Former US Agency for International Development (USAID) administrator Samantha Power hugs a person after workers cleared out their desks in Washington DC, US, on February 27 2025.
Image: REUTERS/NATHAN HOWARD

US-funded projects worldwide, including those providing life-saving care for millions of people in countries such as Sudan and South Africa, received termination notices on Thursday, sending shock waves across the global aid community.

The latest cancellations come as US President Donald Trump's administration nears completion of a review to ensure that grants are aligned with his “America First” agenda after ordering a 90-day pause on all foreign aid in January to assess whether projects were consistent with his policy aims.

US secretary of state Marco Rubio had dismissed concerns that Washington was ending foreign aid, saying waivers had been provided to life-saving services.

Only weeks later, the Trump administration decided to terminate more than 90% of the US Agency for International Development programmes (USAID), according to a February 25 court document. Those included many that were initially covered by waivers such as work addressing HIV as well as wider health programmes. It is unclear whether the projects can be reinstated.

Major UN health programmes were among those to get termination notices, including UNAids, the Stop TB Partnership and Scaling Up Nutrition, as well as projects helping millions of forcibly displaced people.

“We are hit but we will continue to be there,” Lucica Ditiu, Stop TB's executive director, said.

Ditiu said the group has different sources of funding it would use for procuring TB tests and treatments, but it would have to terminate contracts with 140 partners around the world, many of which provide services including helping TB patients get diagnosed and stay on treatment.

Charlotte Slente, secretary-general of the Danish Refugee Council, said she was appalled after receiving more than 20 termination notices for projects across a range of countries including Sudan, Yemen and Colombia.

“Not only are these terminations egregious breaches of contracts but they endanger the lives of millions of the world's most vulnerable people,” Slente said, adding the decision would hit forcibly displaced people in conflict zones.

“While it is understood that incoming governments want to review their overseas development assistance, the decisions from the US government over the past month are abrupt and unilateral and the rationale for these are unfathomable,” Slente added.

A global NPO with projects on malaria and newborn health, among other areas, said most of its contracts had been cancelled. Smaller organisations were also hit, such as Khana in Cambodia, a TB and HIV organisation, and many organisations working on HIV and Aids in South Africa.

UNAids on its website called the termination of its relationship with USAID a “serious development” that would affect life-saving services and said it had asked the US government for more information.

Reuters was not immediately able to determine how many organisations worldwide were affected. Trump's administration also eliminated nearly 30% of state department foreign assistance grants, worth $4.4bn (R81.22bn).

The state department did not respond to a question on why life-saving aid programmes were terminated.

“Secretary Rubio and [USAID] deputy administrator [Peter] Marocco have determined your award is not aligned with agency priorities and made a determination that continuing this programme is not in the national interest,” said the notice received by organisations, which was seen by Reuters.

For some groups, USAID represents most of their funding and they will struggle to survive, while for others it is only one of many donors.

International Aids Society president Beatriz Grinsztejn, referring to cuts worldwide, said: “The US funding cuts are dismantling the system. HIV treatment is crumbling. TB services are collapsing.”

The programmes which received their termination letters this morning [Thursday] were among the most efficient, effective health delivery programmes in the country 

Francois Venter, executive director of Ezintsha Research Centre in Joburg

In South Africa, which has the world's largest number of people living with HIV at about 8-million, health experts said the cuts could roll back years of progress on the epidemic.

“We will see lives lost. We are going to see this epidemic walk back as a result of this,” said Linda-Gail Bekker, COO of the Desmond Tutu HIV Foundation, which works with many organisations that were affected.

Bekker said she expected a funding cut for programmes targeting specific groups such as LGBT+ people and sex workers, but the cuts are far-reaching and include HIV/Aids prevention and treatment programmes for women and children.

The US provides about 17% of South Africa's HIV/Aids budget and health experts said this funding was crucial for providing testing and getting new patients on treatment.

“The programmes which received their termination letters this morning [Thursday] were among the most efficient, effective health delivery programmes in the country,” said Francois Venter, executive director of the Ezintsha Research Centre in Johannesburg, which is not funded by USAID, calling it a “devastating blow” for South Africa's HIV response.

NPO Humanity & Inclusion had more than 30 contracts with the US government to provide services to hundreds of thousands of people with disabilities in multiple countries. Over the past 36 hours, the organisation received notice that about half of those contracts had been cancelled, said its US executive director Hannah Guedenet.

“If you want to cut funding there's a way to responsibly do that. That is not what's being done. This is complete disregard for human life,” Guedenet said.