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An investigation published Tuesday reveals how the Trump administration's cuts to foreign aid—even those that have been quickly restored under public pressure—have proven deadly for children in poverty-stricken nations.
The halting of a global supply chain program that ships crucial antimalarial and HIV medications around the world was one of President Donald Trump's first actions, as Secretary of State Marco Rubio said that many of the programs run by the US Agency for International Development "run counter to what we’re trying to do in our national strategy" and moved to end USAID's operations.
Portions of the Global Health Supply Chain Program resumed within days of Trump's executive order suspending foreign aid, but as The Washington Post reported in its exclusive investigation, "the suspension had lingering effects that left aid deliveries severely disrupted for months" and severely reduced public healthworkers' ability to distribute lifesaving medications, screening tests, and other supplies to more than 40 countries.
While more than $190 million worth of anti-HIV/AIDS and antimalarial supplies were scheduled to arrive at distribution warehouses by the end of June, nearly $76 million did not arrive, including a majority of the medications to fight malaria.
Medical supplies worth $63 million did eventually make it to warehouses, but were delayed by 41 days on average, and many sat on warehouse shelves for weeks instead of being sent to clinics and hospitals.
The newspaper told the story of five-year-old Suza Kenyaba, one victim of the delay in the Democratic Republic of Congo, who contracted malaria when the medication supply chain was in a state of chaos due to Trump's order.
"The Trump administration's claim that no one has died from cuts to USAID is devastatingly and disastrously untrue."
The medication the little girl needed was just seven miles away from the clinic where she was battling a high fever caused by the infection, but the disruption to the supply chain program left the medicine stranded in a warehouse.
"The medication that USAID sent was seven miles away due to Trump chaos and suspensions," said Sen. Amy Klobuchar (D-Minn.). "It would have saved her life. Shame. This is not leadership. This is callous arrogance."
The Post published its report a week after Rubio appeared on ABC News and told anchor George Stephanopoulos flatly that "no one has died because the United States has cut aid."
The secretary of state claimed—contrary to evidence—that the administration had simply worked to structure programs to make them more efficient.
But as the Post reported, the stop-work order issued by the administration had rippling effects across the foreign aid pipeline. Chemonics, a contractor that operates the Global Health Supply Chain Program, lost access to a government payment system, inhibiting its "ability to order suppliers to resume work.” As a result, it was forced to furlough 750 people in its US workforce as well as lay off local staff.
While Rubio rolled back some of the foreign aid cuts in late January, issuing a blanket waiver for "lifesaving humanitarian assistance," Chemonics' logistics program that delivers medications from local warehouses to clinics like the one where Kenyaba was fighting malaria was not included in the waiver.
The investigation revealed, said one observer, that Trump has the "deaths of children on his hands."
Oxfam America called on Congress to "fund lifesaving aid."
"The Trump administration's claim that no one has died from cuts to USAID is devastatingly and disastrously untrue," said the group. "Their attacks on USAID stranded lifesaving medication and children died waiting."
The US Supreme Court on Friday gave President Donald Trump the green light to withhold billions of dollars of congressionally approved foreign aid, a major win for the White House and executive authority and, according to critics, a body blow to the bedrock constitutional principle of congressional power of the purse.
The high court's right-wing majority found that "the asserted harms to the executive’s conduct of foreign affairs appear to outweigh the potential harm" to aid recipients, while cautioning that "this order should not be read as a final determination on the merits."
BREAKING: Supreme Court lets Trump unilaterally freeze billions in congressionally appropriated foreign aid money apparent 6-3 vote with liberals in dissent @courthousenews.bsky.social
The Trump administration sought not only validation of its claimed ability to claw back spending previously approved by Congress—which under the Constitution generally holds power of the purse—but also of "pocket recission," a highly contentious budgetary maneuver to cancel previously approved federal expenditures by exploiting legal ambiguity in the Impoundment Control Act (ICA).
Democrats and many legal experts contend that pocket recissions are illegal, and Democratic lawmakers warned even before Trump's White House return that he would try to use the tactic in order to refuse to disburse funds allocated by Congress for social programs.
Justice Elena Kagan—who dissented along with fellow liberals Sonia Sotomayor and Ketanji Brown Jackson—asserted that the majority approved "essentially a presidential usurpation of Congress' power of the purse."
"The stakes are high: At issue is the allocation of power between the executive and Congress over the expenditure of public monies," Kagan said.
“That is just the price of living under a Constitution that gives Congress the power to make spending decisions through the enactment of appropriations laws,” she wrote. “If those laws require obligation of the money, and if Congress has not by rescission or other action relieved the executive of that duty, then the executive must comply.”
Earlier this year, the Supreme Court dealt a temporary blow to Trump's evisceration of the US Agency for International Development (USAID) in a ruling that left intact a lower court's decision ordering the resumption of approximately $2 billion in foreign aid frozen by the administration.
Friday's ruling could complicate bipartisan negotiations to avert a Republican government shutdown as the September 30 deadline looms. Democratic negotiators now worry that Trump, buoyed by the high court decision, could again refuse to spend funds designated by Congress.
“Today’s ruling allows the administration to unilaterally refuse to spend $4 billion in foreign assistance funds that it is required by law to spend," said Nicolas Sansone, an attorney at the consumer advocacy group Public Citizen and counsel for the AIDS Vaccine Advocacy Coalition. "This result further erodes separation of powers principles that are fundamental to our constitutional order. It will also have a grave humanitarian impact.”
With newly embraced direct cash assistance programs a casualty of the Trump administration's slashes to foreign aid, a study released Monday showed that such direct transfers had a "showstopping result" in reducing child mortality rates in low-income families in the Global South.
The National Bureau of Economic Research (NBER) on Monday released a study of cash transfers given to more than 10,000 households in Siaya County, Kenya between 2014-17 by the nonprofit group GiveDirectly.
The group provided $1,000 in three installments—without conditions on how it would be spent—over eight months to the families, covering about 75% of their expenses.
Researchers examined the effects over a decade, completing census surveys and collecting data on households that received the funds versus those that didn't.
Unsurprisingly, and as numerous previous studies have shown, the NBER found that the cash transfers dramatically improved the families' lives, helping them to sustain themselves even amid a drought and the coronaviruspandemic. Economic activity in the 650 villages the researchers examined also improved.
But the dramatic decline in infant and childhood mortality rates "became obvious almost immediately," the New York Times reported, and surprised the researchers and other observers.
"This is easily the biggest impact on child survival that I've seen from an intervention that was designed to alleviate poverty," Harsha Thirumurthy, an economist at the University of Pennsylvania who was not involved in the study, told the Times.
NBER found that the unconditional cash transfers led to 48% fewer deaths before a child reached age 1 and 45% fewer deaths in children under the age of 5.
The transfers appeared to help mothers take parental leave, with a 51% decline in women performing hard labor in the last months of their pregnancies and the three months after giving birth.
The direct infusion of cash also helped women receive prenatal care they might otherwise not have received.
"I have seen firsthand what it means when an expectant mother can't access timely care," said Dr. Miriam Laker-Oketta, a senior research adviser for GiveDirectly, in a video posted on YouTube by the group about the project's results. "I remember a time when a woman arrived after being in labor for three days. Sadly, by the time she arrived, her baby had already died. Our clinic was nearby, but she never had a prenatal visit where her condition might have been caught early."
Laker-Oketta told the Times that "when you come across an intervention that reduces child mortality by almost a half, you cannot understate the impact."
The research was released four months after US State Department spokesperson Tammy Bruce said in a press briefing that the Trump administration was terminating a number of foreign assistance awards "because they provided cash-based assistance, which the administration is moving away from given concerns about misuse and lack of appropriate accountability for American taxpayers here at home."
That announcement came just six months after the US Agency for International Development (USAID) signaled a long-awaited shift and said it would "include direct monetary transfers to individuals, households, and microenterprises... as a core element of its development toolkit."
"Critically, transfers respect the dignity of individuals, households, and microenterprises by allowing them to make spending and investing decisions, while also promoting efficient markets such that entire communities and regions, not just recipients benefit. In sum, direct monetary transfers provide USAID with a flexible and localized programming approach to achieve development objectives," said the agency in a position paper last October.
As Daniel Handel, a policy director at the foreign aid think tank Unlock Aid, toldNPR this month, the embrace of direct monetary aid at the agency "was largely unheard of" a decade earlier.
"There was an amazing amount of handwringing about the idea," Handel told NPR, with officials concerned about families "misspending" the money. The shift last year was "a real sea change," he added.
As Common Dreams has reported, experts have warned that President Donald Trump's cuts to foreign aid will be a "death sentence for millions of people" in the Global South.
According to a study published in TheLancet last month, "projections suggest that ongoing deep funding cuts—combined with the potential dismantling of the agency—could result in more than 14 million additional deaths by 2030, including 4-5 million deaths among children younger than 5 years."
A federal court ruled last week that Trump can move forward with the cuts, including nearly $4 billion in funding for global health programs and more than $6 billion for HIV and AIDS programs.
NBER's study suggested the State Department's plan to abandon cash transfers could be a driving cause of the "death sentence" caused by the cuts; the researchers found that "infant and child mortality largely revert to pre-program levels after cash transfers end."
