How will Trump and Musk’s freeze on USAid affect millions around the world?

What is USAid and why is it so important?

The state agency was founded in 1961 by President John F Kennedy in the middle of the cold war. It was established to underpin the US’s security and bolster its standing against Soviet influence by providing aid to struggling countries, and to respond to emergencies from famine to diseases such as polio and smallpox.

Its responsibilities, budget and independence have been fought over by Republicans and Democrats ever since. The US reportedly provided 40% of all humanitarian aid accounted for by the UN in 2024 and spends about $72bn on aid each year, $40bn of which is distributed through USAid.

One programme, the Pepfar initiative (president’s emergency plan for Aids relief, set up by President George W Bush), has invested $110bn worldwide to tackle Aids, and is often cited as one of the biggest health success stories of recent times.

Why do Trump and Musk want to stop it?

Donald Trump, a longtime critic of overseas aid, has argued that its spending is “totally unexplainable … close it down!” and that it doesn’t fit with his “America first” agenda. Musk has falsely accused it of being a “criminal organisation” that needs to “die”. The White House has published a list of US aid programmes it says are evidence of “waste and abuse” but fact checkers have questioned much on the list.

It is clear from the executive order that the administration sees dismantling international aid as a way to extend its internal culture war against progressive policies. The “foreign aid industry and bureaucracy” were in many cases “antithetical to American values” the order on aid said. “They serve to destabilize world peace by promoting ideas in foreign countries that are directly inverse to harmonious and stable relations internal to and among countries.”

How much does the US spend – and how does this compare with other G7 countries?

The US government spent $72bn in foreign aid in 2023, according to Foreign Assistance.gov, more than $40bn of which was administered by USAid. In 2023, foreign aid amounted to 1.2% of the federal budget of 6.1tn.

Although the largest donor, the US spends less by percentage of its national income on aid than all other G7 countries, at 0.24%. The UK, for instance, spends 0.58% of its national income on aid.

What is US aid used for?

In 2023, more than $40bn of the total $72bn of US foreign assistance was distributed by USAid, the remainder was administered by the state department. That year, the largest sector spend of all foreign aid was “economic development” at $19.4bn, most of which ($14.6bn) went to Ukraine. Disaster relief and other humanitarian aid to various countries made up 21.7%, or $15.6bn. Health took up 22.3%,or $16bn, $10.6 of which went towards combating HIV and Aids.

Who receives the most?

All of the US foreign assistance budgets supported 209 countries and territories in 2023. The top five largest recipients were Ukraine at $16.6bn, Israel with $3.3bn, Ethiopia at $1.8bn, Jordan, $1.7bn, and Egypt at $1.4bn.

Are there any exemptions?

On 28 January, waivers to the funding freeze were issued by the US state department for “lifesaving” humanitarian assistance, including “core lifesaving medicine” and “medical services, food, shelter and subsistence”. Two weeks after the freeze was imposed, on 6 February, the waiver was clarified to include HIV care and treatment services, prevention of mother-to-child transmission services and associated administrative costs. But by then, it had already affected prevention programmes and many projects had closed. The payment system that USAid relies on to distribute assistance has also been closed down, so even those programmes with exemptions cannot continue.

Is it legal to dismantle USAid?

Legal challenges have already begun, while more are in the pipeline. Last week a federal judge ordered the Trump administration to temporarily lift the funding freeze on USAid, citing the financial devastation caused to aid groups and suppliers. In a separate ruling, a judge temporarily blocked the Trump administration from placing 2,200 USAid employees on leave, after hearing arguments that the administration lacked the authority to shut down an agency enshrined in congressional legislation.