Critical shortages of life-saving medicines and widespread malnutrition among children have been reported worldwide following Elon Musk’s decision to shut down the United States’ leading international aid agency.
Chaotic scenes have unfolded across multiple countries as aid organizations warn of escalating disease, famine, and disastrous consequences in areas such as family planning and girls’ education.
The crisis stems from President Donald Trump’s decision to freeze funding to USAID, which managed more than $40 billion (£32bn) in 2023.
As a result, countless aid organizations have been forced to close or lay off staff.
Analysis indicates that several thousand women and girls are likely to die from complications during pregnancy and childbirth as a direct result of Trump’s 90-day freeze on USAID funding.
Trump has assigned Musk—who has falsely accused USAID of being a “criminal” organization—to oversee the downsizing of the US government’s primary humanitarian assistance agency.
The global aid sector has already felt profound and immediate consequences. U.S. foreign aid accounts for four out of every ten dollars spent worldwide on humanitarian aid.
A former senior USAID official described Musk’s actions as an “extinction-level event” for international humanitarian efforts.
Initial fallout includes the abandonment of critical drug supplies in warehouses in Sudan—the epicenter of the world’s worst humanitarian crisis—and the Democratic Republic of the Congo (DRC), where recent fighting in the east has further destabilized the region.
Across Africa, hundreds of thousands of children who depend on school meals have been left without food after supplies were left to rot following Musk’s statement that he wanted USAID to “die.”
“Partners on the ground [are saying] that in DRC and Sudan, medical supplies are stuck in warehouses,” said a spokesperson for a leading international aid organization.
Like many aid workers interviewed, the spokesperson requested anonymity, amid reports that officials from the Trump administration have pressured the humanitarian sector not to speak out. Many were also reluctant to comment publicly for fear of losing future funding.
Among the projects already shut down is a girls’ education program in Nepal, raising concerns about increased child marriage and trafficking.
“All payments are frozen for these projects. There’s a lot of misinformation. Organizations are having to make decisions in a vacuum,” said one humanitarian official.
In Bangladesh, the International Centre for Diarrhoeal Disease Research—renowned for its pioneering work on one of the leading causes of child mortality—has laid off some of the world’s most respected malaria researchers.
Similarly, malaria-control programs in Uganda have suffered severe cutbacks, with numerous frontline care initiatives shutting down.
In Malawi, where many depend on donor-funded aid programs, fears are mounting that the aid freeze could reshape the country’s entire economy.
Mike Dansa, chair of the Nsanje Civil Society Organization, warned that agricultural aid programs that provide smallholder farmers with improved seeds, irrigation, and climate-resilience support are at risk. This could threaten food security in a country already grappling with extreme weather events.
Protest Against Elon Musk (Photo: Getty Images)
In Johannesburg, programs that have relied for over two decades on funding from the U.S. HIV/AIDS response initiative, known as PEPFAR, have closed their doors.
Dawie Nel, director of Johannesburg-based LGBTQ+ clinic Out, which serves 6,000 clients, said his organization had suspended treatments. “The US is a totally unreliable partner,” he stated. Across the Atlantic, similar turmoil is unfolding.
In Colombia, a country plagued by six decades of internal conflict and drug-related violence, many organizations depend on USAID funding.
Programs offering emergency assistance to families fleeing armed violence and initiatives encouraging farmers to transition from coca cultivation to legal crops have been halted.
Former Colombian president and Nobel Peace Prize laureate Juan Manuel Santos told The Guardian: “I have seen the massive benefit these programs funded by USAID have generated for people across the country. To cut it, suddenly, is going to have a terrible humanitarian effect.”
A director of a major international aid organization in Colombia—who also requested anonymity—expressed concern for those most vulnerable: “The people who this is going to affect the most are those already without a safety net. Precisely those who are least able to find another source of food, shelter, or income.”
However, some argue that the crisis highlights the fragility of development programs that depend on external funding.
Former Kenyan president Uhuru Kenyatta urged African nations to view the aid freeze as a “wake-up call” to prioritize their own development.
“Nobody is going to continue holding out a hand to give you. It is time for us to use our resources for the right things,” he said.
Despite this perspective, many maintain that Trump and Musk’s intention to dismantle USAID is disastrous.
“Without naming countries or areas, we have had to close life-saving services, for children with acute malnutrition, and also testing and treatment sites for health facilities, nutrition facilities and wash facilities,” said one aid worker.
Jeremy Konyndyk, president of Refugees International and a former USAID official, warned that Musk’s plan to shut down the agency represents an existential threat to the humanitarian sector.
“If this goes forward, it really is an extinction-level event for the global aid sector in the US and for much of the global relief and development sector around the world.”
Konyndyk also noted that the move would “destabilize” the budgets of numerous major aid and United Nations organizations. “It threatens really the collapse not just of what USAID does, but of this huge ecosystem of relief and development organizations that are doing good around the world every day,” he said.
Research from the Guttmacher Institute supports such concerns, estimating that during the 90-day aid freeze, 11.7 million women and girls will be denied access to contraceptive care, leading to 8,340 deaths from pregnancy and childbirth complications.
A survey of 342 international development organizations highlighted the sector’s dire situation, revealing that more than half of these groups are likely to shut down before May without U.S. funding.
Attempts by the U.S. government to mitigate the crisis through a waiver for “life-saving assistance” projects have only added confusion.
“Is Plumpy’Nut [a paste used to feed severely malnourished children] life-saving? Is a vaccine life-saving? What is a life-saving part of a project? What qualifies under the waiver?” one aid worker questioned.
To track the impact of the freeze, a “global aid freeze” monitoring tool has been launched, inviting civil society organizations to input data.
