The Health Consequences of Foreign Aid Cuts

Editor’s note: This is an actively evolving situation with limited transparency, so some information may shift.

The Trump administration’s attack on foreign aid began on his first day in office in January 2025. Through executive actions, he initiated a 90-day review of foreign aid, accompanied by a “stop-work order” that froze payments and services for work that was already underway in countries and clinics around the world. Following this initial disruption, the dissolution of the United States Agency for International Development (USAID) caused even more services to shutter—leaving people in the lurch as their jobs, their health, and their livelihood were all being threatened.

Consequences of Cutting Foreign Aid

Now, several months into Trump's second presidency, billions of dollars for lifesaving foreign assistance have been stripped away. It is hard to quantify the impact these cuts have had on the well-being of people who relied on these services, but it's clear that critical supplies, jobs, and lives have been lost.  

“If we look at an example from PIH, tuberculosis (TB) case detection rates in Lesotho have declined as patients are unable to receive a diagnosis at local clinics even if diagnostics are available, due to the thousands of health care workers who were laid off through project terminations,” said Vincent Lin, PIH associate director of health policy & advocacy. “Referral hospitals are seeing fewer patients and TB is spreading.”

And these are still the early consequences—these cuts will reverberate for generations to come.

If the current situation continues:  

• At the patient and family level: We fear increased morbidity and mortality from undiagnosed or delayed-diagnosis illnesses. We are also concerned about the long-term impacts to families, communities, and individual patients, like the unmitigated spread of infectious diseases and limited access to health care services.
• At the microbial level: Resistance develops rapidly to the antiviral and antibiotic tools that we do have, which can increase when patients don’t have access to the medication they need to complete their treatment.
• At the system level: Clinicians, who are specialized in delivering health care, have been laid off and may leave the field entirely, or are bearing the burden of trying to provide care to patients with limited resources and limited staff.  

“There's great uncertainty around several key variables that determine how the landscape will appear a year from now,” Lin said. “Lawsuits around terminations and impoundment, agency reorganization, congressional action on rescissions—these are all likely to be resolved within the next year and are each critical to what global health funding will look like in the future.”

Changing the Future of Aid Through Rescissions

On June 3, the White House sent Congress a rescissions package that would cut $8.3 billion in foreign aid funding. Rescission packages happen when the President requests that Congress cancel previously allocated—but unspent—funds. The current package includes devastating cuts to global health programs, including the President's Emergency Plan for AIDS Relief (PEPFAR) and the United Nations Children's Fund (UNICEF).  

PEPFAR, which PIH co-founder Dr. Paul Farmer advocated for at the White House using evidence from his work in Haiti, has helped avert the deaths of over 25 million people by providing critical HIV treatment and prevention around the world. Currently, the State Department estimates that 20.6 million people are receiving U.S.-funded antiretroviral therapy.  

Without these programs, some of the world’s most vulnerable will lose access to essential health services. Maternal mortality rates will rise, more children will suffer from malnutrition, and more people will die from treatable, preventable illnesses like TB. In their justifications, the Administration wrote that these cuts “would not reduce treatment,” which simply isn’t true.  

For one proposed cut, the Administration writes, “this proposal would not reduce treatment but would eliminate programs that are antithetical to American interests and worsen the lives of women and children, like ‘family planning’ and ‘reproductive health’...” Each year, an estimated 287,000 women—primarily in low- and middle-income countries—die from complications during pregnancy and childbirth. An estimated one-third of maternal deaths could be averted each year if women had access to and used effective contraception. Regardless of rhetoric, the truth is that essential health treatment would be yanked back as a result of these rescissions.

Unfortunately, rescission bills only need a simple majority in the House and Senate to become law, which makes it much easier for these funding cuts to become permanent. If Congress were to codify this rescissions package, the health consequences would be devastating, and it would set a dangerous precedent for future funding cuts.

While PIH recognizes that current aid structures have their flaws, removing funding completely—without any resources to support critical programming—is not the solution.  

“We must aspire beyond the reinstatement of U.S. aid, which by itself will never be enough to realize health as a human right,” said Joel Curtain, director of advocacy at PIH. “While getting U.S. aid funding back out the door is essential in delivering health system inputs to reduce the acute and unnecessary suffering caused by its reckless removal, broader transformations are required to halt the ongoing unnecessary suffering inflicted by centuries of colonialism, neocolonialism, and ecological breakdown.”

The People’s Power

Despite its lifesaving track record and overall bipartisan support, aid for health programming is being targeted by the current administration.  

Currently, by using only around 1% of the federal budget, U.S. foreign assistance saves around 9,000 lives on an average day. There is also large public support for global health foreign aid: around eight-in-ten Americans believe the U.S. should provide medicine and medical supplies, as well as food and clothing, to people in low- and middle-income countries, according to the Pew Research Center.  

At PIH, we’ve seen an overwhelming number of our supporters and partners speaking up against the removal of foreign aid.  

“We've mobilized more than 16,000 calls and letters to Congress from 96% of House districts and 100% of Senate offices, as well as hundreds of volunteers via multiple rounds of global health advocacy on Capitol Hill, including an unprecedented TB Hill Day,” Curtain shared. “In spite of the enormous challenges posed to global health at this moment, this advocacy is having a clear impact; we are seeing record numbers of Congressional offices calling for increased funding support for these programs.”

Use Your Voice

With the rescissions package currently in the hands of Congress, constituent voices are extremely important in influencing its passage into law.  

“Congress—under Article I of the Constitution—holds the power of the purse, as well as oversight authorities for foreign aid,” Lin said. “Local voters have a major role to play in influencing the positions of their members of Congress.”