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Executive Action and Agency Overhaul
On January 20, 2025, the White House issued Executive Order 14169, directing the immediate freeze of most foreign aid programs. The order paused non-emergency humanitarian assistance and development funding, with the exception of military aid to Israel and Egypt. According to reporting from Reuters and The Guardian, this freeze impacted thousands of programs across health, education, food security, and governance sectors. In May, the administration confirmed that the U.S. Agency for International Development (USAID) would be dismantled, with its remaining operations transferred to the State Department by July.
USAID, which previously employed more than 10,000 staff worldwide, now retains fewer than 300 employees in transitional roles. According to Reuters, more than 5,800 contracts and projects, valued at over $54 billion, have been canceled or paused since the order went into effect. These programs included HIV medication distribution, maternal health clinics, school meal services, and agricultural support across more than 80 countries. Most operations have been shut down entirely or handed off to local governments with limited capacity to continue them.
Public Health Impacts Around the World
The most immediate consequences of the freeze have been seen in global health. According to models published by the Center for Global Development, more than one million preventable deaths may occur within the next year due to halted services. This includes an estimated 675,000 people who may die from untreated HIV infections and over 300,000 from tuberculosis and malaria. The World Health Organization reported in March that at least eight countries, including Kenya, Malawi, and South Sudan, are at risk of running out of HIV medications by July.
UNAIDS stated that as many as 10 million new HIV infections could occur globally if treatment programs are not resumed. According to Reuters, the national health ministry in South Africa reported a 21% drop in HIV viral load testing for pregnant women and newborns. Reports from the Democratic Republic of Congo, Tanzania, and Uganda show disruptions to malaria prevention campaigns and vaccine shipments. Multiple clinics in East Africa have already shut down due to lack of funding, with many more expected to follow by the end of the summer.
Loss of Influence at the Global Level
The shift in U.S. aid strategy has also weakened Washington’s presence in key multilateral forums. At the United Nations Financing for Development Summit in Seville this June, U.S. representatives were absent, prompting criticism from European and African delegates. According to Reuters, U.N. leadership expressed concern that the lack of U.S. participation could jeopardize efforts to close a $4 trillion global funding gap for the Sustainable Development Goals. In response, several low-income countries have begun seeking alternative partnerships with China, Russia, and Turkey, impacting the U.S.'s position as an aid-giving country.
Legal Challenges and Political Opposition
Although The Brookings Institution confirms that foreign assistance accounts for less than one-quarter of one percent of U.S. GDP, the decision to freeze funds without congressional input has prompted legal and political backlash. In early June, a coalition of 12 state attorneys general and bipartisan lawmakers filed a legal challenge citing the Impoundment Control Act. Senators Susan Collins and Patty Murray have argued that the freeze violates congressional authority by withholding appropriated funds without approval. According to Politico, the Senate has until July 18 to vote on restoring $8.3 billion in funding, including large portions allocated to PEPFAR, Gavi, and the Global Fund.
The administration has defended its actions by claiming the review is temporary and needed to ensure that taxpayer dollars are used effectively. However, the Office of Management and Budget has not released a clear timeline for when or how programs will be evaluated. Development organizations and former USAID officials have warned that the damage to ongoing projects is already irreversible. In many cases, clinics have laid off staff, destroyed expired medications, or ended service contracts, making restarts costly and time-consuming.
Institutional Impacts and Long-Term Effects
While the humanitarian consequences of the freeze are visible now, the long-term institutional damage is harder to measure. Former USAID administrator Sarah Charles told The Washington Post that dismantling the agency breaks up networks of technical experts who have spent decades improving disaster preparedness, anti-corruption programs, and agricultural sustainability.
The McKinsey Global Institute noted in a May article that U.S. foreign aid is increasingly being reframed as an instrument of return-on-investment, rather than humanitarian assistance. Funding priorities are expected to shift toward economic and security outcomes, including energy development deals and border enforcement contracts. In interviews with local governments in Latin America and sub-Saharan Africa, Devex found that several leaders now view U.S. aid as unpredictable and politically motivated. As a result, more countries are investing in regional partnerships and self-financing strategies to reduce dependency on external donors.
