What USAID Cuts Look Like Overseas
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During the height of the Cold War, President John F. Kennedy set up what he saw as a critical humanitarian tool, a way of countering the Soviet Union around the world. It was the United States Agency for International Development, or USAID. The people who are opposed to aid should realize that this is a very powerful source of support

strength for us. It permits us to exert influence for the maintenance of freedom. One of the people now opposed is President Trump. His administration has begun to dismantle the agency and freeze foreign aid. It's a disaster what the people, radical left lunatics, they have things that nobody would have even believed. The whole thing with 100 million spent on you-know-what.

With money going to all sorts of groups that shouldn't deserve to get any money with the money, I'd like to see what the kickbacks are. Over the years, USAID has faced accusations of inefficiency and waste. It has also helped fund and support humanitarian work in more than 100 countries on behalf of the U.S., the world's largest donor of humanitarian aid.

To get a sense of what USAID had been doing around the world and what dismantling it might mean, we're going to hear from correspondents in South Africa, India, Mexico, and we start in Ukraine with NPR's Joanna Kakissis.

Ukraine is the largest recipient of USAID funds. It's received $37 billion in the last three years since Russia's full-scale invasion. That aid has touched practically every aspect of Ukrainian life, says Oleksandr Medeshko, a member of parliament from President Volodymyr Zelensky's party.

There are lots of programs which are very useful, including support of our war veterans, programs related to health care, support of parliament.

And paying the salaries of emergency service workers. It's also kept farmers in business, and it's helped rebuild Ukraine's power grid after repeated Russian strikes. Now that the Trump administration is dismantling the agency, the chaos has left many in limbo, including Olena Horyacheva, who runs a medical charity in the southern city of Mykolaiv.

She says programs providing treatment for tuberculosis and HIV have shut down for now. We paid to deliver antiretroviral therapy to HIV patients who could not get to a hospital or see an infectious diseases specialist. We worked with medical institutions so nurses could send out those parcels every month.

The cuts have also hit local Ukrainian media. The news website Tsuker in the northeastern city of Sumy relies on USAID funding. More than 60 percent of our budget. Dimitro Tishenko is Tsuker's editor. So now we have a big challenge. We're trying to communicate with our European partners to cover that. He says Tsuker has enough money for just another month.

And Sumy, a frontline city frequently attacked by Russia, depends on facts, he says, not unfiltered social media compromised by Russian propaganda.

Modeshko, the lawmaker, says he hopes the Trump administration will revive USAID after reviewing or overhauling it. It's important not only for Ukraine. I think it's important for the United States. And besides, let's not forget about information war on the part of Russia and China. He says without USAID, the United States will leave a void that will quickly be filled by Russia and China. I'm Joanna Kikisis in Kiev.

USAID used to do a lot of heavy lifting in South Asia, as well as in Afghanistan, where there's been an ongoing humanitarian crisis. Now, amid chaos in Washington, the aid agency's education projects are suspended in Afghanistan. That includes secret schools for hundreds of Afghan girls after the Taliban banned them from learning beyond grade 6.

USAID funded other work to support Afghan women, including a project to train female journalists. That was through a news outlet called Zan Times. The editor Zahra Nader tells NPR this project is now on hold. The notification actually came on the day that we were supposed to start our first online class and

And we couldn't dare to tell to this woman journalist who was joining us online from Afghanistan. Nader says it feels like Afghan women are being abandoned.

In Bangladesh, a fairly poor country of about 170 million people, USAID had all sorts of projects, including a popular local version of Sesame Street. USAID last year shared a video of one of the Bangladeshi puppets, Halam the Tiger. MUSIC PLAYS

USAID also took on quite big public health issues in Bangladesh, like a project to screen and treat tuberculosis patients. And NPR producer Ahmad Hussain spoke to a doctor who worked on that project. He requested anonymity. He wasn't allowed to speak to the media, fearing his group will be denied future funding from Washington.

He told NPR that Bangladesh likely has about 3.7 million people infected with tuberculosis, or TB. It's a highly contagious bacterial infection that can be deadly. But many Bangladeshis don't know they're infected, so USAID funded a program to teach medics to screen for the illness. That included training around 3,000 paediatricians, because it's often children who aren't diagnosed.

USAID was also funding TB centres to treat patients. And the doctor NPR spoke to says more people will be infected as a result. And he says more lives are going to be lost. I'm Dia Hadid in Mumbai. South Africa has the highest number of people living with HIV in the world, over 8 million by some estimates. In recent years, it's made great inroads with prevention and treatment.

And much of that is done to the support of USAID with its funding of the President's Emergency Plan for AIDS Relief, or PEPFAR. I'm standing on the street in Johannesburg outside the Engage Men's Health Clinic. It's sponsored by PEPFAR and there's a notice saying, regrettably, our clinic is temporarily closed because the funder has killed their services.

So I just came today just to do collection of my PrEP medication. I bump into 30-year-old Alex on the street outside the clinic. He's been coming here for years to collect his pre-exposure prophylaxis, or PrEP.

We're not sharing his second name for medical privacy reasons. PrEP medication prevents HIV infections in people at high risk. This place is also catered for LGBT. So a lot of people, they can be in the closet and they don't want their family to find out they would come to this clinic. HIV-positive people in South Africa are bracing themselves for tough times ahead.

While the government here provides the antiretroviral drugs, about 17% of its other HIV funding comes from PEPFAR. That's about $440 million a year.

The government here says 15,000 healthcare workers stand to lose their jobs. Where we will see an impact is in areas of prevention. Professor Salim Abdul Karim, an award-winning epidemiologist, has spent his career fighting HIV in South Africa. He says people can still receive ARVs at government hospitals.

While South Africa is one of the richest countries on the continent, places like Mozambique and Malawi depend almost entirely on PEPFAR. The entire AIDS pandemic...

We'll be under threat in that we could now see a resurgence of AIDS infections because patients are stopping their medication. He also says HIV research will be hit hard. Several large programs he was involved in have already come to an abrupt halt. Back outside the shuttered clinic, Alex is trying to work out how to get his medicine. I am devastated that the infections are going to skyrocket.

It has actually affected us in a great way. We are now living in fear, he says. For NPR News, I'm Kate Bartlett in Johannesburg. In Mexico, President Claudio Sheinbaum did not mourn the loss of USAID money. If the U.S., she said, actually wanted to help develop countries, it should be transparent. But USAID has so many parts that the truth is it's

better that they close it down. On the Platform X, the president of El Salvador, Nayib Bukele, rejoiced at the news, saying the majority of USAID funds are, quote, funneled into opposition groups, NGOs with political agendas. In Colombia, President Gustavo Petro said the U.S. shouldn't be funding public employees in his country. Trump is right. Take your money.

Trump is right, Petro said. Take your money. I asked Jake Johnston at the Center for Economic and Policy Research if this surprised him. Not one bit. No. Johnston wrote Aid State, a book critical of USAID's role in Haiti. And he says this reaction across Latin America comes because of

two main reasons. These democracy promotion, quote unquote, things, which are political interventionism in sovereign countries, is a part of what USAID does. In both Mexico and El Salvador, for example, USAID has funded investigative journalism outfits that uncovered vast corruption or human rights abuses by the sitting government.

Both countries have bitterly complained that USAID is funding the opposition. The second reason is more complicated. USAID rarely awards money directly to governments. USAID funding goes almost entirely to contractors, NGOs, or multilateral agencies like the UN. It means that USAID programs with serious overheads run in parallel to public institutions like hospitals and schools.

And that often runs in direct contradiction to or undermines those public systems. In Haiti, for example, as USAID pumped free rice into the country, local production couldn't compete and went bankrupt. It means today Haitians import rice from U.S. companies. And this, says Johnston, It forces people off of their land into either the city to search for low-wage employment or to leave the country altogether and migrate to the United States or elsewhere.

Johnston says USAID has created toxic dependencies and does need an overhaul, but... That's not what's happening here. And instead, you're just going to cause a bunch of people to lose their jobs and a bunch of people to lose life-saving support. In Haiti, for example, the end of USAID could mean the end of HIV medicine or even life-saving food. Eder Pralta, NPR News, Mexico City.

We also heard from Kate Bartlett in Johannesburg, Dia Hadid in Mumbai, and Joanna Kakissis in Kiev. That's the state of the world from NPR. Thanks for listening. This message comes from NPR sponsor, Sotva. Founder and CEO Ron Rudson shares why Sotva sales associates are focused on finding the perfect mattress for their customers.

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