In the days after President Trump ordered a pause on nearly all U.S. foreign aid, Secretary of State Marco Rubio suggested that scrutiny on the money the U.S. spends abroad is a matter of plain self-interest.
“Every dollar we spend, every program we fund, and every policy we pursue must be justified with the answer to three simple questions,” Rubio said in a State Department press release . “Does it make America safer? Does it make America stronger? Does it make America more prosperous?”
Chris Beyrer is an internationally recognized epidemiologist who has worked on the front lines of HIV/AIDS and COVID-19 treatment and research. (Image credit: Chris Beyrer)
One may take issue with such a narrow view of the value of foreign development assistance, which is essential to the survival of millions of people in regions affected by war, poverty and the impacts of human-caused climate change. But even by this narrow standard, the Trump administration’s reckless dismantling of U.S. foreign aid programs makes no sense. In fact, it fails all three of Rubio’s tests, making America weaker, less safe, and more prone to shocks that could cripple our economy.
Nowhere is the short-sightedness of the administration’s strategy clearer than in the havoc it has brought on the U.S. Agency for International Development. USAID provides development assistance in more than 120 countries, funding projects that bring health services, education, food and clean water to vulnerable communities across the globe. From building schools to aiding in recovery from natural disasters, its work contributes in important ways to the health and economic development of regions that are prone to poverty, conflict, displacement and the political extremism that can often accompany social and economic disparity.
In terms of direct and tangible benefits to the U.S., one of USAID’s most critical functions is to fight the spread of infectious diseases that have the capacity to spark a global pandemic. In 2014, for example, USAID deployed teams in West Africa to coordinate the response to a fast-growing Ebola outbreak. A significant part of that response was the establishment of screening protocols for people traveling from the affected region, a key measure in preventing an Ebola crisis in the U.S., which recorded only 11 Ebola cases in that year.
A volunteer medical team helping to bury people who died from Ebola in Sierra Leone during an outbreak in 2014. (Image credit: Anadolu/Getty Images)
Such pandemic threats have not gone away. Ebola cases are rising in Uganda , and Tanzania recently experienced a deadly outbreak of Marburg virus , which causes severe hemorrhagic fever. Last August, an outbreak of mpox in the Democratic Republic of the Congo triggered the World Health Organization to declare an international public health emergency , signaling renewed concern about a virus that spread to 122 countries in a 2022 outbreak.
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In other parts of the world, USAID is a critical player in efforts to identify novel forms of avian influenza and other pathogens that have the potential to cause a future pandemic. As part of maintaining this global early warning system, the agency has funded labs and surveillance protocols in more than 30 countries, an investment of more than $900 million in 2023.
The best way to prevent an epidemic in our own country is to control it at its source.
Chris Beyrer, Director of the Duke Global Health Institute
While much of this work is carried out far from the U.S., infectious diseases know no borders, and we have seen countless instances of viruses that arise in one part of the world but quickly find their way to other countries. The best way to prevent an epidemic in our own country is to control it at its source.
What is disappearing is our ability to react to such global health threats. USAID had been leading efforts to respond to the mpox crisis in the DRC, committing more than $55 million to orchestrate efforts to screen for the virus and distribute vaccines. However, among the many devastating impacts of President Trump’s foreign aid freeze is that this work has stopped. All but six of USAID’s 50 staff dedicated to global outbreaks have been fired, and on-the-ground disease response teams have been sent home.
The abrupt withdrawal of staff and financial support has left underresourced health systems such as the DRC’s on the brink of collapse , unable to provide even basic health services. These disruptions continue to affect even the programs permitted to continue under the administration’s narrow waivers for life-saving interventions.
Thousands of children will be paralyzed by polio without access to USAID-funded vaccines, a report has warned. (Image credit: John Moore/Getty Images)
The administration’s announced order to cancel more than 90% of USAID’s foreign contracts , effectively cutting nearly $60 billion in assistance, will only deepen these risks. According to USAID documents obtained by Propublica , discontinuation of the agency’s services is predicted to lead to surges in cases of malaria and drug-resistant tuberculosis. One million more children will suffer severe malnutrition, and 200,000 more will be paralyzed by polio, according to the report.
In dozens of countries around the world, clinics that provide antiretroviral medications to 20 million people living with HIV — most of which rely on USAID for administrative and logistical support through PEPFAR (U.S. President’s Emergency Plan for AIDS Relief) — have been shuttered. According to our research , even just a 90-day interruption in these services will lead to an additional 100,000 HIV-related deaths this year, threatening more than two decades of progress toward ending the global epidemic of HIV and AIDS .
For decades, U.S. leaders on both sides of the political spectrum have recognized the strategic value of these efforts. President John F. Kennedy, who launched USAID in 1961, described foreign aid as “a very powerful source of strength” for the U.S., allowing the country “to exert influence in the maintenance of freedom.” Four decades later, President George W. Bush made historic investments in global health a centerpiece of his national security agenda, launching both PEPFAR, the largest commitment to fight a disease in our history, and the President’s Malaria Initiative.
These presidents, like countless other leaders over the years, understood that working to secure the health and prosperity of other countries is, in fact, a direct investment in our own national health and prosperity. By contrast, what we see today is a haphazard retreat that will inevitably result in a world that is sicker, less stable and perilously exposed to threats such as climate change or a future infectious disease outbreak. We need only to look at the COVID-19 pandemic to understand how a health crisis that emerges in one part of the world can impact lives and economies across the globe. It is a dangerous strategy, and one for which we all may pay dearly.
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