In moments of crisis, the stories we tell matter. The right story has the power to shape a movement, disrupt a crisis, provide comfort, community, inspiration.
The wrong story can fuel chaos, thwart justice and progress, and cause irreparable human suffering – even loss of life.
At ONE, we consider ourselves to be “factivists,” driven not by partisan ideology but by facts and data – and a desire to use those facts and data to ensure that everyone, every where can lead a life of dignity and opportunity.
In the wake of significant disruptions to US humanitarian and development assistance, a global trend toward reductions in foreign assistance spending, and denial from world leaders that these actions have consequences, we need to be telling the right story – that reckless cuts to lifesaving foreign assistance programs without a backup plan in place have, in fact, claimed lives – and will continue to do so unless we take action.
“If U.S.A.I.D. would be here, [he] would not have died.”
You might have heard accusations of “tremendous fraud” at USAID – that “massive sums of money” have been wasted.
While no one disputes the need for common-sense reforms, these claims don’t hold up – let’s look at the real numbers. In fiscal 2023, (the most recent year for which data is complete) the US disbursed $71.9 billion in foreign assistance. That’s not a small number, to be sure, but it actually amounts to … less than one percent of the federal budget. And when you break that $71.9 billion down into what is spent on actual lifesaving assistance, it’s an even smaller fraction of our annual spending. In fiscal year 2023, for example, the US spent a little over $12 billion on global health.
You might have also heard that “no one has died” as a result of disruptions to that life-saving foreign assistance funding. (During recent testimony before Congress, United States Secretary of State Marco Rubio went as far as to call it “a lie” to say that people have died.)
This narrative is both demonstrably false and incredibly dangerous.
- Peter, 10, relied on PEPFAR to access antiretroviral drugs to combat the HIV he contracted from his mother at birth. Under the State Department’s limited humanitarian assistance waiver, only certain PEPFAR operations are permitted – leaving no room for the nuance of the AIDS epidemic in the many countries in which it persists. Peter relied on a community health worker – Moses Okeny Labani – to ensure he and other orphans received their lifesaving medicines. When that program was shut down, Peter died.
- Abdo, an 18-month old boy suffering from acute malnutrition, was rushed to a clinic in Sudan. The next day he was dead. The USAID freeze shuttered a soup kitchen near Abdo’s family’s house – and more than 1,000 similar kitchens throughout the country, jeopardizing access to food for 1.8 million people.
- Yamah, a 21-year-old mother of two, hemorrhaged while giving birth to her third child. Villagers summoned an ambulance to take her to the hospital – a service implemented by USAID to reduce maternal mortality. But in the wake of USAID’s closure, there is no longer fuel for the vehicles – crews that were ready to come help Freeman were unable. Several of her neighbors started the 10 mile walk to the nearest hospital, carrying Freeman in a hammock. She and her unborn son died on the way.
- Eight people in South Sudan – including five children – died during a three hour walk to seek treatment for cholera. The foreign assistance freeze had forced their local health services to shut down.
- Evan, age 5, and his mother Jennifer, both HIV-positive and, now, both dead – got sick after the USAID freeze disrupted their access to care.
- Basic antibiotics would have cured Omran’s chest infection, according to physicians at his local clinic. But USAID cuts prevented the medicines from being delivered. His mother carried the 3-year-old to 11 different facilities in search of treatment. He died in May.
- One-year-old Gbessey contracted malaria in March. Normally, a community health worker would have been able to administer medicines but the closure of USAID led to the collapse of supply chains – they had no medicine for Gbessey, and neither did a nearby clinic. He died the next day. Now, Gbessey’s mother says, his newborn brother is also sick with malaria.
- Achol, 8 years old, who contracted HIV at birth, lost her ID card in January. Without it, she was unable to access the medicine she needed to stay alive. Following the stop-work orders, there was no longer a caseworker available to help her get a new card and get new medicines – she became sick and died.
- Martha, 25, and Viola, a 28-year old mother of three, died earlier this year. The remote area of South Sudan did not have the infrastructure to provide antiretroviral drugs following the shut down of USAID supply lines, according to Angelina Doki, the community health worker who supported them. Angelina is HIV-positive herself – and her own supply of antiretorvirals is running low.
- After the USAID stop work orders in January, almost all the soup kitchens in Fatma’s neighborhood on the outskirts of Omdurman, Sudan closed overnight. Her 18-month-old daughter Nada starved to death in February. Her three-year-old son, Omer, died in March.
- 11-year-old Kevin and his 13-year-old brother, Victor, both contracted HIV at birth from their mother, Sarah. All benefited from access to lifesaving antiretroviral drugs made possible by USAID – until stop-work orders disrupted their access to these meds earlier this year. Kevin contracted tuberculosis, which is endemic in Kenya. He died in May.
- Yagana, mother of twins, brought one of her children to a Nigerian health center to be treated for malnutrition. Her son was recovering under the care of the clinic – until the foreign assistance freeze shut it down. Yagana’s son died four days later.
- Lydia, 28, relied on the services of a mental health program to assist with her HIV-treatment. Such services are not included under the lifesaving humanitarian assistance waiver. Lydia stopped taking her medications following disruption to services, and died in March.
- Cholera, a waterborne disease that can kill within hours, is sweeping through Omdurman, Sudan. USAID had largely funded supplies that helped respond to outbreaks. Waleed, a soup kitchen manager, said dozens of people in his neighborhood had died of cholera on a single day in May– including his uncle and cousin.
- Mariam’s 7-year-old son Babagana had sickle cell disease. In February, when he ran a fever, she took him to their local clinic and found it closed – a result of a USAID stop-work order. The clinic was allowed to resume work in April, but it was too late – Babagana died the very night his mother tried to take him to the clinic.
- In the city of Bo, Sierra Leone, many people living with HIV lost access to their medicines between March and May. Access has since been restored, but not in time for 32-year-old James, 39-year-old Gbossay, and 27-year-old Mommy, who died when they were not able to take their antiretroviral medicine.
- Pauses to funding for the U.N.’s World Food Program have spiked malnutrition cases at Kakuma Refugee Camp in Kenya. Food rations for Kakuma’s 300,000 residents have been halved and cash transfers used by residents to but proteins and vegetables to supplement rations have ceased. 15 children died in the camp’s largest hospital in May.
“We are going to choose now between food and drugs.”
You might also have heard that “lifesaving assistance” hasn’t been disrupted, that a waiver permits the continuation of humanitarian support and emergency medical care. For example, in his recent testimony, Secretary Rubio told lawmakers that 85% of PEPFAR, the lifesaving HIV/AIDS program, is functioning.
While accurate on paper – there is in fact a waiver allowing for lifesaving assistance – it is a far cry from reality for millions of people. (And, re: Secretary Rubio’s statement, other analysis found 71% of HIV-related work has been terminated.)
- Dorcas, 10, and her mother Theresa took their last antiretroviral drugs in April. The clinic where they usually recieve the lifesaving medication closed in January. Even after just 8-10 days, Dorcas developed a fever and chills – often one of the first symptoms after someone goes of HIV treatment as the level of virus rises and the body tries to fight it off. Theresa, now caring for her daughter, is unable to go to work.
- Mary, a 42-year-old mother of four, has been rationing her antiretroviral drugs – taking them only every third day – since her local clinic closed in January. She’s developed rashes and a large sore on her ankle that makes it hard to walk – meaning traveling to the nearest clinic with a medication supply could take hours.
- South Africa’s National Health Laboratory Service found that HIV viral load testing – key to keeping track of how likely a person is to transmit HIV – fell by up to 21% among key groups between March and May, which four HIV experts said appeared to be due to the loss of U.S. funding. South Africa is the epicenter of the AIDS epidemic – 1 in 5 adults are HIV-positive.
- The manufacturer of Plumpy’Nut (a peanut-based paste that helps treat malnutrition) said the termination of transportation contracts by USAID had disrupted its ability to deliver product. They now have a stockpile of 5,000 tons – worth $13 million – which could feed nearly 500,000 children. 500 tons of high-energy biscuits stored at a USAID warehouse in Dubai – enough to feed 27,000 acutely malnourished children for a month – are set to expire in July.
- Plumpy’Nut helps feed children like, like 13-month-old Abukamara. But cuts to USAID led to delays in shipping and even cancellations of orders of the life-saving paste, much of which is made in Georgia and Rhode Island. The latter state has 185,535 boxes of RUTF (ready-to-use-therapeutic food) piled up waiting to be delivered.
- Dalvin, 40, has tuberculosis. At an already concerning 110 pounds, he fears the disease will kill him and has been desperate to be on medication to treat it. Dalvin is one of thousands of Kenyans, and hundreds of thousands of people worldwide, who have lost access to TB treatments and testing in the weeks since the US slashed foreign assistance and withdrew funding for health programs around the globe.
- For years, Congolese women relied on U.S.-supplied antiretrovirals such as post-exposure prophylaxis kits, to prevent HIV infection after an assault. Those funds have dried up as a result of USAID cuts, threatening a fresh wave of HIV cases. “Most of the women call me crying,” said Noella, a protection officer for CARE International. “They are very worried, but we have no drugs to give them.”
- Brian, 56, has been on antiretroviral drugs for 15 years, and has made a living painting houses. Since his US-funded clinic closed in early February, he hasn’t been able to refill his medication and has grown weaker – now unable to work. He and his wife went to a nearby government clinic to get their medications refilled, but they were told they must bring their medical records in order to register as new patients. Their shuttered old clinic still contains their files.
- Alice, 50, and her 15-year-old daughter Chichi are both HIV-positive. Previously, Alice was able to secure supplies of their HIV medication from a local clinic every six months but, in the wake of the foreign assistance freeze, the clinic is rationing drugs to a one-month supply. Not far away from Alice’s home in Nairobi, millions of doses of life-saving drugs sat on warehouse shelves, unused.
- Margaret felt “useless” before USAID began providing antiretroviral drugs to Kenyans in 2009. It changed her life – she went to college, got married, and gave birth to three HIV-negative children. Cuts to USAID have jeopardized her access to the lifesaving drugs she picks up every three months. Even if she found drugs elsewhere, she could not afford them on her stipend as a community health worker.
- Evelyne’s 16-year-old son went to fetch water in June and never came home – a familiar reality to families in eastern Congo. Cuts to US assistance have stranded dozens of half-finished water and sanitation projects across the globe, creating new hazards for some of the people they were designed to benefit. Reuters has identified 21 unfinished projects in 16 countries – including Congo – leaving millions of people who were promised clean drinking water and reliable sanitation facilities on their own. Failure to complete these projects means women in some areas will have to walk for hours to collect unsafe water, children will face increased disease risk, and health facilities will be shuttered.
Too often, global moments are measured by lives lost – conflicts, pandemics, natural disasters. The creation of effective, accountable, and life-saving programs like PEPFAR, The Global Fund to Fight AIDS, Tuberculosis and Malaria, and Gavi, the Vaccine Alliance ushered in an era that could be measured by lives saved – lives that have now been abruptly sidelined in the name of salvaging a mere fraction (less than one percent) of the budget.
At ONE, we believe actions speak louder than words. In the wake of foreign assistance cuts around the world, our global community of activists have taken thousands of actions to make sure world leaders know: Slashing lifesaving programs is not in anyone’s best interest.