Myanmar
The 7.7 magnitude earthquake that struck the war-torn country at the end of March was the first large-scale natural disaster to occur since the Trump administration’s cuts to USAID. More than 3,300 people were killed, nearly 5,000 injured, and tens of thousands of homes were damaged, with some neighbourhoods reduced to ashes.
Myanmar has been one of the leading recipients of US foreign assistance in south-east Asia for more than a decade, and that money and support has only become more vital since the outbreak of civil war in 2021. Nearly 20 million people, roughly a third of the population, were already in need of humanitarian assistance and protection before the earthquake.
The US has pledged just $9m in aid. For comparison, in 2023 when a 7.8 magnitude earthquake hit Turkey and Syria, the US pledged $185m. But it is not merely a question of funding. In 2023, it deployed hundreds of relief workers. In Myanmar, there are few staff present on the ground, and it is not clear whether any of the money will get to where it needs to be. In fact, earlier this month, the government fired three aid workers who had been sent to Myanmar to assess how the US could contribute to relief efforts, just days after they arrived in the devastated city. Without assistance and funding, rescue workers have struggled to recover bodies from collapsed buildings and debris.
The US appears to have doubled down on this minimalist approach, with secretary of state Marco Rubio stating that Washington is “not the government of the world”. As many predicted, other actors have stepped in, just as Rubio suggested they should. China, Russia, India and the UK – albeit even as it reduces its own international aid budget – have moved to fill the conspicuous void left by the US, a development that will almost certainly have consequences for America’s international standing.
Afghanistan
Earlier in April, the US terminated funding for World Food Programme (WFP) emergency operations in more than a dozen countries, a decision widely condemned for endangering the lives of millions. Within days, the state department reversed the decision for several countries, but upheld the cuts in Afghanistan and Yemen. The government stated that the reductions were based on “credible and longstanding concerns that funding was benefiting terrorist groups including the Houthis and the Taliban”.
Approximately 23 million people in Afghanistan, one of the poorest countries in the world, are in need of humanitarian assistance. The US has previously accounted for 43% of the total aid funding entering the country, so these cuts have been devastating. Last week, the aid agency Action Against Hunger – which lost significant funding through the cuts – said that the result would be children dying from malnutrition.
Similarly, the WFP estimates that the loss of funding in Afghanistan will end all of its emergency food distribution in the country for the foreseeable future. Approximately 2 million people, including about 400,000 malnourished children and mothers, rely on this assistance.
According to current and former USAID officials and partner organisations, the cuts are also affecting medical care, access to safe drinking water, support for maternal health services for millions of women, services addressing gender-based violence and mental health treatment for survivors of sexual and physical abuse.
Accessing the most basic medical care has now become infinitely more difficult as more than 200 World Health Organization-supported health facilities in Afghanistan have either closed or ceased functioning, in a country that already was facing a healthcare crisis due to critical underfunding. The WHO estimates that 10% of Afghans could lose healthcare by the end of the year.
Sudan
As the war in Sudan enters its third year, the country is facing an unprecedented humanitarian crisis: 30 million people are in need of aid, more than half of them children. Around half of Sudan’s population of 50 million are experiencing some degree of acute hunger, and famine has taken hold in at least five areas, including several parts of Darfur and Kordofan. It is estimated that half a million people died from hunger and disease across Sudan in 2024 alone.
Last year, USAID contributed 44% of Sudan’s $1.8bn humanitarian response, according to the UN. Within weeks of the cuts, 80% of community kitchens across Sudan closed, leaving millions at risk of dying from starvation or preventable illness. The cuts have also affected Sudanese refugees who have fled into Chad. Life-saving resources such as food and water, along with other US-funded programmes including mental health counselling and education, which were already operating on extremely limited budgets, have been further reduced.
The cuts are vastly consequential for the staff who work for local NGOs, too. In this piece for the Conversation, Naomi Ruth Pendle, an international development expert working with a team of Sudanese researchers in South Kordofan state, notes that each salary supported dozens of family members.
South Africa
Over the past two decades, the United States President’s Emergency Plan for Aids Relief, known as Pepfar, has had a significant global impact on the prevention and treatment of HIV and Aids. Experts have also said that Pepfar funding was contributing to research efforts aimed at finding a cure for HIV. However, that work came to a halt earlier this year, and researchers believe the cuts could set progress back by several years.
The Lancet estimates that without consistent and stable funding for Pepfar programmes, up to one million children could become infected with HIV, nearly half a million could die from Aids by 2030, and 2.8 million children could be orphaned across the region.
South Africa, which has the largest HIV and Aids programme in the world, is particularly vulnerable to these cuts and has been thrown into turmoil. Over 7 million people in the country are now living with HIV, including an estimated 270,000 children under the age of 14. In the past year, South Africa received approximately $440m in Pepfar funding, accounting for more than a fifth of its $2.56bn HIV budget.
Linda-Gail Bekker, an HIV and Aids researcher at the University of Cape Town, reported in the Annals of Internal Medicine in February that if Pepfar’s funding is not replaced, South Africa could face 565,000 additional new HIV infections and 601,000 more deaths from the virus by 2034. The additional healthcare required would cost an estimated $1.7bn.
It is not only the direct healthcare that this funding supports. Other vital services that help families with infected children – such as food vouchers and support groups – have also been cut.
Even if Donald Trump were to attempt to reverse course and restore the department along with all of its funding, the damage already inflicted will have lasting consequences, both in terms of human suffering and in the erosion of international trust. As former USAID senior official Atul Gawande told the New Yorker last month: “Everybody’s taking on the lesson that America cannot be trusted. That has enormous costs.”
