April 8, 2025

Global Health Catastrophe from 2025 U.S. Foreign Budget Freeze

The Trump administration’s 90-day freeze in January-March 2025 on U.S. foreign aid has blocked billions of dollars in funding for global health initiatives, including contraceptives, climate justice, HIV, and TB. The U.S. allocated $63.1 billion for foreign assistance in Fiscal Year 2024, with $10.5 billion for humanitarian aid and $4.1 billion for global health efforts. The freeze disrupted the continuity of essential health services, placing vulnerable populations at risk.

Impacts on African Countries

The freeze on U.S. foreign aid has left millions across Africa without access to essential healthcare services. In Sudan, over 10 million people were set to receive health services, but more than half may now lose access, as local organizations have been forced to suspend operations due to funding shortages. Similarly, in Mauritania’s Mbera refugee camp, home to 100,000 displaced individuals from Mali, the suspension of psychological and refugee support programs has created panic and uncertainty among aid workers and residents alike. In the Democratic Republic of Congo, access to food, water, and healthcare for 4.6 million displaced people is at risk. While in northern Syria, the loss of U.S. aid has forced the closure of 12 field hospitals, cutting daily consultations from 5,000 to just 500.

The ripple effects extend to disease control efforts across the continent. Monitoring for a dangerous strain such as bird flu and Marburg fever has been disrupted and harder to contain. While Senator Rubio announced an exemption for the U.S. President’s Emergency Plans for AIDS Relief (PEPFAR), a critical HIV/AIDS program supporting over 20 million people, many of its operations have been thrown into disarray. South Africa, a major recipient of PEPFAR funds, has seen the abrupt halt of HIV prevention, testing, and contact tracing programs, which could reverse years of progress in combating the epidemic. In Kenya, medication shortages have led clinics to ration antiretrovirals, with some patients receiving only one month’s supply instead of the usual six. The true scale of the crisis is still unfolding, but the impact on millions across Africa is already catastrophic.

Impacts on Asian Countries

Although Asia is not the largest recipient of the U.S. Agency for International Development (USAID), the aid freeze has severely impacted health programs in Myanmar, Nepal, Indonesia, and the Philippines. In junta-controlled Myanmar, where the U.S. contributes approximately $200 million annually—$40 million of which is dedicated to health—essential services have come to a halt. Seven of nine hospitals serving 80,000 refugees near the Myanmar border have closed, while in Thailand’s Umpiem Mai camp, the sudden halt of medical aid has already resulted in multiple deaths among patients reliant on oxygen support.

In Nepal, the La Isla Network has suspended its $4 million U.S. grant-health screenings program for Nepalese workers migrating to the Middle East. Similarly, in Indonesia, where 40% of HIV/AIDS prevention funding comes from foreign donors, hundreds of field officers have been laid off due to the USAID freeze. In 2024, USAID disbursed $180 million to the Philippines in aid, supporting multi-drug-resistant tuberculosis programs, HIV epidemic control, and disaster relief following devastating typhoons. With funding halted, these programs face severe setbacks, leaving thousands without treatment or emergency assistance. 

Impacts on Global Health Projects

The suspension of USAID-backed global health projects has led to severe disruptions in research, data collection, and healthcare interventions worldwide. For example, Bangladesh’s renowned International Research Centre for Diarrhoeal Diseases Research (ICDDR,B) has been compelled to dismiss 1,000 employees and suspend 10 U.S.-funded studies, which included tuberculosis research, nutrition programs, fungal infection surveillance, and viral spillover risk assessment. 

The freeze has also had significant repercussions on global health security, as critical forecasting systems and clinical trials have been forced to stop. The Famine Early Warning Systems Network, which has provided life-saving food crisis predictions since 1985, has gone offline, erasing access to crucial data. Furthermore, a pivotal malaria vaccine trial in the U.K., led by Oxford scientists in partnership with India’s Serum Institute, has been paused mid-trial due to the funding freeze, putting at risk the progress of a new vaccine vital for Africa. The crisis has also left women in South Africa with experimental birth control devices inside them, highlighting the abrupt and harmful nature of these funding cuts on vulnerable populations worldwide.

Fighting for Influence over the Global South

The suspension of U.S. foreign aid has raised concerns that the country is relinquishing a significant tool of soft power, allowing geopolitical rivals like China and Russia to expand their influence. In Southeast Asia, China allocated $4.4 million to demining efforts in Cambodia after U.S.-funded programs were halted. Experts in Washington D.C. warn that such decisions provide openings for China and Russia to strengthen their influence in regions where U.S. assistance has historically provided crucial support in healthcare, clean water, and humanitarian aid. Despite the freeze on USAID funding, exemptions have been granted for military financing to Israel and Egypt, as well as emergency food assistance, highlighting a shift in priorities.

Russia and China have long viewed global health engagement as a strategic tool to bolster their international standing. Russia’s Foreign Policy Concept outlines its commitment to countering Western influence by supporting epidemic preparedness, noncommunicable disease prevention, and scientific cooperation. Meanwhile, China has backed the World Health Organization (WHO), stepping in with an additional $30 million in funding after the Trump administration cut U.S. contributions in 2020. With its increased financial support, China now ranks second only to the U.S. in assessed contributions to the WHO, positioning itself as a responsible global power in health governance.

By the end of March 2025, the administration had terminated 86% of its global programs and moved remaining programs under stricter control of the State Department.

This aid freeze underscores a stark reality: the Global South must reassess its dependency on U.S. foreign assistance and reclaim agency over its health systems. The unpredictability of U.S. policies exposes a fundamental weakness in relying on external funding for critical health infrastructure. It is imperative for Global South nations to explore regional funding mechanisms, strengthen public health investments, and foster South-South cooperation to ensure sustainable and resilient healthcare systems.

References

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Photo credit: Alice Tecotzky