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Study Finds Cash Transfers Reduce Childhood Deaths by Nearly Half as Trump Cuts Threaten Direct Aid
"This is easily the biggest impact on child survival that I've seen from an intervention that was designed to alleviate poverty," said one researcher.
Aug 18, 2025
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 coronavirus pandemic. 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, told NPR 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 The Lancet 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."
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America First Is America Alone
Trump's cruel and misguided destruction of global public health is a horrific sight to behold.
Aug 17, 2025
The totalitarian playbook that Donald Trump seems to follow lacks a chapter. Power-crazed the president may be, but he fails to grasp soft power. Wise military and diplomatic minds understand it well. George C. Marshall, the nation’s top general through World War II and later secretary of state and secretary of defense, lent his name and his energies to the greatest exercise of soft power in American history, the Marshall Plan. Such was his stature that, with help from President Harry Truman and Senator Arthur Vandenberg, he persuaded an isolationist post-World War II Congress to approve the costly program and so secured western Europe from Soviet political control, while defining the preeminent battle line of the Cold War.
More than six decades later, Jim Mattis, a retired four-star Marine Corps general who served as secretary of defense in the first Trump administration (when experience and professionalism were sometimes entertained in the Oval Office), championed soft power as Marshall had done. In testimony to Congress in 2013, he said, “If you don’t fund the State Department fully, then I have to buy more ammunition.” He was endorsing the soft power of diplomacy — to which he might have added the soft power of non-military assistance and moral and cultural influence. Soft power is the ability to “obtain the outcomes one wants through attraction and persuasion rather than coercion and payment” — through means, that is, other than bullets, bullying, and bribery.
The United States Agency for International Development (USAID) was a lineal descendant of the Marshall Plan and an embodiment of soft power. Its abandonment and ultimate destruction by the second Trump administration marks a watershed moment in the projection of American influence globally. Next to its headstone in the graveyard of institutions, one might also place a marker for the era that publisher Henry Luce once labelled “the American Century.” Like a married couple, the agency and its century deserve to be buried together, their lives having been intertwined and their dates nearly the same.
The Murder Was Not Premeditated
A possibly ketamine-pumped Elon Musk, brandishing a chainsaw at the Conservative Political Action Conference in February, proved an apt image for the Trumpist demolition of government institutions this year. The hideously misnamed Department of Government Efficiency, then led by Musk, performed no meaningful analysis of which government functions were essential to preserve, let alone which civil servants had the expertise and experience to make such functions viable. Employees were simply fired en masse in the bureaucratic equivalent of a meat-cleaver amputation (no scalpels involved).
Initially, there was no plan to demolish USAID, just shrink it. However, what began as layoffs and the appointment of unqualified individuals to positions of authority led to resistance from employees loyal to their agency and their mission. That, in turn, prompted further cycles of layoffs and demolition. When the red mist of fighting finally lifted, there wasn’t much left of the agency. Its remains were swept into the State Department, accompanied by solemn assurances that vital humanitarian programs had not been and would not be compromised, assurances no more real than an invitation to buy the Brooklyn Bridge.
Yes, USAID had problems. What $30-billion-a-year organization doesn’t? Some of its long-term advocates decried its faults as loudly as any MAGA cheerleader. In the words of one veteran partner of the agency, “The bureaucracy… was legion, hugely frustrating. In order to donate/spend a dollar you had to spend three, just to make sure the treasury wasn’t getting ripped off.”
It’s vital to understand that the agency’s sclerotic procedures and glacially slow decision-making resulted not from the rampant waste, fraud, and abuse alleged by Trumpists but in order to avoid those evils. As a top executive of one of USAID’s largest contractors told me, “Outside auditors were never not in our offices.” Every expenditure was examined, checked against the highly detailed contract and program of work, and verified.
In cases where speed was necessary or where arrangements in some back-of-beyond province were too fragile, USAID bypassed its labyrinthine contracting process and made direct grants to non-governmental organizations, or NGOs, that were locally based and staffed whenever possible. Admittedly, in those cases financial controls were looser, usually because scant infrastructure and operational uncertainties made bean-counting impossible. Sometimes, to build capacity or save lives, a relief organization simply has to wing it. It’s tough to have it both ways.
Condoms for Hamas!
The Trump administration’s diligent researchers wasted no time in unearthing the most egregious examples of abuse. In her first White House briefing, Press Secretary Karoline Leavitt bragged that the administration had blocked a lunatic plan to buy $50 million worth of condoms for Palestinians in Gaza. A victory for common sense, right?
Wrong! The Gaza in question was a province of Mozambique, 29,000 square miles in size and supporting a population of about 1.4 million. The USAID grant would have funded family planning services in that poverty-stricken region. The confusion no doubt derived from a DOGE word search, similar to the one that caused photos of the B-29 that dropped the atomic bomb on Hiroshima to be marked for deletion from Defense Department websites because, well, the plane’s name was Enola Gay, which to Elon Musk’s whiz kiddies sounded DEI-ish. (Actually the plane was named for the pilot’s mother.)
Even after the mistake was reported to the White House, Trump repeated it (with elaboration): “We identified and stopped $50 million being sent to Gaza to buy condoms for Hamas… They’ve used them as a method for making bombs.”
Possibly his staff lacked the guts to tell him the boast wasn’t true. Possibly he thought it was just too good a line not to use.
HIV, Malaria, Malnutrition
The humanitarian consequences of USAID’s destruction have not gone unnoticed. Issue-specific websites have sprung up to tally the cost in money and lives. The New York Times, Washington Post, and other leading news outlets have published dispatches from impacted areas documenting the harm being done. Esteemed journals like the Lancet and Science have published reports from on-going field studies predicting dire outcomes. When I’ve brought such sources to the attention of ostensibly intelligent members of the MAGA faithful, I’ve been told that the estimated losses can’t be modeled, or that ChatGPT says the models are flawed, or that domestic humanitarian needs should take priority over foreign ones. Sound familiar? It’s climate-change denial in a new suit of clothes.
Such debating tactics track well with Dietrich Bonhoeffer’s analysis of stupidity. In his telling, stupidity is “not an intellectual defect but a human one.” Bonhoeffer deemed stupidity “more dangerous” than evil because, unlike evil, it cannot be directly contested. Bonhoeffer, a German anti-fascist who died for his heroism in 1945, described the characteristics of stupidity this way: “reasons fall on deaf ears; facts that contradict one’s prejudgment simply need not be believed… and when facts are irrefutable they are just pushed aside as inconsequential.”
Zambia provides some consequential facts: USAID assistance to Zambia peaked in 2024 at $409 million. Assistance under the Trump regime for 2025 has plummeted to $61.6 million, a decrease of 85%. More than half of those funds ($34 million) are marked for combatting HIV/AIDS, which sounds reassuring. Essential stuff will still get done, right? Oops, sorry, the previous 10-year average for USAID’s Zambia HIV/AIDS program was $147.7 million (and those years included both the first Trump administration and the chaos of the Covid pandemic years).
When you slash a program by 85%, what happens to the mothers and children who depend on it for life-saving therapies? Even if you continue to buy some of the drugs, you still have to deliver them to widely dispersed patients in countries with limited transportation infrastructure. So, if the administrators, warehousemen, truck drivers, and clinicians who make the system work have been fired, and if the warehouse and office leases have been terminated, and now fuel-less, unrepaired trucks remain mothballed, maybe the drugs will find their way to the dump or the black market, but they surely won’t be going where originally intended or most needed.
Something similar happened to 500 metric tons of high-energy food bars stockpiled in Dubai in the United Arab Emirates and intended for mothers and children facing malnutrition. Trump officials, with a customary lack of accountability, blamed the Biden administration for having bought too much, creating an unneeded surplus. Now that the use period for the bars has expired, they will be burned, dumped, or converted to animal feed. Evidently, the Trump administration failed to find any people who needed nourishment. One wonders if they looked in South Sudan. Or in Gaza. No, not that Gaza! The other one.
Applying a Wrecking Ball to Multiple Successes
USAID wasn’t the only U.S. agency fighting HIV/AIDS in Zambia, nor was the U.S. the only nation in the fight, but the U.S. provided about 44% of overall funding for the program. Here’s what we and our global partners, including Zambia itself, managed to accomplish: “Despite population increase, AIDS-related deaths in Zambia dropped from 120,000 in 2001 to 19,000 in 2022” — that’s a drop of 84%. Elizabeth Burleigh, an international health expert with nearly three decades of experience with USAID in Latin America and Africa, provided me with those numbers. As she put it, “This was due to global efforts in prevention, particularly the use of condoms and reduction in the practice of multiple concurrent partnerships, and to increased access to anti-retroviral therapy.” The near-conquest of HIV/AIDs in Zambia is a great story and it’s not the only one.
In Africa, malaria kills far more people than AIDS, but the fight against that grim disease has been hugely successful, too. Its incidence in Zambia has dropped by two thirds since 1996, when the U.S. began funding malaria control. Children under five and pregnant mothers, both of whom are especially vulnerable, have seen their rates of infection drop by half in those years. Currently, the U.S. provides about a third of anti-malarial funding in that country. President Trump’s current budget proposal for FY 2026, however, would cut that contribution by half.
The story of tuberculosis, Dr. Burleigh points out, is another chronicle of reduced infection rates and lives saved. But here’s the catch: if you’re serious about controlling infectious disease, as the U.S. used to be, you commit to the long haul. You don’t turn the funding on and off like a spigot. If you do turn it off, as the Trump administration has indeed done, you have to expect significantly more people to get sick and many of them to die, while hard-earned progress in reversing the spread of debilitating and often fatal diseases will itself be reversed. You can visualize the outcome of funding cuts for HIV/AIDS, malaria, and tuberculosis in a two-line graph: long-term funding gradually rises over a period of decades until 2025, when it suddenly plunges, while the long-term trend of diminishing deaths, inversely proportionate to funding, ceases its decline and begins to leap upward.
At Least the Trumpists Are Being No Less Cruel to American Citizens
One might sensibly strive to reform and improve USAID or, if termination were imperative, to at least devise a thoughtful and compassionate strategy for weaning countries, patients, and other beneficiaries from its programs. What stands out amid the carnage wrought by the Trumpists, however, is its sheer meanness. In the mob world, “making your bones” is shorthand for establishing your bona fides. Part of the mythology of gangsterdom is that an entry-level thug makes his bones by murdering someone. Contemporary bro culture features an analog to this. A true bro cultivates a harsh, insouciant machismo. He’s no softie and he’s not afraid to be cruel. He’s Joe Rogan. He’s Stephen Miller. He’s Pete Hegseth. He’s Russell Vought, Trump’s director of the Office of Management and Budget and an architect of Project 2025. Vought has said publicly of federal employees: “We want to put them in trauma.” Within the bro culture now ascendant in the Oval Office, compassion has become a form of squeamishness — and the people USAID used to serve are paying the price.
Should we care about the deaths caused by abrogating our commitments? Should the abandonment of possibly hundreds of thousands of individual human beings in mid-treatment trouble our sleep? Well, for perspective, it may be worth knowing that Trump’s crew is doing the same thing to thousands of as-yet-uncounted American citizens, thanks to chainsaw cuts to the budget of the National Institutes of Health, the largest funder of biomedical research on the planet. NIH has been forced to terminate research-funding affecting at least 113 clinical trials around the country involving thousands of patients. Some of those participants were being kept alive by the therapies the trials provided. Some have devices planted in their bodies, including experimental brain implants, that will no longer be serviced or monitored. Good luck to them.
And let’s not even talk about the impacts on non-human subjects in terminated medical research programs. No one wants to think about the millions of laboratory rodents and the thousands of macaques and other primates that will be euthanized because the government has reneged on their support. In some cases, the animals represent genetic strains that have been developed over many years and their loss will compromise prospects for future research for many years to come. Bones, indeed. The Trump administration is making a lot of bones.
What Used to Be in It for Us
Let’s talk, for a moment, about self-interest. What good did USAID do for this country? For starters, it created markets for our goods, especially agricultural surpluses, which USAID was still purchasing to the tune of several billion dollars annually before the recent chainsaws arrived. The shopping list grew longer with time and lately included billions of dollars-worth of drugs, test kits, contraceptives, medical equipment, personal protective equipment, computers (to help curb all that waste, fraud, and abuse), construction equipment, and goodness knows what else — the whole catalog of things that people, institutions, and developing nations need. Buy America!
Add to that the friends (or in some cases the non-enemies we made): the millions of refugees in camps around the world who saw “USDA” (United States Department of Agriculture) stamped on the bags of meal and beans that kept them alive; the patients and staff of the clinics and medical programs we funded; the in-county employees of not just USAID and its contractors but the NGOs that carried out so much of the agency’s programmatic work; the government officials whose agendas we advanced (and with our money also shaped); and our global partners, both other nations and multinational alliances, to whom we made what seemed to be solemn, multi-year commitments. Can you blame any of them for now feeling betrayed?
The list of benefits also included intelligence, the kind not gathered by spies but by something better: having eyes and ears in places where it’s hard to go, having a network of care and reciprocity that wrapped around the world, creating a “distant early warning” system for everything from epidemics to grassroots discontent. And yes, there were other, unquantifiable gains to be made for national security, because where misery and instability decline, peace can grow. That’s good for America and good for American businesses.
And then there’s the issue of influence, if not hegemony. In the capitals and far corners of the developing world, which superpower will people and their governments favor when a choice is to be made? Now that the many nations and populations that USAID once cultivated, provisioned, and cared for feel double-crossed by the Trump regime, who will benefit most? (Xi Jinping, is that a smile on your face?)
Donald J. Trump and his minions think they’re right to put America first. What they don’t understand is that, defined in their narrow way, “America First” is America Alone. In an interconnected world, those who are alone, to use a favorite word of the president’s, are losers.
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Rights Group Pushes Delaware AG to Revoke Gaza Humanitarian Foundation's Corporate Charter
A Center for Constitutional Rights lawyer called on Kathy Jennings to "use her power to stop this dangerous entity that is masquerading as a charitable organization while furthering death and violence in Gaza."
Aug 13, 2025
A leading U.S. legal advocacy group on Wednesday urged Delaware Attorney General Kathy Jennings to pursue revoking the corporate charter of the Gaza Humanitarian Foundation, whose aid distribution points in the embattled Palestinian enclave have been the sites of near-daily massacres in which thousands of Palestinians have reportedly been killed or wounded.
Last week, the Center for Constitutional Rights (CCR) urgently requested a meeting with Jennings, a Democrat, whom the group asserted has a legal obligation to file suit in the state's Chancery Court to seek revocation of the Gaza Humanitarian Foundation's (GHF) charter because the purported charity "is complicit in war crimes, crimes against humanity, and genocide."
CCR said Wednesday that Jennings "has neither responded" to the group's request "nor publicly addressed the serious claims raised against the Delaware-registered entity."
"GHF woefully fails to adhere to fundamental humanitarian principles of humanity, neutrality, impartiality, and independence and has proven to be an opportunistic and obsequious entity masquerading as a humanitarian organization," CCR asserted. "Since the start of its operations in late May, at least 1,400 Palestinians have died seeking aid, with at least 859 killed at or near GHF sites, which it operates in close coordination with the Israeli government and U.S. private military contractors."
One of those contractors, former U.S. Army Green Beret Col. Anthony Aguilar, quit his job and blew the whistle on what he said he saw while working at GHF aid sites.
"What I saw on the sites, around the sites, to and from the sites, can be described as nothing but war crimes, crimes against humanity, violations of international law," Aguilar told Democracy Now! host Amy Goodman earlier this month. "This is not hyperbole. This is not platitudes or drama. This is the truth... The sites were designed to lure, bait aid, and kill."
Israel Defense Forces officers and soldiers have admitted to receiving orders to open fire on Palestinian aid-seekers with live bullets and artillery rounds, even when the civilians posed no security threat.
"It is against this backdrop that [President Donald] Trump's State Department approved a $30 million United States Agency for International Development grant for GHF," CCR noted. "In so doing, the State Department exempted it from the audit usually required for new USAID grantees."
"It also waived mandatory counterterrorism and anti-fraud safeguards and overrode vetting mechanisms, including 58 internal objections to GHF's application," the group added. "The Center for Constitutional Rights has submitted a [Freedom of Information Act] request seeking information on the administration's funding of GHF."
CCR continued:
The letter to Jennings opens a new front in the effort to hold GHF accountable. The Center for Constitutional Rights letter provides extensive evidence that, far from alleviating suffering in Gaza, GHF is contributing to the forced displacement, illegal killing, and genocide of Palestinians, while serving as a fig leaf for Israel's continued denial of access to food and water. Given this, Jennings has not only the authority, but the obligation to investigate GHF to determine if it abused its charter by engaging in unlawful activity. She may then file suit with the Court of Chancery, which has the authority to revoke GHF's charter.
CCR's August 5 letter notes that Jennings has previously exercised such authority. In 2019, she filed suit to dissolve shell companies affiliated with former Trump campaign officials Paul Manafort and Richard Gates after they pleaded guilty to money laundering and other crimes.
"Attorney General Jennings has the power to significantly change the course of history and save lives by taking action to dissolve GHF," said CCR attorney Adina Marx-Arpadi. "We call on her to use her power to stop this dangerous entity that is masquerading as a charitable organization while furthering death and violence in Gaza, and to do so without delay."
CCR's request follows a call earlier this month by a group of United Nations experts for the "immediate dismantling" of GHF, as well as "holding it and its executives accountable and allowing experienced and humanitarian actors from the U.N. and civil society alike to take back the reins of managing and distributing lifesaving aid."
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