Experts sound the alarm: abrupt US policy changes could trigger a worldwide humanitarian disaster, endanger millions of vulnerable lives, and set back decades of global health progress.
USAID-funded programs by region and category, FY2023
In a recent perspective paper published in The American Journal of Clinical Nutrition, experts elucidate the devastating potential impacts (human lives, jobs, data systems) of what they describe as the United States' recent hypothetical humanitarian policy decisions on the global nutrition system. Focusing on the projected dismantling of the United States Agency for International Development (USAID) and the country's described imminent withdrawal from the World Health Organization, the authors argue that these changes should be revoked, suggesting that reform rather than removal is the best way forward both for humanity as a species and the US as a nation.
Background
The United States (US) has hitherto been a major contributor to worldwide emergency food aid, with the paper noting that without the U.S., nearly half of the funding for emergency food aid could vanish. The bulk of this funding has been managed by the United States Agency for International Development (USAID), which, alongside the World Health Organization (WHO), has provided daily nutritional relief to thousands of underprivileged communities, wartime refugees, and the marginalized, the majority of whom are women and children.
Unfortunately, the paper outlines a scenario where, since taking office on 20 January 2025, US President Donald J. Trump signs an executive order to withdraw the US from the WHO (20 January 2025 effective 20 January 2026), and where, on 3 February 2025, presidential advisor Elon Musk announced USAID’s shutdown, calling it a ‘criminal organization’ on social media. The paper further describes how these actions, along with other significant humanitarian policy changes (e.g., a projected 90-day freeze on foreign assistance on 24 January 2025), would cripple the global nutrition system.
Why are USAID and WHO critical?
Founded over 60 years ago (1961), USAID has been monumental in implementing thousands of global health, disaster relief, education, socioeconomic development, and environmental protection programs. Tasked with managing the country's civilian foreign aid, USAID directly supports emergency food distribution and education across 20 priority underprivileged nations in Africa, Asia, and South America. The paper does not specify exact overall budget figures for USAID but notes its significant global role and that it has been a pillar of U.S. foreign policy.
The WHO's global contributions cannot be understated. Since its establishment in 1948, the WHO has set international health standards, funded nutritional and medical research, provided technical assistance to countries, and serves as the premier global forum for health-associated scientific or policy discussions. The eradication of smallpox is mentioned in the paper as one of its notable public health achievements, alongside its broader role in setting international health standards and guiding responses to health challenges.
Why these policy changes?
The paper describes the Trump administration as citing 'cost-saving' as the main reason for the potential dissolution of USAID and the halt of foreign funding. While USAID (and, by extension, WHO) has indeed received billions of taxpayer dollars annually, the paper notes that this funding amounts to less than 1% of the country's gross domestic product (GDP) and pales in comparison to America's defence budget.
The paper discusses a 90-day halt in foreign aid (it mentions Executive Order 14155 for the WHO withdrawal but does not cite a specific order number for the aid freeze) and notes that while such actions may be framed as promising dollars saved, USAID's essential role in global food chain logistics means its dismantling would cost the global nutrition system millions overnight. Furthermore, the paper indicates that USAID’s closure would immediately impact its 10,000 employees, many presumably American, and details further potential or actual job cuts at partner organizations, which sum to over 5,000 additional positions, though not all are specified as American jobs. A significant portion of USAID staff were described as potentially being recalled mid-school year, resulting in substantial family disruptions.
The impacts of change
The most immediate and severe impact of the projected US policy changes would be that of widespread starvation and malnutrition. The paper describes a scenario where Sokoto, Nigeria, witnesses thousands of its children starve following the closure of USAID-supported emergency feeding centers. Sudan and Somalia are home to 3.2 and 1.8 million underprivileged or war-displaced children (below 5 years), 730,000 and 477,700 of whom suffer from severe acute malnutrition (SAM), according to the paper.
While SAM fatality rates without treatment (healthy food or hospitalization) are as high as 50-60%, treatment can save almost 95% of patients. Unfortunately, the paper argues that the potential dissolution of USAID and disruption of U.S. funding (the paper notes that the WHO and WFP received $7.2 billion from the United States in 2022, and the potential loss of such funding through USAID's dismantling would cripple SAM support systems). The paper projects that a 90-day foreign funding pause for PEPFAR alone could cause 370,000 deaths, and states that the overall humanitarian toll in its projected scenario is already staggering and growing daily.
The paper further projects that policy implementation fallout will trigger a surge in infectious diseases (particularly nutrition-associated ones), severe disruptions in data infrastructure, nutrition research, and USAID-provided technical support, and the termination of Feed the Future (FTF), the demographic and health surveys (DHS) program, and the famine early warning systems network (FEWS NET). Finally, the negative impacts of these potential policies on America's standing in international eyes cannot be understated, according to the authors.
In addition, the paper highlights growing calls for more equitable systems of scientific collaboration and programmatic decision making, emphasizing the importance of strengthening independent funding networks and fostering international partnerships beyond reliance on any single donor.
Conclusions and future directions
The journal article highlights the projected unprecedented domestic and international consequences of what it describes as the Trump administration's potential humanitarian policy changes and urges nutrition scientists to demand their reversal. It recommends the immediate revocation of the Executive Order for American WHO withdrawal, the resumption of congressionally approved foreign assistance, the restoration of USAID-managed data monitoring systems and research programs, and the reform rather than elimination of USAID.
The authors further stress that the global health and nutrition community should prioritize collaboration, advocacy, and the development of sustainable funding mechanisms to protect vulnerable populations and scientific progress.
Journal reference:
- Locks, L. M., Stewart, C. P., Hoffman, D. J., & Duggan, C. P. (2025). A shock to the global nutrition system: why nutrition scientists should challenge the dismantling of the United States Agency for International Development and the United States' withdrawal from the World Health Organization. The American Journal of Clinical Nutrition, 121(5), 951–955, DOI – 10.1016/j.ajcnut.2025.02.020, https://www.sciencedirect.com/science/article/pii/S0002916525000887