In his speech to a joint session of Congress Wednesday night, President Donald Trump described foreign aid programs as wasteful.
But organizations in Massachusetts that have seen funding pulled from their humanitarian work say the cuts will directly result in countless deaths among the world’s most vulnerable populations. And they say the elimination of foreign aid puts the U.S. at risk in a number of ways.
The administration has repeatedly targeted the U.S. Agency for International Development, which for decades has worked with non-governmental organizations to improve health and education worldwide. First came a funding freeze and layoffs within USAID. Then the administration canceled thousands of contracts.
Until its USAID contract was canceled last week, Waltham-based Education Development Center had been helping young people in South Sudan with job skills and placement, in an effort to avoid the pull of gangs and militias.
“With the sudden termination of our program, we’ve had to walk away from these thousands of young people who are in the middle of training programs and employment support,” said Alisha Keirstead, EDC’s director of global health.
The organization also provides teacher training, health education, and care and assistance for HIV-positive children and adolescents, among a range of other programs.
“How many young men end up getting pulled into militias because our support to find a good job suddenly disappeared? Or how many young women end up in exploitative situations because they never developed the literacy and entrepreneurship skills we were going to provide them?” Keirstead said. “These are the kinds of consequences our communities in South Sudan are facing because we’ve been forced to shut down.”
In addition to canceling contracts, the Trump administration has refused to pay contractors for foreign aid work that’s already been completed — totaling about $2 billion in owed funds. On Wednesday, the U.S. Supreme Court issued an order leaving in place a lower court’s ruling that required the administration to pay those bills.
Among the plaintiffs in that lawsuit was Management Sciences for Health , which has an office in Medford and provides health services in 20 countries. The group chose not to make anyone available for an interview for this story, but the lawsuit stated USAID provided about 88% of the organization’s funding. The cuts have forced Management Sciences for Health to furlough nearly 50% of its U.S.-based staff and may need to terminate as many as 1,000 employees abroad.
A spokesperson for the plaintiffs said they were encouraged by the Supreme Court ruling but that they were still waiting for relief.
“Each passing day that we are not compensated for work already performed causes additional harm to American workers and suppliers across the country,” the spokesperson said. “Thousands of jobs all over the U.S. have already been lost, with more likely to come. Hundreds of businesses — primarily small businesses, the backbone of our economy — face an existential crisis and the possibility of financial ruin. Meanwhile, every passing second denies millions around the world the essential care they desperately need, putting countless lives at even greater risk.”
Among those most impacted by the cuts are people living with diseases like HIV and malaria, according to Dr. Joia Mukherjee, medical director for Boston-based Partners In Health .
“More than 20 million people on Earth receive their HIV treatment thanks to a U.S. program, PEPFAR ,” Mukherjee said, referring to the U.S. President’s Emergency Plan for AIDS Relief, which was created in 2003 under then-president George W. Bush. “If those people lose their medicines, the ability to get tests, all of that, they will die. I mean, there’s no alternative at this moment.”
Mukherjee said she recently returned from a trip to Liberia, where the top killer of children is malaria. The mortality rate has dropped in the last 20 years as a result of foreign aid, she said, and the loss of USAID will have an immediate impact.
“Malaria is not something you can wait around for a year for treatment. It’s an acute infection,” she said. “What we’ve seen is that the majority of U.S. money in Liberia that goes to commodities is around malaria treatment. So that will have an immediate effect on children and therefore their families and women. Women also die in childbirth if they get malaria because they already have low blood counts.”
A spokesperson for Partners in Health said the organization has received letters of termination of grants serving patients in three of the 11 countries where they work — Peru, Rwanda and Kazakhstan — as well as programs dedicated to testing, treating, and preventing drug-resistant tuberculosis.
Michael VanRooyen, director of the Harvard Humanitarian Initiative , said the cuts will also result in deaths from food insecurity.
“Stockpiles of grain that are sitting in warehouses in, you know, Sudan cannot be distributed. … There’s some tens of millions of people will not have food aid,” he said. “And what that means is that you’ll push entire populations from being food insecure to becoming malnourished to becoming severely malnourished, and those mortality rates skyrocket at that point.”
Among the Harvard Humanitarian Initiative’s own grants that have come to a halt was a program that sent doctors to Ukraine to train civilians and health care providers on how to care for trauma patients.
The program’s director, Sean Kivlehan, recalled getting a recent message from a student whose apartment was hit by a missile the day after a training session.
“She said she’s so thankful for the training because when the missile struck her building today, her neighbor who was injured and bleeding, she was able to take out the tourniquet that we gave her and apply it and stop the bleeding and get her to the hospital,” Kivlehan recalled.
Harvard relies on other NGOs to make the program possible in Ukraine, Kivlehan said.
“We bring that technical expertise and the skills, but we don’t have really the operational or logistical capacity to move people in and out of different countries, in particular conflict zones,” Kivlehan said. “For us to do our work at Harvard Humanitarian Initiative, we rely on these partners to get us to the places that we need to get us there safely and get the work done. And those partners rely on USAID. So without that funding, the whole partnership starts to collapse.”
There’s currently no active funding to continue the program, Kivlehan said.
While the cuts to USAID are impacting programs overseas, the head of a Tufts University program says they could also have a profound impact on public health in the U.S.
Dr. Hellen Amuguni is a professor at the Cummings School of Veterinary Medicine at Tufts and the director of a program called Strategies to Prevent (STOP) Spillover , which is monitoring the risk around the globe from zoonotic diseases with the potential to spill over into human pandemics. Until last week, the program was funded by USAID.
“We were very confident that our project actually protects the United States,” Amuguni said, adding that she believed a stop work order issued about a month ago would be temporary. She was expecting a request for details on the program so they could make their case and regain funding.
“What’s your project about? What are you doing? What have you done? Where are you going? What’s the impact? That’s sort of our thinking. That’s what we were hoping,” she said “And then we just got an email that said, ‘your award has been terminated immediately.’”
Amuguni, who’s worked in the field for more than 20 years, knows there will be repercussions.
“I can see the impact it will have on any disease that can move around the U.S. We are having an Mpox outbreak. We have an unknown disease going around in the [Democratic Republic of the Congo]. We’ve had a pandemic before, and we saw how many people were impacted, not just through death, but even financially, the livelihoods that were changed and affected,” she said. “Honestly, it’s terrifying that this could happen, especially right now.”
The cuts, Amuguni said, also damage the very idea of what it means to be an American.
“One of the big things that the U.S. has been successful at is empathy,” she said. “USAID had this sticker that said ‘from the American people’ … That’s our story. The story of reaching out. The story of always helping. The story of being there for each other and for someone else. This takes all of that away.”
