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A cable from the U.S. State Department Tuesday showed that the Trump administration is eliminating the entire international workforce of the foreign aid agency that has provided lifesaving assistance in the Global South for over six decades.
“The Department of State is streamlining procedures under National Security Decision Directive 38 to abolish all USAID overseas positions,” read the cable, referring to the U.S. Agency for International Development. The document was obtained by The Guardian.
USAID was one of the first targets of the so-called Department of Government Efficiency (DOGE), whose former leader, billionaire Elon Musk, has baselessly called the agency a “criminal organization.”
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Secretary of State Marco Rubio announced in March that 5,200 of the agency’s 6,200 international initiatives had been eliminated and that the few remaining programs were now under the control of the State Department.
The announcement by Rubio on Tuesday means all foreign assistance programs will be managed by the department, with the administration firing hundreds of foreign service officers, contractors, and local employees across more than 100 countries.
USAID officials and international humanitarian experts have warned since the Trump administration first moved to freeze foreign assistance in January that cuts to the agency would leave at least 1 million children without treatment for malnutrition, leave 200,000 more children paralyzed from vaccine-preventable polio over next decade, and cause up to 160,000 deaths from malaria.
But President Donald Trump has persistently claimed the agency is “run by a bunch of radical lunatics” and Rubio has said USAID operates “independent of the national interest.”
“Everything they do has to be aligned with U.S. foreign policy,” said Rubio earlier this year.
The announcement of the elimination of USAID’s entire workforce came as government watchdog Public Citizen released a new report on Trump’s stop-work order affecting the agency in January. The order “likely affected 32 USAID-funded clinical trials conducted across 25 countries and as many as 94 thousand participants.”
According to the report:
- More than half of the trials (17 of 32) were specifically researching the world’s deadliest infectious diseases: human immunodeficiency virus (HIV) infection, tuberculosis, and malaria.
- For eight trials where contact persons provided additional information, seven trials were affected before participants were enrolled or after data analysis was complete; one trial reported minor patient safety issues.
- The trials were conducted across five continents, predominantly in Africa (13 countries) and in Asia (nine countries).
- The study sites most frequently mentioned across all trials were South Africa (9 times); Kenya and the United States (6 times each); and Uganda, Zambia, and Zimbabwe (4 times each).
Due to the stop-work order, said Nina Zeldes, a health researcher at Public Citizen’s Health Research Group, “researchers were unable to safeguard the welfare of participants and uphold their ethical obligations.”
Public Citizen said that “the sudden, medically uncalled-for suspension of the clinical trials was a serious violation of research ethics, potentially jeopardizing the health of trial participants and the integrity of the trials.”
The Center for Global Development also published an analysis Tuesday of estimates that have stated the White House’s proposal of cutting global health and humanitarian aid funding by two-thirds would put 1 million lives at risk.
Researchers Charles Kenny and Justin Sandefur found that it was “implausible” that cuts to U.S. foreign assistance would only impact so-called “waste” and would preserve lifesaving assistance, as the administration has claimed.
“Using our estimates of costs per life saved for U.S. global health and humanitarian assistance based on available empirical evidence, we can calculate the potential number of lives at risk from such cuts,” wrote Kenny and Sandefur. “The calculation suggests the cuts could lead to 675,000 additional deaths from HIV, and a combined 285,000 deaths from malaria and tuberculosis.”
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