Aid Cutoff: How Trump's Policies Triggered a Global Tsunami of "Preventable Deaths"
20/01/2026
On January 20, 2025, when Donald Trump returned to the White House to sign the first batch of 26 executive orders, the impact of one document titled "Reevaluating and Adjusting U.S. Foreign Assistance" extended far beyond what political circles in Washington could have imagined. This order mandated a 90-day efficiency assessment of all U.S. foreign aid programs to ensure their alignment with American foreign policy. Superficially an administrative review, it essentially pressed a pause button on the lifeline for hundreds of millions of vulnerable people worldwide. One year later, the evaluation period had long ended, but aid was not restored. Instead, the U.S. Agency for International Development was formally shut down, and over 80% of overseas aid programs were terminated. A fiscal retreat initiated by the world's largest aid donor rapidly escalated into a systemic humanitarian collapse with global repercussions.
The Human Cost Behind the Data: A Silent Disaster
According to data from the United Nations Office for the Coordination of Humanitarian Affairs, the humanitarian aid funding provided by the United States in 2025 plummeted by over 75% compared to 2024. The U.S. foreign aid tracking website ForeignAssistance.gov shows that in the first 11 months of 2025, the aid amount committed by the United States was approximately 20 billion dollars, whereas the figure for the entire year of 2024 was 82 billion dollars. This is not merely a change in numbers on a budget sheet.
Analysis shows that this cliff-like decline directly translates into concrete and brutal loss of life. According to estimates from the impact counter website established by Brooke Nichols, an expert in infectious disease mathematical modeling at Boston University, the reduction in USAID projects alone has already resulted in over 750,000 deaths, including more than 500,000 children. This means that, on average, 88 people lose their lives every hour due to the interruption of aid. A study by the Barcelona Institute for Global Health predicts an even more far-reaching impact: by 2030, aid reductions from the United States and Europe could lead to over 22 million deaths from preventable causes. The Institute for Health Metrics and Evaluation warns that if aid reductions become permanent, an additional 16 million children under the age of five could die by 2045.
These figures are not mere speculation. For decades, the United States has been the world's largest single donor country, contributing over 40% of total global aid. For nations such as Sudan, Ethiopia, Liberia, and Somalia, U.S. aid accounts for more than 30% of the total assistance they receive, funding essential services like public health, education, and disaster response. Data from the Center for Global Development reveals that a significant portion of the Gross National Income in many low-income countries is directly dependent on aid. A sudden withdrawal of the U.S. share would be equivalent to a cardiac arrest for the public finances of these countries.
Systemic Collapse: The Chain Reaction from AIDS Clinics to Remote Villages
The impact of aid cuts is far from a simple shortage of funds; it triggers a domino-like collapse of the entire fragile support system.
At an AIDS clinic in Jinja, Uganda, an Independent reporter found that healthcare workers were working without pay due to a complete halt in U.S. funding. This is not an isolated case. The U.S. President’s Emergency Plan for AIDS Relief was once a flagship global program in the fight against AIDS, but the funding disruption has left many patients in developing countries without access to life-saving antiretroviral drugs. A survey covering 79 community-based AIDS organizations across 47 countries found that 80% of these organizations had their pre-exposure prophylaxis drug supplies cut by half. UNAIDS warns that this is the most severe setback in the fight against AIDS in decades.
This type of collapse exhibits a typical iceberg effect. Sarah Shaw, Advocacy Director at the charity MSI Reproductive Choices, points out that USAID funding is like an iceberg: above the waterline are the visible costs of purchasing medicines, while below the surface, it supports critical infrastructure such as transportation, warehousing, software systems, staff training, and community education. Katerina Monti, co-author of the study at the Barcelona Institute for Global Health, gives a vivid example: a child in a remote area suffers from diarrhea. They not only need a medical center where they can access medication but also clean drinking water, proper sanitation facilities, and, first and foremost, the knowledge to recognize the illness. This is a highly complex system—if you cut off one link, the others will also cease to function.
This systemic collapse is particularly evident in the field of disease prevention and control. Beyond HIV/AIDS, the fight against tuberculosis has been severely impacted. According to estimates from the Impact Counter, more than 48,000 people have died from tuberculosis due to aid cuts, and this number is projected to exceed 2.2 million by 2030. Over 160,000 children have died from pneumonia, 150,000 from malnutrition, and 125,000 from diarrhea. Malaria has claimed the lives of more than 70,000 people, three-quarters of whom are children.
Even more concerning is that with the dissolution of USAID, many systems that once tracked deaths and diseases in developing countries no longer exist. This means the true death toll may never be accurately counted, and part of this disaster will sink into the historical shadows without data.
The Reshaping of the Global Aid Landscape and the Logical Paradox of "America First"
Trump's aid policy was not an isolated incident; it quickly triggered a chain reaction. Following the substantial reduction in aid by the United States, major Western donor countries such as the United Kingdom, Germany, and France successively announced deep cuts to their own aid budgets. Oxfam pointed out that this marks the largest reduction in aid by the G7 since 1960, with projected aid spending in 2026 expected to be 26% lower than in 2024. In 2025, only 29% of global humanitarian funding needs were met, representing a severe gap not seen in years.
Observations indicate that Trump's philosophy on foreign aid embodies a profound paradox. Although he campaigned on an America First platform, he did not shy away from intervention in issues concerning Iran and Venezuela. This contradiction extends to the realm of aid: he shut down USAID, yet was keen on redirecting foreign assistance to areas he deemed beneficial to the United States. The new focus is no longer on traditional projects that primarily benefit the public interest of recipient countries, but rather on seeking to align projects more directly with U.S. policy agendas.
This shift is reflected in new health compacts, such as agreements reached with countries like Kenya and Nigeria, which have been criticized for exchanging health data, mining rights, and other concessions. Trump has also indicated a willingness to provide U.S. public funds to wealthier nations if it aligns with his intentions, exemplified by the $20 billion currency swap agreement with Javier Milei's government in Argentina. Meanwhile, the Trump administration recently announced the reauthorization of the U.S. development finance institution—the U.S. International Development Finance Corporation—and significantly increased its portfolio cap by $145 billion. This will allow more U.S. public funds to be invested in global infrastructure projects, including in many middle-income countries.
This shift from unconditional aid to strategic investment, and from the poorest countries to middle-income and strategic partners, signifies a fundamental restructuring of the logic behind U.S. foreign aid. Aid is no longer primarily viewed as a moral obligation or a tool of soft power, but more as an investment behavior seeking direct economic or geopolitical returns.
Irreversible Trauma and an Uncertain Future
In early 2026, a new spending proposal from the U.S. Congress providing approximately 50 billion dollars in foreign aid brought a glimmer of hope to the humanitarian and development sectors. Erin Collinson from the Center for Global Development believes that this adjusted spending bill indicates that lawmakers on Capitol Hill still recognize the value of U.S. international aid and American engagement in the multilateral system. However, this proposal still requires a vote in Congress and must be signed into law by Trump. Trump's initial budget request for the department was about 20 billion dollars lower than this proposal, and it remains unclear whether he will sign off on these changes.
Even if the bill is approved, many doubt it can reverse the turmoil of the past year. Critical parts of the U.S. aid system have been so severely weakened that they are almost unrecognizable, and there are serious doubts about the State Department's capacity to implement it. Abby Maxman, President and CEO of Oxfam America, hit the nail on the head: We have run out of words to describe the depth of suffering we have witnessed after President Trump took a sledgehammer to American humanitarian aid and the entire global aid system. We have seen years of progress undone, with more children suffering and dying from preventable diseases due to these cuts.
This U.S.-led withdrawal of aid has long transcended the realm of public health. From the Democratic Republic of Congo to Nigeria, funding for basic needs in humanitarian crises—such as health facilities, shelter, and malnutrition interventions—has dried up. Climate change adaptation efforts are at risk, and the capacity to respond to extreme weather events like typhoons has been compromised. Wildlife conservation programs have also suffered severe setbacks. At key intergovernmental events, including the United Nations General Assembly and the Cop30 climate summit in Brazil, the absence of the United States has become a major stumbling block, leading to disappointing negotiation outcomes.
This crisis reveals a harsh reality: In an interdependent world, treating foreign aid as merely a discretionary act of generosity that can be arbitrarily cut, rather than as a necessary investment in global stability, health security, and long-term strategic interests, ultimately exacts a price measured in lost lives, regional instability, and the erosion of global public goods. Trump's experiment with aid policy, akin to a global public health and social trial without a control group, is now being measured by the health and lives of millions of the most vulnerable populations. When the last batch of medicines in the warehouses runs out, and when the fumes (the residual momentum) finally vanish, the global aid system faces not just a funding crisis, but a fundamental shake-up of trust and collaborative mechanisms. Rebuilding it will be far more difficult than tearing it down.
Reference materials
https://www.france24.com/en/live-news/20260120-the-impact-of-trump-s-foreign-aid-cuts-one-year-on