In a remote health facility in Afghanistan, a young mother clutches her newborn, desperately waiting for the care she and her child so urgently need. But the clinic’s doors may soon close. Like hundreds of other health centers across Afghanistan, this facility is caught in the fallout of abrupt U.S. foreign aid cuts. For this mother, and millions like her in crisis-affected regions, the consequences are immediate and tragic — losing access to essential care at the very moment it is needed most.
In Afghanistan, several international NGOs have been forced to suspend critical health services, from maternal care to tuberculosis (TB) treatment, due to the abrupt termination of U.S.-funded programs. Therapeutic feeding centers in provinces like Badakhshan and Kabul have shut down, leaving malnourished children without care. Key services such as TB treatment, maternal health, mental health, mobile clinics, and vaccination programs have been suspended in multiple provinces, leading to reduced patient care, increased referrals to private (often unaffordable) facilities, and gaps in disease surveillance.
This is not an isolated story. Over the past 100 days, we have witnessed a growing, human-made disaster. The abrupt termination of U.S. foreign aid is dismantling critical health and humanitarian services across the globe, as the United States alone accounted for nearly 40 percent of global humanitarian funding.
While the scale of the U.S. cuts is shocking, it is a part of a wider shift. In the last few months, the United Kingdom, France, Switzerland, Belgium, and the Netherlands have all made significant cuts to their aid budgets.
Programs addressing diseases like HIV, tuberculosis, and malaria, which have saved millions of lives, are now at risk of collapse. The resulting gaps will be felt most severely by those who already face the greatest challenges to their survival.
At Médecins Sans Frontières (MSF)/Doctors Without Borders, we do not accept U.S. government funding, and we continue to run medical humanitarian programs in more than 70 countries. However, we cannot do this alone. We work closely with other health and humanitarian organizations to deliver vital services, and many of our activities involve programs that have been disrupted and, in some contexts, dissipated due to funding cuts.
A Crisis Is Already Unfolding
In our operations across regions where these funding cuts are most profound, we are already witnessing the devastating effects.
The United States has historically been a key contributor to humanitarian efforts in Afghanistan, accounting for 43.9 percent of all reported aid in the country, according to the United Nations. Following the recent aid suspension announced by the Trump administration, over 200 World Health Organization-supported health facilities — previously serving 1.84 million people — have either closed or halted operations. These closures have cut off access to vital services such as vaccinations, maternal care, and child health programs.
The impact is especially severe in northern, western, and northeastern Afghanistan, where more than one-third of clinics have shut down, and an additional 220 facilities are projected to close by June due to ongoing funding gaps. The crisis extends beyond the WHO. Save the Children has shuttered 18 of its 32 clinics, and the Norwegian Refugee Council has closed two community resource centers supporting displaced populations, with two more on the brink of shutting down. Action Against Hunger was forced to halt all U.S.-funded operations in March when the funding was abruptly cut.
In Bangladesh’s Cox’s Bazar, home to one of the world’s largest refugee camps with 1 million Rohingya refugees, the United States has typically contributed nearly half of the total humanitarian aid allocated to support the refugees, amounting to approximately $300 million in 2024. Around 48 health facilities, including 11 primary care centers, have been affected by aid cuts, resulting in many refugees being left without access to essential healthcare services, according to the International Rescue Committee. As per the Inter-Sector Coordination Group, which oversees NGO activities in Cox’s Bazar, disruptions in healthcare services have impacted roughly 300,000 refugees.
MSF teams in more than 20 countries have reported concerns with disrupted or suspended sexual and reproductive health (SRH) programs, which MSF relies on for referrals for medical emergencies, supplies, and technical partnerships. These include contexts with already high levels of maternal and infant mortality. In Cox’s Bazar, MSF teams report that other implementers are not able to provide SRH supplies, like emergency birth kits and contraceptives. Referrals for medical emergencies, like post-abortion care, have also been disrupted, increasing urgent needs for SRH care in the region.
In Pakistan, the pause on U.S. foreign assistance would affect 1.7 million people, including 1.2 million Afghan refugees, who would be cut off from lifesaving sexual and reproductive health services with the closure of over 60 facilities, according to the U.N.
Cuts to President’s Emergency Plan for AIDS Relief (PEPFAR) and USAID have led to suspensions and closures of HIV programs in countries, including South Africa, Uganda, and Zimbabwe — threatening the lives of people receiving antiretroviral (ARV) therapy. South Africa’s pioneering Treatment Action Campaign — which helped transform the country’s response to HIV/AIDS — has had to drastically reduce its community-led monitoring system that helps ensure that people stay on treatment. The monitoring is now only happening on a small scale at clinics.
Disproportionate Impact on the Vulnerable
The reported decision of the U.S. government to end its support for Gavi, The Vaccine Alliance, which was set up 25 years ago to increase access to vaccines for the world’s poorest countries, will have devastating consequences for children across the globe. As per Gavi’s own estimates, the loss of U.S. support to Gavi is projected to deny approximately 75 million children routine vaccinations in the next five years, with more than 1.2 million children potentially dying as a result.
The United Nations has warned that these funding cuts are disrupting global childhood immunization efforts almost as severely as the COVID-19 pandemic did. Millions of children are now missing routine vaccinations, heightening the risk of outbreaks of preventable diseases such as measles, polio, and diphtheria.
For more than 50 years, we have been vaccinating children who live in some of the world’s hardest-to-reach areas, including war zones, refugee camps, and rural areas cut off from health care. This decision will risk leaving these children unprotected. While we do not accept Gavi funding and will not be directly affected by cuts to the program, more than half of the vaccines we use in our projects come from ministries of health and are procured through Gavi.
Restoring Commitment to Global Health
We are standing at a perilous crossroads where political agendas and funding decisions are dismantling lifelines for millions. The erosion of humanitarian aid is not a future threat — it is a present catastrophe unfolding in clinics, refugee camps, and conflict zones worldwide. We cannot allow narrow national interests and harmful narratives to dictate who lives and who is left to suffer.
The international community — governments, donors, and citizens alike — must reaffirm an unwavering commitment to humanity. This means urgently restoring and protecting funding for essential health and humanitarian services, shielding vulnerable communities from the fallout of political decisions, and upholding the principles of impartiality, dignity, and care. Silence and inaction will cost lives. Now is the time to stand in solidarity, to demand that humanitarian aid remains a beacon of hope, not a tool of politics. The world must not turn its back on those who need us most.