“In less than two months, the Trump Administration has undone six decades of investments that made the United States more respected and influential than any other nation. The resulting chaos has left us weaker and more vulnerable. Like all of my colleagues, I have always supported reforming government and making sure our tax dollars are spent wisely. But this administration has ignored U.S. laws enacted by Congress-cutting foreign assistance programs and USAID staff that are essential for our na
On April 2, 2025, U.S. Senator Jeanne Shaheen (D-NH), Ranking Member of the Senate Foreign Relations Committee hosted a public roundtable for Senators to exam the profound consequences of the Trump Administrations’ cuts to U.S. global health programs.
The panel highlighted the increased risks to the health of Americans from diseases, including drug-resistant TB and Ebola, to Americans livestock and plant farmers from bird flu and plant diseases, and the increase in global mortality from cuts to vaccines, HIV prevention, malaria, maternal care, newborn care and water and sanitation programs.
Top Line Impact of Global Health Cuts
-Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
Quotes from panelists on the consequences of the cuts are represented below.
The written testimony of witnesses is available below and a full transcript is available HERE.
Congressional participants included
USAID Programs are Cost-Effectiveness and Accountability
“I led 800 health staff in [USAID] headquarters working alongside more than 1,600 staff in 65-plus countries. With less than half the budget of my Boston hospital system…they saved lives by the millions and contained disease threats everywhere. The new administration not only shuttered this work, they fired the staff of the entire agency, terminated 86% of its programs, and kneecapped the rest – all against Congressional directives. They dismantled the US’s largest civilian force advancing global stability, peace, economic growth, and survival. And they have done it in a way maximized loss of life and mismanagement of taxpayer dollars.” -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
“So, you know, for USAID, in the last six inspector general reports, 94% of the spending had been audited, 0.3% were found to have issues. Half of that was reclaimed. That is not an enterprise that has been, you know, utterly driven by, criminal behavior.” -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
“…11 of our 20 top trade partners were U.S. aid supported countries. You have a place like India where my parents came from that went from famine to agricultural exporters, including the village where my father came from. And now becoming a critical partner in being a counterweight to China. So, there is direct health benefit, but also trade benefit and then security benefit from the partnerships that we have created.” -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
Cuts are Increasing health risk for Americans
“The safety of Americans is very much at risk as global health security programs are shuttered. Programs that…. addressed things like the plague, Ebola, [and] drug-resistant tuberculosis. Those have suddenly ended with no warning, even as…the United States experienced the worst tuberculosis outbreaks in decades. Emerging health programs…helped address emerging health threats at their source in other countries. They're gone.” -Dan Schwarz, Vice President at Management Sciences for Health
“…And I think it should be clear to all of us by now that outbreaks abroad do not stay overseas. That's why Congress has appropriated millions and millions of dollars to shore up early warning systems, surveillance and fragile health systems around the world so that we can protect and detect and respond to diseases early and … so that we can get them before they get out of control, before they come to our borders. And unfortunately, these are exactly the programs that have been terminated.” -Whistleblower Nichloas Enrich, former Acting Assistant Administrator for Global Health, USAID
“[W]e have had a global reduction in, childhood deaths, childhood mortality in the U.S. and abroad of 75% over the last 50 years. 40% of that benefit is from vaccines alone. 60% of that benefit is from measles vaccine alone…” -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
The PRC is Stepping Up where the U.S. is Stepping Back
“That support has been withdrawn and the sustainability and the long-term system of strengthening…is questionable for the future. The People's Republic of China is filling that gap. The people in the communities that we serve have lost services, and they are quick to, frankly speaking, look towards other options for [the]…support that they need.” -Dan Schwarz, Vice President at Management Sciences for Health
People are dying because of cuts to foreign assistance
“About the claim that no one has died. It's absolutely false. [A] medical facility [in Burma] was cut off with no access to oxygen [and] no alternative delivery system. A woman who had come with severe pneumonia had to be turned away because the facility was shut down. And she died three days later from pneumonia. -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
Malaria Deaths are Increasing Unnecessarily
“U.S. global health efforts have led to a decline in over 48% of malaria deaths globally in Nigeria. During the time that I am delivering these remarks to you, at least two children will die of malaria in Nigeria.” -Dan Schwarz, Vice President at Management Sciences for Health
Ebola Response Programs Terminated
“On February 25, 2025, Elon Musk said in a White House cabinet meeting that Ebola activities had been accidentally turned off, and then turned back on immediately. This was also false, as none of the activities were approved, and no funds had been made available for any Ebola response activities.” -Whistleblower Nichloas Enrich, former Acting Assistant Administrator for Global Health, USAID
“[U.S. assistance] does…not just buy medicine at the last moment that people need it, but…work[s] upstream to build stronger systems in governments that can then drive solutions on their own. [A]ll of our work in disease response has enabled capacity [so] that….in a country as poor as the Democratic Republic of Congo that [before] had an Ebola outbreak spreading for months before a response could be mounted and required $1 billion or more of global aid to get it under control, now has managed multiple Ebola outbreaks with response times that are under are a matter of 24 to 48 hours and without emergency assistance, needing to come in behind it.” -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
“…a bipartisan effort supported the creation of a 50-country network that eliminated our blind spots around the world by having global health security advisers and working with governments to detect when diseases broke out and speed [up] our reaction time. And it made a dramatic effect. There were 21 serious outbreaks beyond COVID in the last four years, and we got response times to less than 48 hours, and stopped 11 outbreaks of Ebola and cousins of Ebola, for example, from reaching here.” This is now gone due to cuts. -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
HIV-AIDS Transmission and Deaths are Increasing because of Cuts to PEPFAR Funding
Cases of HIV have risen and they're seeing now complications of HIV. There's a disease called Cryptococcus meningitis [where]…a parasite get[s] to the brain because of the loss of immune systems. [The] U.S. had supported…a treatment for Cryptococcus meningitis and it was sitting on shelves in the warehouse, but inaccessible to this person. And this person died, and they still don't have that treatment on hand to be able to address these problems. -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
American scientists had developed a drug called Lenacapavir that could prevent or treat HIV with a single injection that lasted six months and perhaps even a year. Deploying this game-changer in high-risk communities through PEPFAR could finally bring an end to HIV as a devastating public health threat.” Cuts to PEPFAR will prevent USAID from deploying this game-changing tool. -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
“We're in the opposite place now. We're seeing babies born again with HIV at rates we haven't seen before. We're seeing HIV transmissions now regularly occurring.” -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
Tuberculosis
“USAID [had] launched a trial of a four-dose pill that could prevent tuberculosis in exposed individuals and dramatically reduce cases. This intervention is at risk from funding cuts. -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
Maternal and Child Health Cuts will Halt Hemorrhage Interventions
Funding for Maternal and child health programs has been halted. “USAID was just about to scale up a novel, inexpensive package of existing drugs and treatments that was found to reduce severe hemorrhage after childbirth – the leading cause of maternal hemorrhage – by 60%.” -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
U.S. Withdrawal from the World Health Organization Means No Role in the Flu Vaccine
“On day one…the United States not only said we were ending membership in the WHO, but [that] our agencies could no longer provide funds immediately to WHO….and could no longer even communicate [with the WHO]. [There are i]ssues like getting…the fall flu vaccine, which depends on a WHO process that accesses specimens from people in China…where we don't have direct access. [The WHO] directly provides that capability for the United States to guide the determination of our own fall flu vaccine. Now, that's still going to happen….but not with direct U.S involvement and not with [the U.S. on] an advisory committee doing the technical oversight.” -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
Pandemic Risk and Zoonotic Viruses
“[The] Food and Agriculture Organization…is a critical network that we have now brought….49 countries around the world [into]; 75% of our pandemic risks come from animal to human transfer of disease. [FAO] are the ones who are out in the communities monitoring bird flu, monitoring for anthrax, monitoring for, African swine fever, which doesn't necessarily transfer to humans but does devastate our agricultural sector. And [FAO] enable[s] a response that can contain matters before they, before they get out of control. That capability alone…is often [the] highest priority investment that [countries]…call for. And shutting off that capability is blinding ourselves to what we need to be able to see the surveillance in the first place and then critical to getting that response time.” -Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
Trump Administration Failure to Continue Lifesaving Assistance
“From January 28, 2025, implementing the LHA [Life Saving Humanitarian Assistance] waiver was my top priority for the Bureau. However, by the time I was placed on administrative leave on Sunday, March 2, 2025, the [Global Health Bureau] had been fully prevented from implementing the waiver, and our lifesaving programs had been effectively eliminated. By Sunday, March 2, 2025, when I was pushed out of USAID, the following occurred:
(a) all – or nearly all – of our contracts and awards needed to implement the LHA waiver were terminated;
(b) authority to approve LHA activities was moved from [Global Health Bureau] leadership to the USAID Front Office, with an increasingly restrictive definition of what constituted ‘lifesaving activities,’ that ultimately excluded all [Global Health Programming] funds (except HIV);
(c) with some miniscule exceptions, no payments had been processed for any of the lifesaving work, which resulted in the complete incapacitation of many implementing partners (even those whose awards had not been terminated).”
-Whistleblower Nichloas Enrich, former Acting Assistant Administrator for Global Health, USAID
Trump Administration Fraud, Waste and Abuse
“When the [USAID] Inspector General, Paul Martin, reported on half a billion in food aid that was rotting in warehouses, having lost controls to prevent diversion to actors who should not get it, the response was not to address the problem, but instead to fire the inspector general.” Dr. Atul Gawande, former Assistant Administrator for Global Health, USAID
“If you want to see waste, look no further than the interest accruing on unpaid bills since payments were stopped – interest at levels we have never seen before. If you want to see fraud, look into the contractual promises we have made and then broken, forcing our partners into debt for relying on the deals we made with them. If you want to see abuse, look at how the administration has prioritized payments for the few firms that have the ear of senior officials.” -Whistleblower Nichloas Enrich, former Acting Assistant Administrator for Global Health, USAID