Dismantling USAID and Withdrawing from World Health Organization “Will Cost Lives and Destroy Critical Infrastructure,” Writes BU Global Nutrition Expert
Lindsey Locks argues that, in a world with an abundance of food, these decisions will cause millions of children and families to go hungry
Protestors have rallied against the dismantling of the US Agency for International Development (USAID). BU nutrition researcher Lindsey Locks says that curtailing the agency’s work would have profound implications for global health. Photo via AP/J. Scott Applewhite
The global nutrition community is facing an unprecedented crisis—one that has nothing to do with a major environmental disaster or an insufficient global food supply. Instead, it stems from political decisions that threaten to dismantle the infrastructure supporting nutrition and health programs worldwide.
On January 20, US President Donald J. Trump signed an executive order withdrawing the United States from the World Health Organization (WHO). Then, four days later, on January 24, Trump froze foreign assistance for 90 days, halting most United States Agency for International Development (USAID) programs.
Because of these two decisions and the long-lasting consequences, lives will be lost. Livelihoods will be destroyed in the US and abroad. Critical expertise, infrastructure, and data needed to combat food insecurity and malnutrition will be lost. Long-standing US foreign aid policies that are being abruptly halted will leave a diplomatic and humanitarian void.
USAID and WHO have been pillars in the fight against malnutrition and hunger. I, and several other prominent global nutrition researchers, recently argued in The American Journal of Clinical Nutrition that the abrupt withdrawal from WHO and dismantling of USAID will have immediate humanitarian consequences. Although the Trump administration cited cost savings as the rationale for stopping foreign aid, foreign assistance is approximately 1 percent of the federal budget.
In the weeks since the executive orders were signed, the situation has deteriorated substantially. In late February, the administration terminated approximately 10,000 foreign assistance projects. This action led to the cessation of critical health services worldwide—such as malnutrition, HIV, and tuberculosis treatments—and contributed to mass layoffs around the world. Quantifying the toll on human life will be almost impossible given the destruction of global data systems funded through these programs; however, early reports from news outlets and nongovernmental organizations are already reporting excess mortality and the breakdown of lifesaving programs.
For example, Sudan is currently experiencing the world’s largest humanitarian emergency, exacerbated by war-induced famine. Over half of its population of 50 million people are starving, including 3.2 million children under five with acute malnutrition. The US had pledged $2 billion in humanitarian aid to Sudan before USAID’s shutdown. In Somalia, three million people are displaced due to conflict and are dependent on foreign aid. USAID was set to provide $125 million to Somalia in 2025 for nutrition programs. Without treatment, it is estimated that 50–60 percent of children with severe acute malnutrition in hospital or famine settings will die. By contrast, the risk of mortality for children with severe acute malnutrition in a well-managed therapeutic feeding site is often below 5 percent. That means that if USAID and humanitarian partners like the WHO are unable to mount a full humanitarian response to these crises, there could easily be hundreds of thousands of preventable deaths due to severe acute malnutrition in children in Sudan and Somalia alone.
The dismantling of USAID will not only lead to short-term increases in malnutrition and mortality in humanitarian emergencies, but will also have lasting effects on global food security.
Lindsey Locks
The dismantling of USAID will not only lead to short-term increases in malnutrition and mortality in humanitarian emergencies, but will also have lasting effects on global food security. USAID leads Feed the Future*,* the US government’s global hunger and food security initiative launched in 2010. The initiative supports food security programs in 20 priority countries in Africa, Asia, and South America, including Aquaculture and Nutrition Activity, which enhances fish production and nutrition in Bangladesh, and Growth through Nutrition, aimed at reducing childhood stunting in Ethiopia. It also supports research through a network of university-based labs in 17 US states—including land-grant universities and historically Black colleges and universities—that collaborate with international partners to create innovations in nutrition and agriculture. Feed the Future investigators and implementers were sent stop-work orders on January 30.
The changes will also greatly impact data availability and infrastructure for tracking malnutrition and mortality worldwide. USAID managed the Famine Early Warning Systems Network (FEWS NET), created in 1985 after thedevastating famine in the Horn of Africa that led to over a million deaths. FEWS NET integrates multiple data sources to predict and prevent famine. Its forecasts are an integral part of the United Nations humanitarian response system, guiding governments and humanitarian agencies in planning responses to food crises. FEWS NET has been taken offline and critical early-warning and response capabilities have been lost.
USAID also supported the Demographic and Health Surveys (DHS) Program*,* which received a termination letter on February 25. It’s widely considered the gold standard of global health surveys. Conducted in 90 countries since 1984, DHS provides nationally representative data to track health trends like maternal and child health, malnutrition, HIV/AIDS, malaria, and more. The DHS standardized data collection allows for reliable comparability across countries and over time. How will we measure the impact of the administration’s recent policies on human life and health systems without methodologically rigorous surveys across dozens of countries over time? Or perhaps that’s the point?
These early actions are a wake-up call for all people who believe that health is a human right, and that no child should die from malnutrition in a world with an abundance of food. The decisions being made by the federal government over the last several weeks will reverse decades of progress in reducing malnutrition and hunger worldwide. Scientists, policymakers, and advocates must rally together to oppose these policies, ensuring that nutrition and health remain global priorities.
Now is not the time for silence. The world cannot afford to lose the progress made in global nutrition. The question is not whether we can afford to continue supporting these programs—it is whether we can afford not to.
Lindsey Locks is a Boston University Sargent College of Health & Rehabilitation Sciences assistant professor of health sciences and a School of Public Health assistant professor of global health. She’s a global health nutrition epidemiologist with expertise in nutrition interventions in low-resource settings, and experience working in both sub-Saharan Africa and South Asia with academic institutions, UN agencies, and nongovernmental organizations.
“Expert Take” is a research-led opinion page that provides commentaries from BU researchers on a variety of issues—local, national, or international—related to their work. Anyone interested in submitting a piece should contact thebrink@bu.edu. The Brink reserves the right to reject or edit submissions. The views expressed are solely those of the author and are not intended to represent the views of Boston University.
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