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‘PEOPLE WILL DIE’: TRUMP’S BAN ON HUMANITARIAN AID  
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Brett Murphy and Anna Maria Barry-Jester
January 31, 2025
ProPublica
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_ Organizations that provide vital care for desperate and vulnerable
people around the world have been forced to halt operations, turn away
patients and lay off staff. “I’ve never seen anything that scares
me as much as this,” one doctor said. _

Sudanese refugees, credit: UNICEF

 

On Friday morning, the staffers at a half dozen U.S.-funded medical
facilities in Sudan who care for severely malnourished children had a
choice to make: Defy President Donald Trump’s order to immediately
stop their operations or let up to 100 babies and toddlers die.

They chose the children.

In spite of the order, they will keep their facilities open for as
long as they can, according to three people with direct knowledge of
the situation. The people requested anonymity for fear that the
administration might target their group for reprisals. Trump’s order
also meant they would stop receiving new, previously approved funds to
cover salaries, IV bags and other supplies. They said it’s a matter
of days, not weeks, before they run out.

American-funded aid organizations around the globe, charged with
providing lifesaving care for the most desperate and vulnerable
populations imaginable, have for days been forced to completely halt
their operations, turn away patients and lay off staff following a
series of sudden stop-work demands from the Trump administration.
Despite an announcement earlier this week ostensibly allowing
lifesaving operations to continue, those earlier orders have not been
rescinded.

Many groups doing such lifesaving work either don’t know the right
way to request an exemption to the order, known as a waiver, or have
no sense of where their request stands. They’ve received little
information from the U.S. government, where, in recent days,
humanitarian officials have been summarily ousted or prohibited from
communicating with the aid organizations.

Trump’s rapid assault on the international aid system is quickly
becoming the most consequential and far-reaching shift in U.S.
humanitarian policy since the Marshall Plan to rebuild Europe after
World War II, aid groups and government officials warned.

Among the programs that remain grounded as of Friday: emergency
medical care for displaced Palestinians and Yemenis fleeing war, heat
and electricity for Ukrainian refugees and HIV treatment and mpox
surveillance in Africa.

Experts in and out of government have anxiously watched the fluid
situation develop. “I’ve been an infectious disease doctor for 30
years, and I’ve never seen anything that scares me as much as
this,” said Dr. Jennifer Furin, a Harvard Medical School physician
who received a stop-work order for a program designing treatment plans
for people with the most drug-resistant forms of tuberculosis.
Infectious diseases do not know borders, she pointed out. “It’s
terrifying.”

Trump and Secretary of State Marco Rubio first issued the freeze on
aid operations last Friday, which included limited exemptions. “The
pause on all foreign assistance means a complete halt,” a top
adviser wrote in an internal memo to staff. (The order was separate
from Trump’s now-seemingly rescinded moratorium on domestic U.S.
grants.) Aid groups across the globe began receiving emails that
instructed them to immediately stop working while the government
conducted a 90-day review of their programs to make sure they aligned
with the administration’s agenda.

Trump campaigned on an “America First” platform after
unsuccessfully trying to slash
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the foreign assistance budget during his first term in office. The
U.S. provides about $60 billion [[link removed]] in
nonmilitary humanitarian and development aid annually — less than 1%
of the federal budget, but far more than any other country. The
complex network of organizations who carry out the work is managed by
the State Department and U.S. Agency for International Development.

Over the weekend, that system came to a standstill. There was
widespread chaos and confusion as contractors scrambled to understand
seemingly arbitrary orders from Washington and figure out how to get a
waiver to continue working. By Tuesday evening, Trump and Rubio
appeared to heed the international pressure and scale back the order
by announcing that any “lifesaving” humanitarian efforts would be
allowed to continue.

Aid groups that specialize in saving lives were relieved and thought
their stop-work orders would be reversed just as swiftly as they had
arrived.

But that hasn’t happened. Instead, more stop-work orders have been
issued. As of Thursday, contractors worldwide were still grounded
under the original orders and unable to secure waivers. Top Trump
appointees arrested further funding and banned new projects for at
least three months.

“We need to correct the impression that the waiver was
self-executing by virtue of the announcement,” said Marcia Wong, the
former deputy assistant administrator of USAID’s humanitarian
assistance bureau.

Aid groups that had already received U.S. money were told they could
not spend it or do any previously approved work. The contractors
quoted in this article spoke on the condition of anonymity because
they feared the administration might prolong their suspension or
cancel their contracts completely.

As crucial days and hours pass, aid groups say Trump’s order has
already caused irreparable harm. Often without cash reserves or
endowments, many organizations depend on U.S. funding entirely and
have been forced to lay off staff and cancel contracts with vendors.
One CEO said he expects up to 3,000 aid workers to lose their jobs in
Washington alone, according to the trade publication Devex. Some
groups may have to shutter altogether because they can’t afford to
float their overhead costs without knowing if or when they’d get
reimbursed.

Critics say the past week has also undermined Trump’s own stated
goals of American prosperity and security by opening a vacuum for
international adversaries to fill, while putting millions at immediate
and long-term risk.

“A chaotic, unexplained and abrupt pause with no guidance has left
all our partners around the world high and dry and America looking
like a severely unreliable actor to do business with,” a USAID
official told ProPublica, adding that other countries will now have
good reason to look to China or Russia for the help they’re no
longer getting from the U.S. “There’s nothing that was left
untouched.”

In response to a detailed list of questions for this article, the
White House referred ProPublica to the State Department. The State
Department said to direct all questions about USAID to the agency
itself. USAID did not reply to our emails. Much of its communications
staff was let go in the last week.

In a public statement Wednesday
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the State Department defended the foreign aid freezes and said the
government has issued dozens of exemption waivers in recent days.

“The previously announced 90-day pause and review of U.S. foreign
aid is already paying dividends to our country and our people,” the
statement said. “We are rooting out waste. We are blocking woke
programs. And we are exposing activities that run contrary to our
national interests. None of this would be possible if these programs
remained on autopilot.”

The dire international situation has been exacerbated by upheaval in
Washington. This week, the Trump administration furloughed 500 support
staff contractors from USAID’s humanitarian assistance bureau, about
40% of the unit, and fired 400 more from the global health bureau.
Those workers were told to stop working and “please head home
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The remaining officials in Washington are now attempting to navigate a
confounding waiver process and get lifesaving programs back online.
Officials and diplomats told ProPublica that Trump’s new political
appointees have not consulted USAID’s longtime humanitarian experts
when crafting the new policies. As a result, career civil servants
said they are struggling to understand the policy or how to carry it
out.

During an internal meeting early in the week, one of USAID’s top
Middle East officials told mission directors that the bar for aid
groups to qualify for an exemption to Trump’s freeze was high,
according to meeting notes. It took until Thursday for the directors
to receive instructions for how to fill out a spreadsheet with the
programs they think should qualify for a waiver and why, a government
employee told ProPublica. “The waiver for humanitarian assistance
has been a farce,” another USAID official said.

“Like a Russian nesting doll of fuck-ups,” said Jeremy Konyndyk,
who ran some of USAID’s largest programs under Presidents Barack
Obama and Joe Biden. “It’s just astonishing.”

Fear of retaliation is permeating the government’s foreign aid
agencies, which have become some of Trump’s first targets in his
campaign against diversity, equity and inclusion initiatives. Earlier
this week, the administration pulled down photographs of children and
families from the agency’s hallways.

Many are afraid of being punished or fired for doing their jobs.
Officials in USAID’s humanitarian affairs bureau say they have been
prohibited from even accepting calendar invites from aid organizations
or setting up out-of-office email replies.

On Monday, USAID placed about 60 senior civil servants on
administrative leave, citing unspecified attempts to “circumvent”
the president’s agenda. The group received an email informing them
of the decision without an explanation before they were locked out of
the agency’s systems and banned from the building.

“We’re civil servants,” one of the officials said. “I should
have been given notice, due process. Instead there was an agencywide
notice accusing people of subverting the president’s executive
orders.”

Then, on Thursday, the agency’s labor relations director told the
group that he was withdrawing the agency’s decision because he found
no evidence of misconduct, according to emails obtained by ProPublica.

Hours later, the director was put on administrative leave himself.
“The agency’s front office and DOGE instructed me to violate the
due process of our employees by issuing immediate termination
notices,” he wrote to colleagues, referring to Trump’s Department
of Government Efficiency run by Elon Musk. (Musk did not respond to a
request for comment.)

Later that night, the original 60 officials were placed back on leave
again.

Diplomats have long lauded American humanitarian efforts overseas
because they help build crucial alliances around the world with
relatively little cost.

When he created USAID in 1961, President John F. Kennedy called it a
historic opportunity to improve the developing world so that countries
don’t fall into economic collapse. That, he told Congress, “would
be disastrous to our national security, harmful to our comparative
prosperity and offensive to our conscience.”

USAID is responsible for the most successful international health
program of the 21st century. The President’s Emergency Plan for AIDS
Relief, created in 2003 by President George W. Bush to combat HIV
globally, has saved an estimated 26 million lives over the past 22
years. It currently helps supply HIV medicines to 20 million people,
and it funds HIV testing and jobs for thousands of health care
workers, mainly in Africa.

That all ground to a halt this week. Since receiving the U.S.
government’s stop-work orders, contractors who manage the program
say they have so far received little communication about what work
they will be allowed to continue, or when. They are not allowed to
hand out medicines already bought and sitting on shelves.

If the exemption waivers don’t come through, policy analysts and HIV
advocates say the full 90-day suspension of those programs would have
disastrous consequences. More than 222,000 people pick up HIV
treatment every day through the program, according to an analysis
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by amFAR, a nonprofit dedicated to AIDS research and advocacy. As of
Friday morning, those orders had not been lifted, according to three
people with direct knowledge.

Up through last week, PEPFAR was providing HIV treatment to an
estimated 680,000 pregnant women, the majority of whom are in Africa.
A 90-day stoppage could lead to an estimated 136,000 babies acquiring
HIV, according to the amfAR analysis. Since HIV testing services are
also suspended, many of those could go undiagnosed.

The disarray has also reached warzones and foreign governments,
risking disease outbreaks and straining international relationships
forged over decades.

Government officials worried about contract personnel who were
suddenly stranded in remote locations. In Syria, camp managers were
told to abandon their site at al-Hawl refugee camp
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which is also a prison for ISIS sympathizers. That left the refugees
inside with nowhere to turn for basic supplies like food and gas.

In Mogadishu, Somalia, the State Department instructed security guards
who were protecting an arms depot from insurgents to simply walk off
the site, according to a company official. When the guards asked what
would happen to the armory, their government contacts told them they
didn’t have any answers. (Concerns about the armory were first
reported by The Wall Street Journal
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The contractors in Syria and Somalia have since been allowed to return
to their sites.

An executive at a health care nonprofit told ProPublica he has not
been so lucky. His group is still under the stop-work order and
can’t fund medical operations in Gaza, where there is a fragile
ceasefire deal between Hamas and Israel that depends in part on the
free flow of humanitarian aid.

“People will die,” the executive said. “For organizations that
rely solely or largely on U.S. government funding, this hurts. That
may be part of the message. But there would be less drastic ways to
send it.”

In response to criticism, the Trump administration has offered
misinformation. During a press conference, Karoline Leavitt, the White
House press secretary, touted the initiative’s success so far and
said the government “found that there was about to be $50 million
taxpayer dollars that went out the door to fund condoms in Gaza.”
Trump later went further, saying Hamas fighters were using the condoms
to make explosives.

They didn’t name the contractor, but the State Department later
cited
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$100 million in canceled aid packages slated for the International
Medical Corps.

IMC said in a response that no U.S. government funding was used for
condoms or any other family-planning services. The organization has
treated more than 33,000 Palestinians a month, according to the
statement. It also operates one of the only centers in Gaza for
severely malnourished children.

“If the stop-work order remains in place,” IMC said, “we will be
unable to sustain these activities beyond the next week or so.”

There are also new outbreaks of Ebola in Uganda’s capital and of the
disease’s cousin, the Marburg virus, in Tanzania. The U.S. has long
been a key funder of biosecurity measures internationally, including
at high-security labs. That funding is now on hold.

In Ukraine, groups that provide vital humanitarian aid for civilians
and soldiers fighting Russia have been told to stand down without any
meaningful updates in days, according to three officials familiar with
the situation. The halted services include first responders, fuel for
hospitals and evacuation routes for refugees fleeing the front lines.

“These are people who have been living in a war zone for three years
this month,” the head of one of the organizations said, adding that
they may have to lay off 20% of its staff. “And we are taking away
these very basic services that they need to survive.”

A contractor for the U.S. in Yemen said her entire team had been told
to stop their work last weekend, which ProPublica corroborated with
contemporaneous emails. “One of my tasks was summarizing how many
people had been directly saved by our health programs every week,”
she said. “It was usually 80 to 100.”

Their stop-work order has not been lifted. It will be a week on
Sunday.

_Brett Murphy [[link removed]]: I’m
a Pulitzer Prize-winning reporter on ProPublica’s national desk,
where I write about the government, companies and power. email
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_Anna Maria Barry-Jester
[[link removed]]: I report
on global public health and the agencies that govern it, including the
NIH, IHS, USAID and CDC. email
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