Emergency action to protect lifesaving foreign aid
A series of White House actions have halted health and development programs globally. Lifesaving programs around the world are still shuttered. Meanwhile, the administration is moving to dismantle USAID, our country’s main global anti-poverty agency. Only Congress has the authority to intervene. Members of Congress from both parties have already spoken out, but much more action is needed. We support good faith reform efforts and have worked to strengthen USAID over many years. But stopping lifesaving programs overnight and shuttering the agency that enables them is not reform — it is destruction.
Congressional Leave Behind – Emergency action to protect global health and aid (Updated 3/11)
Background – Understanding USAID and protecting its integrity (Updated 2/4)
Latest updates
On March 10th, Secretary Rubio tweeted, “After a 6 week review, we are officially cancelling 83% of the programs at USAID…”, suggesting that the “90-day foreign aid review” has finished. This may sound like a final decision — but it isn’t. We certainly will not be treating it as one, and Congress shouldn’t either. There is still room for influence.
Days after this message from Secretary Rubio, we are still hearing of reversals on program terminations. But this is only happening when members of Congress push for it. So it is crucial we continue to apply pressure and emphasize the impact and need of these programs. We need to continue to push Congress to demand that the State department reinstate terminated programs, especially critical humanitarian and development programs: TB, HIV, malaria, nutrition, maternal and child survival, education, and more. Our long term work to shape what comes next on U.S. foreign assistance continues as well, in the annual spending process and much more.
Keep using the congressional leave behind linked at the top of this page. Has your member of Congress said they’re willing to push to reverse program terminations? Reach out to RESULTS staff for details to share with the office.
In recent days, awareness about the cruel and reckless cuts to USAID programs are breaking through to Congress and the media. Our advocacy is working. Now, we need to keep the pressure up!
Since last week, the foreign aid review process (or lack of process) has become even more chaotic. It’s impossible to justify cutting 90 percent of USAID’s work, including critical global health and anti-poverty programs. The good news is — some organizations have already had project terminations reversed, like the U.S.-based companies that make specialized food for malnourished children. This is a positive start. But lifesaving nutrition and medicine can’t save lives in a vacuum. To actually prevent death, children and their families depend on strong health systems, community health workers, and other programming that is still terminated.
A recent Supreme Court decision sent two major lawsuits against the government back down to the lower courts. While we are following these cases closely, narrow court cases are not going to solve the entire problem. The individuals and communities who depend on these programs cannot wait months — or even years — for cases to be settled in court. As you read this, people are running out of their tuberculosis (TB) medication, going into labor with no safe hospitals or health centers, and watching malnutrition steal the light from their children’s eyes. Only Congress has the power to intervene immediately.
The recent terminations are adding to the chaos already started in the review, freeze, and waiver process. The U.S. government even had to contact some partners and ask if their projects were terminated. If the government was following a clear and coherent review process, they should know exactly what projects they have terminated and why — but they don’t.
The bottom line is that we still need Congress to act, because limited and piecemeal termination reversals are not enough.
If your member of Congress had been telling you they support the review, let them know that by the administration’s own account, the review is over. Instead programs have been terminated en masse. But one-by-one, some of those programs have come back — when Congress or others have pushed for it. This means we need to keep it up! Urge your member of Congress to demand Secretary of State Rubio to reverse the terminations. All global health, humanitarian, and development programs must be reinstated, including TB, HIV, malaria, nutrition, maternal and child survival, education, and more.
Congress also needs to reassert their authority and ensure the funding they appropriated is spent. And they need to be vocal about shaping the future of foreign aid. They can do this by submitting strong funding levels for USAID global health and education programs in their personal requests to the SFOPS Subcommittee of Appropriations.
Rather than complying with a court order to restart foreign aid, the administration has instead decided to terminate more than 90 percent of all USAID programs. This is not just a further “pause,” but rather ending programs all together. This includes programs that had already gotten lifesaving and humanitarian waivers: all malaria programs, all tuberculosis programs, huge swaths of HIV programs — and much more. It is a stunningly cruel and reckless decision.
This flies in the face of congressional mandate, court order, and basic human decency. As you have been telling Congress for weeks, the impacts in communities around the world are already catastrophic. And now it is about to get much worse. Congress needs to have the backbone to intervene.
We know that members of Congress from both parties are concerned and angry — but we need them to act.
You can use this phone script to call them today.
We don’t yet know exactly which programs remain. Some critical health and development programs are sure to still be on the list of what’s left, but we already know of terminations to critical HIV, malaria, education, and other work. It’s not yet clear what option there may (or may not) be to overturn this move by the administration. But as our partners continue to press in the courts, we need Congress to do their job.
Even for the health and development programs that may still remain, the situation is very unstable. Most of the staff who could restart programs have been laid off, and many groups are still awaiting payment. In theory, based on the latest court filings, all programs are now either officially continuing or officially terminated, so there should be no more requirement for waivers. But this is still unclear.
We laid out more of the impacts of these decisions in our blog post from earlier this week (scroll down below, dated February 24). Congress needs to understand the human impact of their continued inaction.
The administration is flouting the orders of the courts. Congress is the only line of defense, and they cannot abdicate their constitutional duty.
If your member of Congress has ever signed a letter or pushed for funding on global poverty, they need to take action today.
If your member of Congress has ever talked about U.S. standing or global stability, they need to take action today.
If your member of Congress has ever said they care about human dignity or life, they need to take action today.
What are the impacts? The terminations have touched all aspects of USAID’s work, destroying critical health, education, and poverty programs around the world. Many of these had already gotten waivers. That means by the administration’s own analysis, they were lifesaving, humanitarian programs. Yet they still have been cut off entirely. Here are just a few examples of what’s been cut in the last 24 hours:
- Small grants to 130+ community-based networks that reach millions of people each year with tuberculosis (TB) in the hardest to reach places.
- Maternal and child nutrition programs in Bangladesh, impacting over 144,000 people in just one district.
- A project in Sudan that runs the only operational health clinics in a major part of the Kordofan region, at the center of the ongoing violence and famine.
- A nutrition program in Nigeria, requiring 77 health facilities to completely stop treating children with severe acute malnutrition. This puts 60,000 children under 5 at immediate risk of death.
- Access to education for girls in Afghanistan, who are otherwise forbidden by the Taliban from attending school beyond grade 6.
- Support for the global drug facility that coordinates the vast majority of TB treatment and tests globally.
- Contracts with U.S. factories in Georgia and Rhode Island that produce a vital treatment for the most malnourished children in the world, including for emergency response in Gaza and Syria.
- A project in the Democratic Republic of Congo that operates the only source of water for 250,000 people in camps for displaced people located in the center of current fighting.
Millions of people around the world still can’t get health care, food, and essential services they used to depend on. This is because the White House has ordered the U.S. Agency for International Development (USAID) to stop its work. There have been lawsuits and promises of “waivers” to keep lifesaving programs running. However, funding and services remain frozen.
The waiver process is still a mess. Even when waivers are granted, funding is not reaching the people who need it. USAID’s payment system, Phoenix, has been down for weeks. Organizations say they aren’t able to restart programs because they haven’t been paid. Right now, the waiver system and 90-day review are just words on paper. Congress must act immediately to fix this crisis.
Secretary of State Marco Rubio and Special Advisor to the President Elon Musk are taking a “move fast and break things” approach. This may work for for-profit companies in Silicon Valley, but it’s a disaster for complex health and development programs.
Children are starving to death as you read this. Some of them could be saved by food that’s sitting in warehouses just a few miles away. Dr. Jennifer Furin offered a sobering account of how this is playing out in clinics in Burundi (see excerpt below). This is a part of the world with some of the most severe poverty.
I picked up a pack of ready-to-use therapeutic food to see if we could split it somehow. Would that qualify as being efficient under these circumstances? The sachet I held in my hand was emblazoned with the USAID logo. In large red, white, and blue letters, it proclaimed that this life-saving packet the size of a candy bar is ‘from the American people.’ When we had enough to go around, I felt proud of my country and the pragmatic solidarity donations such as this revealed. The generosity of the U.S. was a palpable presence in a place in the world where no American diplomat or leader would ever come. But as I ripped open the envelope and divided its contents into thirds, I felt nothing but a sense of shame. To my patients and their mothers, I offered apologies from the American people.
Across Africa, tens of thousands of health workers have lost their jobs. This includes at least 3,000 doctors, nurses, and lab technicians in Uganda and 1,500 in Kenya. This puts lives at immediate risk. And it exposes a major flaw in the waiver system for “lifesaving” programs. Many global health programs focus on building the foundation of strong health systems. With such a foundation, countries can care for their own people in the future. The aid freeze isn’t just harming today’s health workers. It’s also already disrupting the education of future doctors and nurses. This is especially dangerous for countries facing health worker shortages. A strong local health workforce is essential. Without it, countries do not progress toward more self-sufficiency. Populations don’t get healthier.
On Friday, a federal judge lifted the temporary restraining order on the USAID staffing freeze. That means the administration can continue its plan to put thousands of USAID employees on leave. In response, the administration quickly moved to put most of USAID’s work force on leave. This makes it even harder to get waivers approved and restart funding. There are still court cases challenging the stop-work order, but that isn’t enough.
The administration claims they want to review foreign assistance to make it more effective. Instead, they are dismantling the entire system. How can there be a real investigation — or any real reform — of USAID if there are no staff left? And without workers, who will make sure the money is spent correctly and that there’s no fraud or waste?
USAID has never been perfect. But, the administration should work on reforms alongside Congress. In the past, Congress passed laws to improve transparency. For example, the 2016 Foreign Aid Accountability Act and the 2018 Evidence-Based Policymaking Act required U.S. foreign aid data to be public. Congress also passed other targeted, bipartisan laws related to accountability. These laws included the Global Malnutrition Prevention and Treatment Act and the READ Act.
If the goal is better USAID spending oversight, the answer is to improve data collection and accessibility. Hiding it only makes the problem worse. Instead, the administration has shut down USAID’s website for weeks. There is no public access to key data sets. Congress cannot access reports. Other critical information needed to track spending and program impact is nowhere to be found. If there is fraud or corruption, it should be investigated. But removing data that has been public for years harms accountability. How can Congress track spending and outcomes now? This is the opposite of transparency.
Congress must act now to stop this crisis and to shape what comes next. If the administration has ideas for improving USAID and global health and development programs, they work with Congress. According to the Constitution, Congress holds the power of the purse to make funding decisions about USAID. The administration should work with Congress to make its foreign aid ideas a reality. It should not tear programs apart in the meantime.
The administration’s reckless actions are causing needless deaths. This freeze is destroying the systems, expertise, partnerships, and relationships that are essential for the future. Congress has both the power and the responsibility to step in. This is outlined in the Constitution. They must do so immediately. If Congress sits by and waits for the administration’s review to play out, there may be nothing left to rebuild. They need to act now. Keep urging Congress to speak up in support of critical health and development programs before it’s too late.
Hopeful news and next steps
Last night, a federal judge ordered the Trump Administration to restore funding to U.S. foreign aid programs, temporarily halting the stop-work order. This is great news, and will help prevent more harm from occurring during the administration’s proposed 90-day review period. Now, we need to make sure the administration acts immediately to restart programs. They need to bring the payment system back online, communicate clearly with all program implementers, and begin to address the enormous harm the freeze has already caused.
For the past few weeks, critical global health and development programs have been cut off from funding, despite promised waivers from the State Department. Unfortunately, many programs were forced to furlough staff and shut down supply chains, so restarting will not be simple. As Rep. Cherfilus-McCormick (D-FL) explained yesterday, “some of this damage is irreparable harm. USAID is not a faucet that you can turn on and off. You can’t pause it and think that there would be no damage.”
However, this temporary end to the stop-work order is a very hopeful sign. You have done an amazing job at educating members of Congress on the importance of U.S. foreign assistance. They need to know how the freeze impacted lives, allowed diseases to spread, and led to unnecessary deaths. We need Congress to make certain that programs restart, and that they shape what comes next. Keep urging Congress to speak up in support of critical health and development programs.
Over 206,000 grassroots actions in support of USAID have been taken since the stop-work order, from RESULTS volunteers and our coalition partners. We’ve shared this number with members of Congress, so they can see how Americans care about protecting foreign aid.
However, it’s clear from congressional hearings this week that some members are still dismissive of the critical role USAID has played for over 60 years. Others simply don’t understand how bipartisan USAID funding has saved countless lives and supported the economic development of countries and communities. So your advocacy is still important to protect the future of foreign aid.
Members of Congress must urge the administration to quickly comply with the court order and reinstate funding for all health and development programs. They should also publicly oppose any future attempts to freeze funding or dismantle USAID. You can find resources and actions to protect lifesaving aid here.
Hearing from the Foreign Affairs Committee
Yesterday morning, RESULTS staff and USAID supporters filed into a hearing room on Capitol Hill to hear firsthand how members of Congress feel about the administration’s attacks on USAID. House Foreign Affairs Committee (HFAC) leadership brought in several witnesses to discuss the stop-work order.
Former Rep. Ted Yoho (R-FL), Heritage Foundation’s Max Primorac, and former USAID Administrator Andrew Natsios answered questions from HFAC members. However, committee leadership did not invite Secretary of State Rubio, or anyone from the administration, to defend the funding freeze that threatens millions of lives.
Several members of the committee set out to demonize and dismiss USAID. Some even shared debunked and misleading facts and complete misinformation. They argued against programs that they see as wasteful or irrelevant to Trump’s global agenda. In particular, they criticized funding for programs designed to help LGBTQ people around the world. But Mr. Natsios, USAID Administrator under George W. Bush, explained that those programs have very real impacts that improve the economic development, employment rates, and safety of our allies. They also maintain U.S. leadership and soft power on a global scale.
Former Rep. Yoho emphasized the importance of USAID programs for diplomacy. In an op-ed that came out the morning of the hearing, he explains “It was only after my first foreign congressional delegation trips to Africa and Latin America that I understood that foreign assistance, when structured and deployed correctly, is a uniquely powerful soft diplomacy tool to strengthen the nation’s economy and national security.”
HFAC members from both parties spoke about lifesaving global health programs funded by U.S. foreign assistance. Prevention and treatment for tuberculosis, HIV, and other infectious diseases were top of mind. Ebola and bird flu were counted among the real risks to Americans if we fail to stop infectious diseases early and to fund programs to fight them in the “hot spots.” Chairman Mast (R-FL) was quick to claim that many global health programs have gotten a waiver to restart their work. Unfortunately, as Rep. Jacobs (D-CA) and Mr. Natsios pointed out, programs have not yet gotten access to the funding they need to restart. In addition, some global health programs have already been terminated completely.
“Even though they have waivers, the Phoenix [payment] system is not operating. Unless the Phoenix system can operate, they can’t issue checks. No one is getting funded, even though the waiver has been granted. Please do something about it. It’s having an effect in the field in a profound way,” Natsios urged Chairman Mast.
Since yesterday’s update, the news at USAID has gotten worse. There are official reports from last night that USAID aims to eliminate nearly its entire workforce, and shutter as many as 800 programs.
The consequences continue to be devastating, and we need Congress to speak up. We’re asking them to do three things:
- End the stop-work order, and reinstate critical programs and staff to carry them out.
- Push the State Department to verify that programs under the waiver have restarted, and expand the waiver to all global health and development programs.
- Ensure Congress is involved in shaping the future of foreign aid — standing up for programs that are focused on ending poverty and creating good health, and committed to humanitarian and lifesaving impact.
That last one is a new addition to our emergency asks, but it’s consistent with what we’ve always asked of Congress. It’s what we’ve worked with them to do annually in the appropriations process, in legislation, in support for all our issues. But right now we need them to go directly to the administration to stand up for what they believe in. Even if your member of Congress isn’t willing to oppose the stop-work order or defend USAID — they still can and must stand up for lifesaving programs. They can hold the administration to account for the impact of what U.S. foreign aid makes possible.
After this wave of destruction, it’s not clear what comes next. But we know it will happen fast. So even as we respond to the emergency, we need Congress to take back the reigns and define the future of U.S. spending in the world.
Our work isn’t about defending a government agency — but about what that agency has made possible in the world. Millions of lives saved every year. All at risk moving forward. This is what Congress needs to hear from us.
Last year alone, a staggering 238,000 newborns weren’t breathing at birth, but were resuscitated thanks to USAID-supported health programs.
For decades, members of Congress from both parties have rallied behind this work to make it possible. Across the aisle, Congress has agreed that wherever a baby is born, they deserve access to lifesaving care in the earliest, most dangerous moments of their lives. They deserve to have their umbilical cords cut with sterile instruments and get routine immunizations, so they don’t die from infections before they’ve had a chance to live. For decades, the U.S. Congress has agreed on this.
In a 90-day freeze, nearly 60,000 newborn babies will die without resuscitation. And U.S. global aid goes far, far beyond just a baby’s precious first moments.
In the past two weeks, people with tuberculosis (TB) have lined up at clinics to refill their medicines. They waited with hopes of better health and to protect their families and communities. But they were turned away, rejected, being denied treatment for a preventable and curable disease.
In Zambia, medicines to treat life-threatening diarrhea didn’t reach children who were sick, because the trucking companies transporting them were paid through a USAID project.
Across dozens of countries, the entire year’s worth of seasonal malaria prevention is now at risk, because of the timing of procurement USAID supports during this 90-day window, needlessly exposing 12 million children to malaria.
In 2023, USAID programs supported drug-resistant TB treatment for 113,000 people.
>>>In 90 days, 28,250 people will go without treatment for a deadly, drug-resistant disease.
In 2023, USAID programs reached 28 million children under age 5 with nutrition.
>>>In 90 days, 7 million children will miss out on nutrition that prevents death and disability.
In 2023, USAID programs made sure 12 million women had safe facilities for childbirth.
>>>In 90 days, 3 million women won’t have access to safe facilities to give birth.
This is what’s at stake. Congress needs to act.
As many of you will have seen in the news, the administration has moved to dismantle USAID since the weekend. Its office was shuttered on Monday and all materials taken offline. On Tuesday, they announced that nearly all employees would be placed on administrative leave, and staff based internationally would be recalled home. The agency has been placed under the authority of the Secretary of State, after operating independently for decades.
There has been a lot of confusion in recent days over the status of the U.S. aid freeze and what programs would receive waivers. If not reversed, the latest actions by the administration will render many of these waivers moot. For most parts of the agency, there is no one to submit or approve waiver requests. And there is almost no workforce to implement programs even if they were technically allowed to continue.
Members of Congress from both parties have come out publicly to oppose this series of drastic actions. It has made headlines around the world, as the catastrophic impacts of these decisions unfold. Lifesaving medicines are locked in warehouses. Health workers cannot care for people in need. Nutrition, education, safe childbirth — all remain stopped.
Continued outreach from members of Congress is absolutely still needed, to protect what’s left of the aid architecture and restart lifesaving programs. As the administration considers its next steps, they need to be hearing clearly from Congress. Congress remains the most important bulwark for this work. They cannot sit on the sidelines. They need to stop the harm, and help shape the direction of what happens next.
There is a raft of news coverage of the impacts of what’s unfolding. If you can find an article in your local paper, be sure to include it in your message to Congress. Our colleagues at Global Health Council also have a new brief on the impacts of the stop work order on health.
Many members of Congress do not understand the impact of the destruction of USAID, nor the reality that the “waivers” have not materialized for most programs. They still need to hear from you!
Our congressional action alerts and “leave behind” materials are being regularly updated, and pinned at the top of this post.
Yesterday on our national webinar, we heard from Dr. Atul Gawande about the devastating impacts of these latest actions, as well as a reminder that “there is always a way forward.” And we’re working together to find it.
If you haven’t seen the webinar, check out the recording.
As many of you will have seen, the situation on global health and aid has gotten more dire over the last 24 hours. On top of the devastating stop work order, media is now reporting that the administration could be aiming to shut down USAID by as soon as tomorrow.
As we’ve said before, we support good faith reform efforts and have worked to strengthen USAID over many years. But stopping lifesaving programs overnight and shuttering the agency that enables them is NOT reform — it is destruction.
Only Congress can step in to stop this. Some members have been mobilizing to push back — but not nearly enough. We need many more of them, both Republicans and Democrats, to be much louder publicly, and to personally reach out to Secretary Rubio about the Stop Work Order and USAID.
If you are able to be in action, below is a sample email / call script for your foreign policy aide.
Dear _______,
I’m deeply concerned about the widespread harms from the foreign aid stop-work order. As the Wall Street Journal and NYT and others have reported, the waivers Secretary Rubio promised last week are yet to materialize. Lifesaving programs around the world are still shuttered. And the latest news is the administration may try to shut down USAID altogether.
I’ve been proud to work with your office to support lifesaving programs around the world, and USAID is a key piece of this. I welcome efforts at reform. But closing the agency and stopping programs overnight is not reform — it’s only causing devastation and confusion. I’ve been proud to see both Republicans and Democrats speaking out this week, and I hope you’ll join them — both in publicly standing up for these programs, and reaching out to the State Department.
This is confusing and fast-changing, but here are the three things I hope your office will prioritize:
1 – Reverse the stop-work order
2 – As long as the order is in place, expand the waivers and verify that all programs covered have been restarted
3 – Protect the integrity of USAID
In his confirmation hearing, Secretary Rubio said he would ask three questions about our foreign aid. “Does it make America safer? Does it make America stronger? Does it make America more prosperous?” Stopping aid without warning takes us backwards on all three of these points.
Congress has built these programs in a bipartisan way. That makes me deeply proud. We need your leadership to defend them now.
Thank you,
[Your name]
Last night, the AP reported that there is an internal USAID waiver being put in place for all “lifesaving humanitarian assistance” to ensure these core programs continue even during the freeze on all State and USAID programming. The waiver defines lifesaving humanitarian assistance as “core life-saving medicine, medical services, food, shelter and subsistence assistance, as well as supplies and reasonable administrative costs necessary to deliver such assistance,” according to the internal memo.
This could be a strong step forward! But a lot of confusion and questions remain: Does lifesaving humanitarian assistance include the global health and PEPFAR programs? Is it just the “humanitarian” funding that can be resumed (which has its own line and programming at USAID)? We don’t have those answers yet.
But on top of the confusion — the waiver is still not public and still has not been sent to implementers for them to take action and restart their programs! Without additional clarity from the State Department, this chaos is creating a terrible cooling effect where implementing programs are fearful and overly cautious in putting their teams back to work, even when they technically can.
The State Department/USAID must take action quickly to make the waivers as wide-reaching and inclusive as possible, including all health programs, programs that support vulnerable children, and those that support creating stable and secure communities.
This fight is far from over. These waivers may be short term and limited in scope, so we need to keep making noise against the harmful stop-work order. Keep reaching out to your members offices — getting them to speak out publicly against this freeze on all foreign aid and tell them to push the administration to expand waivers immediately that include all of the global health, humanitarian, and development programs.
At the end of the day on Friday, an executive order was issued by the Trump Administration to put an immediate freeze on all foreign aid and a “stop work order.” This means many lifesaving programs could stop within days, while the administration does a review. We are horrified by this new announcement, and we hope you’ll help us reverse it.
We’ll have more actions for everyone in the coming days if the order isn’t reversed or paused by a legal injunction, but the most important thing short term will be for members of Congress to voice their opposition.
REMINDER: These are funds Congress set aside — appropriated annually — to be used for this purpose. That means this executive order is not only shortsighted and cruel, but it also directly contradicts the will of Congress. So Congress needs to take action to stop it!
Here’s what you can do:
If you have 10 minutes to call or email your foreign policy aide, here is a script: Â
I’m gravely concerned by the freeze on foreign aid and stop work order for USAID. I know your office has helped secure transformational investments in health and poverty programs globally, and that makes me deeply proud. I hope I can count on you to defend them today. It’s not hyperbole to say lives are at risk.
I’m asking your office to reach out to the White House right away to remind them that Congress approved these funds for a reason. Reviewing how and what we fund is fine — but stopping lifesaving programs in the meantime is completely unacceptable. This move by the State Department is at odds with the values I know your office holds. Can you reach out to the White House or State Department right away and let me know what you hear?
In the hearing where you confirmed him, Secretary Rubio said he would ask three questions about our foreign aid: “Does it make America safer? Does it make America stronger? Does it make America more prosperous?”
Stopping all aid without any warning takes America backwards on all three of these points. And will have devastating impacts around the world.
I implore you to contact him as soon as possible.