Humanitarian organizations have attributed more than 350,000 deaths to the foreign aid freeze President Trump implemented on his first day in office. The executive order, signed January 20, 2025, suspended most US foreign assistance pending review, a review that has resulted in permanent cancellation of many programs. Funding for 2026 stands at approximately $8.1 billion after rescissions and cancellations, down from $28.5 billion appropriated before the freeze.
The death toll estimate, compiled by a coalition of global health organizations including Doctors Without Borders and the International Rescue Committee, covers deaths directly attributable to suspended programs. These include vaccines that weren’t delivered, HIV medications that ran out, malaria prevention programs that stopped, and maternal health services that closed. The organizations acknowledge the figure likely understates the full impact, as data collection in affected regions has itself been disrupted.
The administration disputes both the methodology and the premise of humanitarian criticism. White House officials argue that previous foreign aid was ineffective, misdirected, or contrary to American interests. They point to fraud investigations that revealed waste in some programs and ideological objections to funding organizations that provide services the administration opposes. The policy debate continues while the human consequences accumulate.
What the Freeze Actually Did
The January 2025 executive order stopped disbursement of foreign aid across virtually all categories. Health programs, food assistance, education initiatives, and development projects all faced immediate funding interruptions. Organizations that had relied on American funding found themselves unable to pay staff, purchase supplies, or maintain operations.
Some programs received exemptions or resumed funding after expedited reviews. Emergency food assistance in acute crisis zones received partial restoration. Military aid to strategic allies continued or expanded. But the broad categories of development assistance, global health funding, and humanitarian relief remained largely frozen or permanently cancelled.
The PEPFAR program, which has provided HIV/AIDS treatment to millions across Africa, saw significant cuts. Organizations report that hundreds of thousands of patients lost access to antiretroviral medications. Without consistent treatment, HIV becomes resistant to available drugs, potentially creating public health emergencies that extend far beyond individual patient outcomes.
Maternal and child health programs experienced similar disruptions. Clinics that provided prenatal care, safe delivery services, and childhood vaccinations closed when funding stopped. In regions where these programs represented the only healthcare access available, entire communities lost medical services they had come to depend upon.
The Human Cost
The 350,000 death figure attempts to quantify consequences that resist easy measurement. Humanitarian organizations used epidemiological models, program data, and on-the-ground reporting to estimate excess mortality attributable to program closures. The methodology involves significant uncertainty, but the underlying reality of widespread harm is documented beyond reasonable dispute.
In South Sudan, where food assistance programs were suspended, malnutrition rates among children increased dramatically. Organizations that had been providing supplementary feeding closed operations. Local health workers reported rising numbers of severe acute malnutrition cases without resources to treat them.
Democratic Republic of Congo saw similar patterns in health programming. Vaccination campaigns that had reduced measles and other preventable diseases were suspended. Health workers report increased case counts for diseases that had been declining. The return of preventable disease in regions that had made progress represents a particularly bitter form of backsliding.
The impacts extend beyond health to education, livelihoods, and stability. Programs that kept girls in school, provided vocational training, or supported small farmers all faced cuts. These programs don’t produce immediate mortality statistics, but their absence creates conditions for future suffering that models cannot easily capture.
The Administration’s Defense
White House officials have consistently defended the aid freeze on multiple grounds. They argue that previous programs were ineffective, with funding disappearing into corruption or failing to achieve stated objectives. They point to specific cases of fraud and waste as justification for comprehensive review before continued spending.
Ideological objections also play a role. The administration has specifically targeted programs providing reproductive health services that include abortion referrals or access. Organizations unwilling to certify compliance with expanded restrictions on abortion-related activities lost funding regardless of their other programs’ effectiveness.
Strategic arguments feature prominently in administration messaging. Officials argue that American taxpayers shouldn’t fund programs in countries that oppose US interests or fail to align with American foreign policy priorities. The aid freeze becomes leverage for extracting policy concessions, though critics note this approach affects populations rather than governments.
The review process the executive order mandated has proceeded slowly. Programs deemed aligned with administration priorities have resumed funding, while others remain suspended indefinitely. The selectivity has drawn criticism for appearing politically motivated rather than based on program effectiveness assessments.
The Global Response
Other donor countries have attempted to fill gaps left by American withdrawal, with limited success. The United States has historically provided the largest share of global development and humanitarian assistance. Other wealthy nations lack the capacity to fully replace American contributions even if they wanted to.
International organizations have publicly criticized the policy while attempting to maintain working relationships with the administration. The United Nations, World Health Organization, and other multilateral bodies have documented consequences while seeking continued American engagement on issues of mutual concern.
China has expanded its foreign assistance in some regions, though its programs focus differently than American aid traditionally has. The geopolitical implications of American withdrawal create opportunities for competitors to build influence in regions the US had prioritized. Whether this matters depends on how one weighs soft power against other foreign policy considerations.
Private philanthropy has increased in some areas, with foundations attempting to sustain critical programs. The Gates Foundation and others have expanded health funding to partially offset American cuts. But private resources cannot match government-scale funding, and the programs sustained represent a fraction of what was lost.
The Bottom Line
One year after President Trump froze foreign aid, humanitarian organizations document consequences that exceed their worst initial projections. More than 350,000 deaths attributed to program closures, according to organizations tracking the impact. Funding levels that remain a fraction of previous appropriations. Programs that took decades to build, dismantled in months.
The policy reflects genuine disagreements about the purpose and effectiveness of foreign aid. Administration supporters argue that American taxpayers shouldn’t fund programs that don’t serve American interests or that waste money through corruption and inefficiency. Critics argue that the humanitarian cost far exceeds any savings or strategic benefit.
What’s not debatable is that real people in real communities have lost access to healthcare, food assistance, and basic services they depended upon. The abstract policy debate has concrete consequences measured in preventable deaths, untreated diseases, and diminished human potential. Those consequences continue accumulating while the policy remains in place.
The numbers will keep rising as long as the freeze continues. Each month without restored funding means more clinics that close, more medications that run out, more children who don’t receive vaccines. The 350,000 figure isn’t an endpoint; it’s a waypoint in an ongoing crisis with no resolution in sight.
