Foreign Aid on Pause: What It Means for Global Health

President Trump’s 90-day freeze on foreign aid has halted funding for humanitarian and global health programs, sparking legal battles and uncertainty over its long-term impact.

On Jan. 20, 2025, President Donald Trump announced a 90-day freeze on foreign aid, marking a significant shift in U.S. foreign policy. Foreign aid accounts for 1% of the federal budget but plays a critical role in supporting humanitarian efforts. The freeze has sparked concern among experts, particularly regarding its impact on global health efforts.

As the agency primarily responsible for administering foreign aid, USAID has been most affected by the freeze. In accordance with President Trump’s Executive Order on Reevaluating and Realigning United States Foreign Aid, Secretary of State Marco Rubio has paused all U.S. foreign assistance funded by the State Department and USAID. The Executive Order cites a “90-day pause in United States foreign development assistance for assessment of programmatic efficiencies and consistency with United States foreign policy.” 

Initially, only emergency food programs and military aid to Israel and Egypt were exempt from the freeze. In late January, Secretary Rubio expanded the extension to include “life-saving humanitarian assistance,” but uncertainty over what qualifies as such has left many programs in limbo. 

One of the primary concerns among health officials and organizations is the freeze’s impact on global health programs. The World Health Organization (WHO) chief, Dr. Tedros Adhanom Ghebreyesus, notes, "There are actions that the US government is taking... which we're concerned are having a serious impact on global health."

Among the programs facing uncertainty is the President’s Emergency Plan for AIDS Relief (PEPFAR), which has been a cornerstone of the global HIV/AIDS response.

On February 10, 2025, the State Department approved a waiver to resume treatment and prevention services for mother-to-child transmission of HIV. However, many—including UNAIDS, the Joint United Nations Program on HIV/AIDS—continue to express concerns.

UNAIDS argues that critical services—such as condom distribution, HIV testing, antiretroviral treatment, and pre-exposure prophylaxis (PrEP) for HIV prevention—remain unavailable to vulnerable populations beyond pregnant and breastfeeding women.

If PEPFAR funding is not renewed from 2025 to 2029, UNAIDS estimates a catastrophic 400% increase in AIDS-related deaths, amounting to 6.3 million additional fatalities.

Experts say that the funding freeze will affect more than just HIV/AIDS programs. Dr. Tom Wingfield, an expert in tuberculosis (TB), told the BBC it is difficult to underestimate the impact the freeze will have on global health. "People don't appreciate the extent and reach of USAID. It goes towards under-nutrition, hygiene, toilets, access to clean water, which all have a massive impact on TB and diarrhoeal diseases.” Professor Rosa Freedman, Professor of Law, Conflict and Development at the University of Reading, echoes Dr. Wingfield's sentiment, stating, “The prevention of further vaccines being distributed or funded by USAID… could mean that preventable diseases, which we thought had been contained or even eradicated, could reappear or worsen.”

Beyond the immediate funding freeze, the future of USAID itself seems to be up in the air. The Trump administration has moved to eliminate more than 90% of the agency’s foreign aid contracts, resulting in 5,600 employees being fired or placed on leave. On X, Elon Musk criticizes the agency, writing, “USAID is a criminal organization. Time for it to die.”

On Feb. 13, 2025,  a federal judge in Washington, D.C., ordered the Trump Administration to temporarily lift the freeze on all funding of USAID programs around the world and set a five-day deadline for the administration to prove that it is complying. On Feb. 26, 2025, Chief Justice Roberts issued an “administrative stay,” which allows the USAID freeze to continue while the justices continue to deliberate.

As the 90-day freeze nears its end and legal battles continue, the long-term effects on global health remain uncertain. “The administration’s dismantling of the agency has completely invited the next pandemic to unravel and to come to the United States,” a former global health bureau official tells NBC.

Apart from public health, the freeze raises questions about America’s role in international development. As the U.S. withdraws from previous global health commitments to pursue the “America First” agenda, this begs the question of whether other nations will step in to fill the void. U.S. Democratic Senator Andy Kim, warns, “China doesn’t even need to fight for their influence around the world now because of our own effort.” With the U.S. shifting its approach, the world will be watching to see whether this freeze strengthens American national priorities, or creates new challenges for global health and international influence.