"Many people will die because of this": the dismantling of the USAID agency

WashingtonThe aggressive dismantling of the international aid agency USAID has not only unleashed chaos and fear among federal workers in Washington. With programs in more than 100 countries around the world, the effects of the foreign aid freeze and the agency's shutdown have reverberated to thousands of people. "We are seeing immediate repercussions on the ground. Vital health programs like PEPFAR [for treating HIV] have had to turn away patients, including pregnant women, because of confusion in the guidelines. Communications have been cut off with NGOs that we worked with on hunger programs, on which they depend." He denounced one of the agency's workers who spoke to ARA after being temporarily suspended from work last week, like thousands of her colleagues.

The United States is the largest provider of humanitarian aid in the world, yet its federal foreign aid budget, which includes USAID, only accounts for 0.7-1.4% of the total budget. Three out of every five dollars of foreign aid is managed through USAID, which funds projects to combat epidemics, educate children, provide clean water and support other areas of development. According to fiscal year 2023 data provided by the Congressional Research Service (CRS), USAID managed more than $43 billion. The three largest recipients were Ukraine, Ethiopia and Jordan. Other countries that receive a large share of the budget include the Democratic Republic of the Congo, Afghanistan, South Sudan and Syria.

Programs to combat hunger or HIV are the ones that have the most dramatic consequences on the lives of thousands of people. And yet, they are the ones that cost USAID the least money. In 2023, it allocated $10.5 billion to humanitarian aid, some $811 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and more than $330 million in emergency food and nutrition assistance for Afghanistan.

Initially, US Secretary of State Marco Rubio signed an exemption to resume funding for programs deemed "vital." But it was not clear whether the HIV treatment program fell into this category. The NGO Doctors Without Borders (which does not receive US funding) reports that many people in South Africa, Mozambique, Zimbabwe, the Democratic Republic of Congo and South Sudan have been left without medical care and are living with the uncertainty of not knowing whether they will be able to resume HIV treatment.

"Although a limited exemption has been approved covering some activities, what our teams are seeing in many of the countries where we work is that many people have already lost access to vital treatments and do not know whether they will continue to receive them. MSF calls on the US government to immediately resume funding for ", said Avril Benoît, executive director of MSF in the United States, in a statement on Thursday.

With the focus on health and disease prevention alone, the dismantling of USAID will have a global impact in the short and long term. "USAID programs have helped contain malaria, HIV and other infectious diseases, which could now end up spreading, mutating and becoming phenomena that are difficult to predict. We saw this with Covid. Diseases do not stay within the borders of a particular country, and we often do not know how they will mutate" American Progress. McManus also points out how hunger will be a serious problem. "Once hunger sets in, it is not just a matter of giving some food. A major medical intervention will be necessary."

Along the same lines, Adam Wexler, director of the global health area of the health policy organization KFF, recalls that the United States had a key role in tracking outbreaks of infectious diseases. "Will these efforts continue? And if not, what will happen? Will there be outbreaks that go undetected and turn into something more serious? The US government has granted waivers for some of these activities to continue, but there are reports that there is no staff to implement them. In addition, the accounting system that should fund these services is not operational."

'Soft power'

The Congressional Research Service has also revealed that in 2023, USAID allocated the bulk of its budget (about $17 billion) to "governance" issues, despite its humanitarian aspect. In fact, the cooperation agency was created by President John F. Kennedy in 1961 as a tool of American influence or soft power during the Cold War. With its dismantling, it leaves a "huge vacuum" for China and Russia to deploy their influence in countries that the US is interested in having as partners, McManus points out. "China's practices are quite predatory if you look at how it has acted in humanitarian settings in some African countries. It often leaves them heavily indebted and unable to deal with crises on their own. It is also worrying to see the US, which is the largest military power and the largest economy in the world, completely withdrawing from humanitarian settings.

An example of this soft power These are some of the programs that USAID had in Central America to discourage immigration to the US. "The last program I worked on was aimed at young people and served to offer them economic opportunities so that they would stay in Honduras and not emigrate. In other words, it was a program that dealt precisely with one of the priorities of the new administration. But, deep down, they don't care about that," laments another USAID worker who, like the rest, is only willing to talk.