If you don’t typically engage with politics/government, this is the time to do so. If you are American and/or based in the U.S., reaching out to lawmakers, supporting organizations that are mobilizing on this issue, and helping amplify the urgency of this crisis can make a difference.

Why this matters:

1. Millions of lives are at stake
2. Decades of progress, and prior investment, in global health and wellbeing are at risk
3. Government funding multiplies the impact of philanthropy

Where things stand today (February 27, 2025)

The Trump Administration’s foreign aid freeze has taken a catastrophic turn: rather than complying with a court order to restart paused funding, they have chosen to terminate more than 90% of all USAID grants and contracts. This stunningly reckless decision comes just 30 days into a supposed 90-day review of foreign aid. This will cause a devastating loss of life.

Even beyond the immediate deaths, the long-term consequences are dire. Many of these programs rely on supply chains, health worker training, and community trust that have taken years to build, and which have already been harmed by U.S. actions in recent weeks. Further disruptions will actively unravel decades of health infrastructure development in low-income countries. While some funding may theoretically remain available, the reality is grim: the main USAID payment system remains offline and most staff capable of restarting programs have been laid off.

Many people don’t believe these terminations were carried out legally. But NGOs and implementing partners are on the brink of bankruptcy and insolvency because the government has not paid them for work completed months ago and is withholding funding for ongoing work (including not transferring funds and not giving access to drawdowns of lines of credit, as is typical for some awards).

We are facing a sweeping and permanent shutdown of many of the most cost-effective global health and development programs in existence that save millions of lives every year.

• The waivers never worked. Some waivers were processed, but many groups were still waiting on updates as of a few hours ago. Most of the staff at USAID who could authorize the programs to restart have been laid off, and most groups are still awaiting payment.
• Programs that received waivers are being cut now. Even programs that were granted emergency waivers to resume partial functions, such as those under PEPFAR (the President’s Emergency Plan for AIDS Relief), are being cut. 

For EAs, this should raise serious alarm bells. We often focus on identifying the highest-impact, most cost-effective ways to save and improve lives. USAID supports critical initiatives in malaria prevention, vitamin A supplementation, HIV/AIDS treatment, maternal and child health, and more. These programs are among some of the most rigorously evaluated and proven solutions in global health. The elimination of these programs will result in enormous, quantifiable harm, with millions of lives at risk.

Some of the few lifesaving programs that were terminated are:

• Work in Lesotho, Tanzania, and Eswatini to support more than 350,000 people on HIV treatment, including nearly 10,000 children and more than 10,000 women who are pregnant and HIV+ (previously covered under waiver, now terminated)
• The vast majority (likely all) of malaria contracts, including for essential commodities that would have protected 53 million people— nets, diagnostics, treatment, and seasonal malaria chemoprevention (to protect children before the rainy season) were cancelled.
• Contracts with US factories that produce a vital treatment for the most malnourished children in the world.
• Almost all of the Global Health Supply Chain project, which helps deliver billions in lifesaving medical supplies to national governments
• In Nigeria, a nutrition program that supported 77 health facilities across 3 states, putting 60,000 children under 5 at immediate risk of death from preventable causes.
• In Nigeria, training for 10,000 health workers who were set to provide nutrition services to more than 5.6 million children and 1.7 million women

Why this matters for the future of global health & wellbeing

USAID was not perfect by any means, but it has always been an essential partner for improving evidence and cost-effectiveness of foreign aid. This Administration is not taking good faith efforts to improve the effectiveness and accountability of USAID (as shared by Dean Karlan, USAID's first Chief Economist, in an interview with NPR about why he resigned.) USAID should be reformed, not destroyed.

 USAID is a vital and irreplaceable player in the global aid ecosystem and provided critical infrastructure that made all other programming work more effectively. 

• Science & Building the Evidence Base. Many of the interventions we recognize as cost-effective - like vitamin A supplementation, oral rehydration therapy, and community-based treatment for malnutrition - were developed, tested, refined, and scaled up globally with USAID support.
• Surveys & Reliable Data. The Demographic and Health Surveys (DHS) program is the gold standard of global health surveys. The DHS is primarily funded by USAID and as of today, the data repositories are down. Surveys have been conducted in 90 countries since 1984 and provide nationally representative data to track key health trends, including maternal and child health, HIV/AIDS and malaria. DHS data are increasingly used for scientific research. In 2021 and 2022, more than 1,000 articles included “Demographic and Health Surveys” in the title or abstract - the actual utilization for research is likely much higher.
• Early Warning Systems & Coordination. USAID doesn’t just fund direct interventions - it also supports critical infrastructure for global health and crisis response, like the Famine Early Warning Systems Network (FEWS NET) which was created in 1985 after more than 1 million people died in Horn of Africa famine. FEWS NET used to provide data to predict food shortages and prevent famine before it begins. But it’s been offline for weeks. Losing early warning systems like FEWS NET is a devastating blow.

Your action and engagement is needed NOW

This is a moment where political advocacy is not just an adjacent concern—it is a fundamental necessity. If we care about maximizing impact, we cannot afford to ignore the role of government in shaping the global health landscape. Even the most cost-effective interventions cannot function without political will and funding. 

A few actions I recommend:

• Contact Congressional Representatives
  • The good news is that members of Congress from both parties are alarmed. But concern is not enough. They must act. You can find tools for contacting members of Congress on websites like RESULTS (disclaimer, I work there), Oxfam US, and 5 Calls.
• Stay Informed and Mobilize
  • Groups are working to keep the public informed of recent actions - and harm to global communities through initiatives like USAID Stop Work. You can also get connected to advocacy teams in your state through them.
  • I've found Devex and the New York Times to have the most up to date reporting following this crisis and the Center for Global Development is doing timely analysis as well.
• Support organizations working to mitigate harm
  • Advocacy groups: Definitely support with your time and voice. I think there could be a strong argument to re-aligning some financial donations to advocacy, but I'm not sure.  The US government spent billions on global health last year. Even a slightly higher chance of reinstating programs or influencing priorities toward global health could have an outsized impact and affect hundreds of millions of dollars of funding. I would love to hear thoughts in the comments.
  • Implementing groups: There was a forum post recently about bridge funds which could be good to donate to - but your voice as an American/person living in the US can make a HUGE difference. Many smaller NGOs will not be able to work as effectively without the infrastructure USAID provides globally. 

While many EAs tend to focus on private philanthropy, this crisis highlights why government action is indispensable. The global health community is rallying to push back against these terminations. The effective altruism community should join them. Lives are at stake, and the cost of inaction is simply too high.