In the wake of USAID’s shuttering by billionaire Elon Musk and President Donald Trump, those familiar with USAID’s work have been fighting for the restoration of key programs, like those that relieve the starvation of children, while bracing for the impact of the cuts around the world.
One of the most high-profile programs since Musk’s gutting of USAID was a program that supplied acutely malnourished children with a peanut-based food product called Plumpy Nut meant to help save children who are unable to ingest normal food safely. This program was first cut by Trump and his billionaire partner before being reinstated after significant public pressure.
Andrew Natsios, the former administrator for USAID under the President George W. Bush’s administration, told Salon that there are countless programs like this one and that the destruction of the agency will lead to famine, mass migration and suffering unless some of these programs are restored.
“We're going to see mass starvation in many countries,” Natsios said. “I hope that doesn't happen, but the evidence is that the international system is breaking down now, the other donors are not cutting their budgets back. Once USAID was shut down, many other donors said, ‘You know, we're going to shut ours down too.’ They do follow the leader.”
Some of the countries following the United States in cutting foreign aid include the United Kingdom, the Netherlands, France and Belgium. Jean Van Wette, the head of the Belgian development agency Enabel, described the trend as a “snowball effect” to Euronews Health.
“Something we've never seen, I think in the history of international cooperation, is such a massive cut, not from one donor, but from multiple,” Van Wetter said.
Earlier this month, Secretary of State Marco Rubio confirmed that, after a six-week purge, 83% of USAID's programs had been permanent cut — despite congressional authorization — and that the remaining programs would be administered by the State Department. In fiscal year 2023, USAID distributed roughly $44 billion in aid.
In a statement, Rubio thanked Musk, saying that "our hardworking staff who worked very long hours to achieve this overdue and historic reform."
The White House had previously claimed that the agency, which was audited in 2024 and 2023, was rife with fraud and abuse, while also claiming it was "woke," asserting that USAID had funded a Colombian "transgender opera" and a Peruvian "transgender comic book." The White House did not provide any evidence for these claims, and they've since been debunked.
The unilateral shuttering of the agency has been challenged in court, with a federal judge saying that Trump had overstepped his authority by closing down the congressionally-mandated agency, though the judge's order did not force officials to revive canceled contracts.
Beyond food aid, the agency supplied assistance for projects like containing the spread of Ebola, clearing landmines and providing prosthetic limbs to injured soldiers in Ukraine. USAID’s President’s Emergency Plan for AIDS Relief was also one of the largest global programs for combating HIV and AIDS, with operations in more than 50 countries, and had been credited with saving some 26 million people since it was created in 2003.
PEPFAR has since been effectively shuttered. That and the cancellation of food aid threatens the lives of millions, critics say.
Natsios said that, without USAID's intervention, he’s expecting to see at least 2 million people dead by the end of the year from a combination of famine and disease, citing the discontinuation of programs supplying corn soy blend, a food item created to help treat malnourished children; it has recently been used to help treat children in places like Niger and Malawi and is specifically meant to help children who are at risk of dying if they are given too much food too quickly, administered up to 20 times a day in small portions.
Rachel Beatty Riedl, a professor of government at Cornell and director of the university's Center on Global Democracy, told Salon that these sorts of short-term interventions in response to acute humanitarian crises are exactly the sort of thing for which USAID was built. She said that, in the absence of American aid, she expects famines in places like the Congo to quickly worsen in places like Sudan. She also said that populations remember the aid long after the crisis is over.
“Where food supports are provided, those are such immediate and timely interventions that are responding to an acute crisis, but they have very long-term implications in thinking about who has influence with the population,” Riedl said. “The point of these types of programs is that they are rapid response and that they move location as the crisis is identified. That’s why the USAID expertise is so critical and the dollar amount is so small for the long term investment.”
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Oral rehydration salts are another program that Natsios provided as an example, saying that they save countless lives around the world at a relatively low cost to the United States.
“The refugee and displaced camps have oral rehydration salts, ORS, because a lot of the children that die in the famine die from diarrheal disease. That's the biggest killer,” Natsios said. “So we use oral rehydration salts that you mix with clean water, and if you give it to a child, it prevents the child from going into shock.”
While it’s not known how many lives oral rehydration salts have saved exactly, they are credited as being part of the reason that deaths from diarrheal diseases plummeted in the last 20 years of the 20th century, from 4.8 million in 1980 to 1.2 million in 2000, according to an article published in the journal of Health, Population and Nutrition.
While cutting off food will have one of the most immediate effects, Riedl said that ending USAID's infectious disease monitoring programs in places like Tanzania and the Democratic Republic of the Congo may have the most serious long-term consequences globally.
USAID, Riedl explained, has played a critical role in monitoring and containing outbreaks of Ebola and the Marburg Virus in these and other countries. Combined with domestic public health programs, she says the effort to contain these outbreaks has been highly effective.
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Aside from nutritional interventions, Natsios said that there are other public health interventions, once provided by the United States and other countries, that saved countless lives, like vaccinations for measles and other common childhood diseases.
“There are five childhood diseases all kids are supposed to be immunized from under the age of five, because children die first in the famine, then pregnant women and lactating mothers,” Natsios said.
Even interventions like sending condoms and other contraceptives to places like Afghanistan have helped save the lives of women, who, when pregnant, normally die first in a famine. Natsios said that the intervention was administered through health centers established by the United States during its occupation of the country and that he would have sent the aid as well if he were in office, despite the fact that the aid was mocked by conservatives.
“The reason we do is that many of the women who are pregnant will be dead by the end of year, because there's a famine spreading across the country and a woman who is acutely malnourished, usually dies because they're feeding two people, the child they’re pregnant with and themselves” Natsios said.
The effect of Musk and Trump’s efforts to cut USAID, Natisos said, will go far beyond the millions of people he expects to die due to famine. One example is in combating novel viruses and epidemics. Migration is another issue he expects to be affected by the pullback in aid. Specifically, Natsios said he expects the pullback in aid to worsen the ongoing forced migration crisis, which he says is the worst since World War II.
“It's been building up for eight or 10 years now; it's getting worse and worse. The same thing happened, by the way, when the Cold War ended, there was the same kind of crisis, but not as bad as this. This is worse, right now,” Natsios said.
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