“We’re running on fumes,” says Sarah Shaw, associate director of advocacy for MSI Reproductive Choices, which provides contraception and abortion services in 36 countries. “This year has been a really bad year, next year is going to be a really bad year,” she told The Sentinel in an interview late last year about the impact of aid cuts.
U.S. President Donald Trump’s decision in 2025 to shut down the U.S. Agency for International Development (USAID) has hit development programmes around the world. At least 23 million children stand to lose access to education, and as many as 95 million people to lose access to basic healthcare, potentially leading to more than three million preventable deaths a year as a result, according to an Oxfam report in November.
The impact of cuts by the world’s largest aid donor has not just been at the front line of providing aid, but has also affected logistics and the delivery of supplies, according to Shaw.
“Trump dismantled USAID, which is the delivery arm for the world’s development programme. He just stopped 50 years of programming, and the fall-out from that has massively impacted our service delivery.”
For example, some U.S.-funded contraceptives intended for poor nations and worth nearly $4 million have been stuck in a Belgian warehouse since the U.S. aid freeze. They could become unusable by mid-2026, Reuters reported in October.
MSI has diversified its funding sources in recent years, following past cuts in U.S. aid. However, the global impact on the ground of the latest cuts has meant the organisation has needed to help fill gaps elsewhere:
“The closure of USAID and the speed at which it happened has caused so much chaos at country level, it’s blasted a massive hole in health budgets,” Shaw says.
“Governments are exhausted and they’re broke. We’re having to step in in a lot of countries and actually move the contraceptives around for the Ministry of Health to get them to the right place.”
In addition, European governments have been slower than in the past to fill funding gaps, embattled as they are by the economic impact of the COVID-19 pandemic and defence spending needs due to the war in Ukraine.
“The broader trend across Europe is, funding falling massively short of fast‑growing needs,” says Nihad Sarmini, global head of business development and partnerships at Action For Humanity, which delivers life-saving support in over 14 countries.
“There are women in Syria who may have to travel 100 kilometres for a maternity clinic, which may not be there next month when they need it again. Children in Yemen are succumbing to medieval diseases like cholera and diphtheria, entirely preventable and treatable, because governments are withdrawing funding and leaving humanitarians to plug gaps elsewhere.
Non-governmental organisations (NGOs) such as Action for Humanity and MSI are also braced for a planned cut in UK aid spending to 0.3 percent of gross national income (GNI) in 2027 from the current 0.5 percent. This latest cut in UK aid follows a cut in 2021 in response to the pandemic.
UK international development organisation network Bond said in an October briefing note that it was hearing that the UK government was considering ending its aid partnerships with several countries in Africa, including Malawi, Mozambique, Rwanda, Sierra Leone and Zimbabwe.
MSI’s programmes include a major health project in West and Central Africa which is funded by Britain’s Foreign, Commonwealth and Development Office.
Aid cuts are short-sighted, as every dollar invested in sexual reproductive health saves $130 in other development costs, according to Shaw.
“An investment in contraception is way wider than just a health investment. It breaks generational cycles of poverty, it enables women and girls to leverage opportunities by staying in education, by becoming economically independent,” she says.
Sarmini also stresses the far-reaching nature of slashed funding:
“Cuts to one organisation quickly ripple through the system, and communities pay the price.”