The Aftermath of Trump’s Foreign Aid Cuts

When Donald Trump returned to the White House in 2025, his administration rapidly dismantled much of the US foreign aid system, slashing billions of dollars in assistance to the developing world. The cuts forced some HIV clinics to scale back services, disrupted vaccination and disease-monitoring programs and left refugee agencies scrambling to replace lost funding.

Studies estimate hundreds of thousands more lives have been lost as a result of the US cuts, with millions more at risk in the coming years.

In the aftermath of that shift, the US has sealed more than 30 new “America First” deals with recipient countries that, in a sharp break from historical US practices, require mineral and health data access in exchange for aid.

Mozambique signed a five-year, $1.8 billion agreement that is to support HIV and malaria programs while requiring the country sharply increase domestic health spending. The southern African country previously received between $500 million and $800 million annually from the US — meaning the new agreement represents a significant reduction even before inflation and rising disease burdens are considered.

The shuttering of USAID, and the deals that have replaced it, raises questions of how countries will face the realities of propping up fragile health systems while handling future shocks, including the expanding Ebola outbreak in eastern Africa.

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