exemptions have reportedly been granted for those with the resources to mobilize, lobby and apply for a waiver. Aid groups who do not provide essential care must wait for the mandatory 90-day “re-evaluation and realignment” review.
USAID was set to distribute $54.8 billion in Congressionally approved international assistance in 2025. A US district court has just ordered the Trump administration to restore aid it has frozen, saying the White House failed to comply with an earlier ruling.
Women and child recipients in war zones — such as in the eastern Democratic Republic of the Congo and parts of Sudan — are especially hard hit amid the aid pause. The same goes for people in 25 of the world’s poorest countries who depend on American funding for maternal health care and child vaccination programs, among other vital services.
One such organization, the Panzi Hospital in eastern Congo, is affected by Trump’s edict. In 2024, the US funded 70 percent of UN humanitarian response efforts in the Congo, or $910 million. Among the local civil society groups who depend on foreign donations is the Panzi Hospital in Bukavu, the capital of South Kivu Province. The Panzi Foundation, which runs the hospital, counts among its supporters Unicef and the UN Refugee Agency, both of which have historically been major direct recipients of US largess.
Founded by the Nobel Peace Prize laureate Dr. Denis Mukwege, the hospital treats women and girls who have been sexually abused during the numerous on-and-off wars that have wracked eastern Congo. The hospital also offers affiliated services, such as psychological support, to rape survivors and their children.
After the Rwanda-backed rebel alliance M23 recently seized Goma, the capital of North Kivu Province, it has been heading to Bukavu, a UN official confirmed on Feb. 11. The militia’s takeover of Goma has displaced more than 400,000 people in the last few weeks alone. They face overcrowded camps, sexual violence, food shortages and disease outbreaks, among other major deprivations. [Update: The city of Bukavu was seized by M23 on Feb. 16]
Trump’s stop-work order affected if not ended UN emergency services in Goma, including health and shelter provisions; food aid was exempted from the start. Bruno Lemarquis, UN humanitarian coordinator in the Congo, said this week that some US resume-work orders are being issued.
Since the Dec. 3 onslaught by the rebels in Goma, Panzi Hospital has received a massive influx of patients. Dr. Mukwege is a longtime witness to crimes committed by the M23 and other armed forces in the region and is reportedly a target of the rebels, according to Robert Njangala, a spokesperson for the hospital.
In an email to PassBlue from South Kivu, Njangala said that the hospital had not been secured since the departure of the UN peacekeeping force from the province. Known as its French initials, Monusco withdrew last year from the area after the Congolese government demanded it do so. (Monusco remains in Goma and elsewhere in the country.)
“The Panzi Hospital being a structure that treats women raped by rebels and considering the fact that it keeps the constituent elements of the evidence of their abuses, there is a great threat,” Njangala said.
The hospital does not receive direct funds from USAID, but Njangala said it had earlier submitted a plan for a project to take in more women rape survivors during the current outbreak of fighting in Goma between the M23 and Congolese forces. On Jan. 29, the hospital sent a letter to all its global supporters, asking for donations.
Right now, Panzi Hospital remains open but without financial help. It’s uncertain how long it can continue to offer care to patients as the region looks likely to fall to M23 soon. Lemarquis said that the regional summit meeting during last weekend to mitigate eastern Congo’s crisis — including calling for an immediate ceasefire — has had little effect.
Joyce Msuya, an assistant secretary-general in the UN Office for the Coordination of Humanitarian Affairs (OCHA), described to the Security Council in late January how gender-based violence had increased 300 percent in recent years in Congo. Two-thirds of all cases had occurred in the three eastern provinces of North Kivu, South Kivu and Ituri.
Last year, UN-coordinated appeals received $14 billion from the US, making it the biggest contributor to the international humanitarian system, dwarfing the next two-biggest donors to OCHA, Germany and the European Union, at $2.67 billion and $2.66 billion, respectively. The aid money funded part of OCHA’s programs on child protection and gender-based violence worth $665 million and $412 million, respectively.
Elsewhere in Africa, children and women are among the hundreds of thousands of Sudanese refugees who have fled the civil war there and sheltering along the country’s border, inside Chad. Last year, the US paid almost two-thirds of the funding to Sudan’s Emergency Response Rooms (ERR), innovative programs that run food kitchens and offer medical care to communities.
ProPublica has reported that staffers at a half-dozen US-funded medical facilities in Sudan that treat severely malnourished children and babies had defied Trump’s orders to stop their work, saying, “it is a matter of days, not weeks, before we run out of funds, even previously approved ones, to cover salaries, IV bags and other supplies.”
Avaaz, an American nonprofit activists network, reported that 30 to 40 percent of children in refugee camps and communities in Sudan are suffering from severe chronic malnutrition, based on data from the World Food Program (WFP). In 2024, US aid contributed to more than half of the funding for WFP; the agency is run by an American, Cindy McCain.
The Emergency Response Room operating in Khartoum State, home of Sudan’s capital, runs a Women’s Response Room in Juref West and receives 70 percent of its funding from USAID. It offers relocation help for people who have fled fighting zones as well as medical care.
A member of the team told Avaaz activists on the ground that some of their “ERRs lack official registration, making them ineligible for support from other organizations.”
“USAID understood our need for immediate response capability and permitted a flexible fund distribution system,” she added. “Even in the best-case scenario, where they resume funding [for] emergency operations after this [90 day] period, we weren’t given sufficient notice to secure alternative funding for the interim. Additionally, we’ll lose the flexible funding system we had with USAID.”
Meanwhile, in Afghanistan, human rights advocates and aid workers fear that the cancellation of US-funded education programs for girls from primary school up to university, including the American University of Afghanistan, will enable the Taliban to further erase women from public life and their right to education.
Since 2021, girls in Afghanistan have been banned by the Taliban authorities from school beyond the sixth grade. Until now, US aid had helped run projects like classes through the radio and operated schools under the radar to educate over 5,000 girls across the country, according to one aid worker familiar with the project.
“The United Nations leadership and its member countries need a backup plan to ensure lifesaving UN humanitarian aid and human rights work continue,” Louis Charbonneau, the UN advocate for Human Rights Watch, wrote in a statement on Feb. 10. “This is necessary because the UN’s top financial contributor — the United States — cannot be trusted to honor its commitments.”
The UN leadership, he added, “should condemn US brinkmanship and engage other member states to see who can provide cash for lifesaving UN programs.” So far, Secretary-General António Guterres has not issued such a rebuke.
This article was updated to better reflect the funding for OCHA.
We welcome your comments on this article. What are your thoughts on US aid cuts that save women's lives?
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Ilgin Yorulmaz has reported from Turkey, India, Nepal, Philippines, China and Japan for BBC World Service, Huffington Post, Vice, The Guardian, PassBlue, Vogue, Condé Nast Traveller UK, Voices and Maison Française. She has an M.S. from the Columbia University Graduate School of Journalism. In addition, she has an M.A. in international relations and economics from the International University of Japan in Niigata and a B.A. in business administration from Bogazici University in Istanbul. Yorulmaz speaks Turkish, Japanese, French and English.
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It is unfortunate that this USAID needed to be cut from going into these poorer countries around the world. And that these countries need to find an alternative for financial survival for their operations. If they can’t rely on the richer countries to support them, epecially for the needs of women and children, perhaps we can change where the funding may be able to come from. I believe that many of the richer countries already have mechanisms in place, such as funding coming from international organizations that are nonprofits that may have the necessary funding to offer needed services for this population. One organization that comes to mind is Planned Parenthood. What are their outreach programs that can be utilized in these poorer countries? What are they doing for women and children? Just a few examples of nonprofit organizations. Alright, we can not rely on USAID anymore. And every richer country has these types of nonprofit organizations that can be looked at to assist in the area of support to women and children in the poorer countries. Also, another program that may work are hospitals that can sponsor another hospital in a poorer country. These private hospitals throughout the world can do this. They can get together and start a new funding program that can be utilized for poorer hospitals to be able to provide the needed services for women and children in these war-torn areas across the globe. How about the American Red Cross or in some other countries it is called the Red Crescent organizations. Perhaps the UN may need to outreach further than what it is doing now. Or perhaps a new organization can be started that focuses on only women and children in these poorer countries to replace the USAID. Another thought may be that each UN member state and country add a line item in their budgets that goes into a separate UN account that supports the needs of women and children in these war-torn areas. It is a simple financial change that must be available to audit at anytime. Let’s try some of these ideas. Why not?
These are all great funding ideas worth pursuing! I think they need to be heard at the governmental and the international levels. You don’t mention which country you are from but your country’s UN mission might be a good place to kickstart such an initiative. Thank you for your valuable contribution to the discussion.
Thanks for this informative article on this dramatic and unjustifiable decision. One comment on your statistics. You state that the US asssistance “dwarfs” the next two donors, the EU and Germany. Looking at the OECD DAC statistics, the most trusted official record of ODA, the assistance of the US in 2023 (last year recorded) was $ 65 billion. The assistance of Germany was $ 38 billion, the EU gave $ 27 billion, France $ 15 billion and the Netherlands $ 7 billion. In terms of % of GNI, the figures are US 0.24%, Germany 0.82%, France 0.48% and the Netherlands 0.66%. All in all a somewhat different picture.
Thank you for your valuable comment.
The story mainly focuses on the UN-initiated life-saving emergency and humanitarian efforts like those by OCHA rather than the ODA or other longer term assistance and soft loans by entities like the OECD. As such, and based on your your important feedback, we clarified that the stats we used specifically shows the US as the biggest contributor to OCHA and dwarfing the next two donors, Germany and the EU, as shown in the OCHA link.