Front Burner - The human toll of Trump's war on aid

Episode Date: December 18, 2025

On the first day of his second term as U.S. president, Donald Trump signed an executive order effectively gutting USAID — the United States Agency for International Development. It's an arm of the government that, in 2024, was operating in more than 130 countries worldwide, providing food, medicine and other life-saving support.At the time, advocates said the cuts would result in preventable deaths from starvation, malnutrition, and easily treatable diseases. Now, nearly a year later, reporting from ProPublica suggests that’s what happened, particularly in several African countries.Anna Maria Barry-Jester, a reporter with ProPublica, breaks down her investigation into the fallout of the collapse of USAID.

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Donate at lovescarbro.cairbo. This is a CBC podcast. Hey, everybody. I'm Jamie Plesson. In 1961, during the height of the Cold War, the U.S. government set out to create an agency that would advance American interests and foster stability around the world. The U.S. Agency for International Development,

USAID for short, would go on to become the largest humanitarian donor in the world, supporting work in over 100 countries. It funded food programs, HIV-AIDS education, wildlife conservation, disease prevention, the list goes on and on. But on day one of President Trump's second term, all that funding came to a screeching halt. He signed an executive order that froze all foreign aid. All programs would need to go through a review.

And then within weeks, Trump officials eliminated over 90% of USAID-funded programs, cutting around $60 billion worth of funding. Amidst criticisms that this would cost millions of lives, the administration promised to keep or restore critical life-saving programs. According to a new investigation by ProPublica, that promise was not kept. Anna Barry Jester and her colleagues at ProPublica have just launched a three-part series on the fallout from U.S. foreign aid cuts in Africa. Anna, hi, thank you so much for coming on to the show.

Hi, Jamie. Thank you for having me. So I mentioned the executive order that comes down, where essentially all USAID programs are put on pause. USAID run by radical lunatics, and we're getting them out, and then we'll make a decision. As we dug into USAID, it became apparent that what we have here is not an apple with a worm in it, but we have actually just a ball of worms. Before we get to what happened after that, can you just give us a sense of the range of programs that are affected here on day one? We're talking about thousands, right? Right, thousands of programs all over the world. As you said, you know, the largest of USAID is hard to describe.

This was the largest aid and development funder in the world. And so it funded a giant swath of programs. I mean, everything from sort of civil society groups doing democracy work to health care services, which were really. essential. I mean, we're talking, you know, the bedrock of health services in a lot of countries, as well as humanitarian programs that provided basic essentials like food and water to refugees and people in the midst of disasters. In 2023, the agency managed and appropriated more than $40 billion in aid, with the largest sums going to Jordan, Ethiopia, and the top recipient, Ukraine. And just remind me of the pushback to that decision at the time it was

immediate, I remember, from diplomats, NGOs, even staff within the State Department. Yeah, there was both huge pushback, and it was also a bit muted in a way. So this all happened very quickly, and it was a total shock to the system. You know, this was an agency that was congressionally created, meaning, you know, Congress mandated this agency. They funded it with billions of dollars each year. And it was, you know, completely ground to a halt, essentially. You know, there was a lot of pushback from aid groups, from NGOs, but also a lot of fear that if people spoke out, that they would lose their money because they were being subjected to a review. So there was also, you know, of course, an enormous amount of internal outcry and some leadership within USAID spoke out. But then at the same time, the political appointees also fired or put on leave nearly all of USAID's 10,000 employees.

And then I would say that the response from Congress was relative. muted in a sense. And there could be some reasons for that. One thing we know is that they didn't have a lot of information about what was happening. And part of why we started investigating USCID is because we kept learning about a giant disconnect between what was actually happening behind the scenes and what officials were saying publicly about the review and about these lifesaving programs and continuing them. And just tell me a little bit more about what you found was happening behind the scenes. Yeah, so, you know, publicly Secretary of State Marco Rubio was saying that life-saving programs would continue that there was a waiver process. But I issued a blanket waiver that said if this is life-saving programs, okay, if it's providing food or medicine or anything that is saving lives and is immediate and urgent, you're not included in the freeze.

I don't know how much more clear we can be than that. And I would say if some organization... But what we kept hearing from both humanitarian groups and communities on the ground was that that was not happening, right? That there were these programs, they had been frozen, and then there was a process that had to happen in order to get that waiver for life-saving programs to continue. So A-groups were on this pendulum where they were getting a letter that said, you must stop all operations immediately. If they were lucky, maybe a few weeks later, they would get a letter saying you can continue programs, but many of them described. getting four or five letters, turning these programs on and off, which left them very confused and unsure of what to do going forward. Additionally, they were not getting any money, so including

for work that they had already done before the Trump administration took place, as well as money for the kind of continuation of their programs. I wonder if you could give me a few examples of what that meant, like, concretely, day-to-day. Yeah, so there were a series of terminations of programs that happened. There was this spreadsheet. It's a little bit infamous within the walls of USAID. It was created by Trump administration officials. It was an effort to gather up all the programs that USAID had. But it was created using mainly these databases that were for. project management. So they didn't really describe what the programs did. And Trump officials went through and canceled programs. They made a series of cuts. So initially there were some cuts that

were programs they decided were related to DEI, which there had been specific efforts to get rid of programs that dealt with diversity, equity, inclusion. There were a range of other cuts. But then in late February, in sort of the final stretch when they were just terminated, thousands of programs all at once. There was this evening, a Friday evening when people were working late at USAID and they noticed that there was one of the officials in this spreadsheet and he was just turning programs red and yellow, green, you know, essentially terminating them. And some of the program descriptions, I mean, they said things like extension number four, you know, it wasn't really clear. And they were doing this without consulting the many experts that, you know, the government's

own experts on what these programs did. And without. really, you know, having consulted them not clear how much they understood what the programs were doing. But they're making these cuts, you know, every few seconds. It was like just imagine clicking through a spreadsheet just scrolling down and turning them colors. And that was, that was how the cuts were done. And just, you know, these line items that are turning red in this Excel sheet, like these are programs that provided stuff like food, clean water, essential medicines, right? Right. So they were. it was a range of programs. There were also programs doing development, but there were many, at this point, they'd whittled the programs down, and many of them were doing, you know, water and sanitation. We're talking about providing clean water, preventing disease outbreaks, you know, soap, those kinds of things, as well as, yeah, a range of other really essential life services. So Rubio, Secretary of State Rubio, you know, he said at the time that no one died because of cuts to U.S. foreign aid and that,

his staff had reinstated life-saving operations. But according to your reporting, were any attempts made to try and reinstate life-saving programs? Yes. So, yeah, he has said repeatedly, and the State Department continues to say no one has died as a result of the foreign aid cuts. Has anyone in the world died because of what Elon Musk did? Yes or no reclaiming my time. If you won't answer, that's a loud answer. No one has died because if you have.

The people who have died as a result of coming off. And they did maintain programs in a couple of ways. So there was a list of nearly a thousand programs that survived this review. And some of those programs we found, you know, did get funding throughout the spring and summer. But what we found was that across the board, a lot of those programs, many of those programs existed on paper. but received no funding throughout most of the year. And therefore, in many cases, we're not operational. You know, it's hard to run a program if you can't pay your staff.

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So I know you and your colleagues traveled to South Sudan and Kenya earlier this year where these foreign aid cuts, I think, were most felt, right? And let's start with your time in South Sudan. You were in an area hit by a cholera outbreak at the time that the USAID cuts were made. And tell me about what happened there. Yeah, so South Sudan was in the midst of a, pretty intense cholera outbreak, which has gone on to be the largest cholera outbreak in the young country's history. You know, there were many people fleeing Sudan from very intense

conflict there, and there was a cholera outbreak there. It quickly came over the borders. So in December, there was this giant, last, you know, a year ago today, there was a giant outbreak of cholera. And this area we traveled to is up against the Sudan border. And it has also been in the midst of conflict itself for many years. And additionally, it has this very intense flooding that has covered the area in water. So there's the country's largest refugee camp there, and then communities that are scattered on these what are now islands throughout the floodwaters. And they were in the throes of this, it was the epicenter of the cholera outbreak. And there had been, you know, the aid groups had been mounting a giant response. The U.S. had told them to

to respond to the cholera outbreak. In many cases, they told NGOs like, please spend your money aggressively, get this under control. We will review applications for new funding at the very beginning of the new year, or they already had funding and applications kind of going through the works in Washington, just sort of waiting for the money to come to them. But then the Trump administration took office and paused all of that funding. And there was this one program we were aware of that ran several of the community health clinics, you know, rural clinics that were scattered on these now islands. So we went to them. And we met this gentleman, his name is Tortaup. He lived directly next to one of these clinics, but it shuddered at the end of February.

And his mother fell ill with cholera in mid-March. And so he had to try and canoe her eight hours to the state hospital. And she died on the way. Calera is so easy to treat. You really just need hydration, IV bags, while the infection sort of passes through the body. But if you don't get that treatment, it is incredibly deadly. Yeah. Yeah. That's awful. You also spent time in Kenya, where the World Food Program, which gets a lot of its funding from USAID, was dealing with massive cuts. as well, right? And what was the domino effect like there? Yeah, so the U.S. has a sort of long-standing arrangement with Kenya. It's a security partner for the United States. They take in a lot of refugees. They have, you know, 750,000 or so refugees from surrounding countries in Kenya. And the agreement is

sort of, like, if Kenya will take in people and let them live there peacefully, then the U.S. helps with aid. And one of the big things they did was provide nearly all of the food in these two very large refugee camps. So we went to one of them called Kakama. And again, this is a program that existed on paper. It survived the cuts. It survived the terminations. But it didn't, WFP usually gets funding sort of the beginning of the year. They have to ship food over. It takes six months to do that. They also provide some cash assistance. And they had not gotten any money this year. And so WFP was forced to make a series of very complicated decisions where first they, They slashed rations to lows that they had never seen before.

So, you know, 20, 30% of what's considered the daily minimum of calories that a person needs. And then in August, they were so low on supplies that they ended up giving food to just half of the people in the camp. Wow. And then as you write, people have to make desperate decisions, right? mothers having to choose which kids to feed pregnant women with life-altering anemia so desperate that they're eating mud. You know, you talk about a woman who was unable to breastfeed and she was malnourished and her baby as well who then died, right? Yeah, so we spent quite a bit of time in the only hospital in the camp run by the International Rescue Committee.

they were having a influx of malnourished kids, and we met a couple of, we met many of these families, talked to a lot of people who were in the throes of these very difficult decisions, as you say, like they might have one child who's there admitted to the hospital for malnourishment, but they have really several children who are malnourished, and that was the case of this woman, Rose Natabo, that we spent quite a bit of time with as she was trying to figure out how to take care of all of her children, well, she had one who was so sick, who was submitted to the hospital. But we also met this couple, Mary Sunday and Jumelotunia, who they had brought their daughter, Santina, to the hospital in July. She was very, very ill. And she died

within a few days. They said they had, with the cuts, they were down to sort of one very small meal a day. Mary stopped being able to breastfeed. And their baby started kind of withering away and probably died of some very simple infection. I know that you reached out to the Trump administration for a response to your reporting, especially in regards to what you were seeing on the ground in South Sudan and Kenya, and what did they have to say about it?

Yeah, they, you know, they've maintained that nobody has died as a result. of the funding cuts. They told us that's a disgusting framing, and there are people who are dying in horrible situations all around the world all the time. They also told us that the fast and drastic changes were necessary to reform a calcified system. The world, especially U.S. interests, will be better in the long run, and that despite some disruptions in the short term, this was a better path forward. So back in March, Rubio announced that the review of USAID programs was finished. More than 5,000 programs have been flat out canceled, right? There are now

fewer than 1,000 that remain, whether just on paper or in real life, I guess. Is there a broad sense of what's been done to try and fill those gaps this year by actually anybody, not just the United States? Yeah, so aid groups described, you know, seeking private funding, moving funding around, trying to sort of keep their most critical operations open. You know, this was a very dramatic hit to sort of the whole humanitarian aid sector in the funding, but other governments have also reduced their funding in recent years. And so this is pretty, it was very difficult to find replacement funding, but they have tried to, in many cases, keep critical operations open. At the end of September, the Trump administration did release some funding for some of these programs. You know,

They had funded a few food programs and some other things, but they released sort of a much larger amount of money. So, for example, the clinics we visited in South Sudan were able to reopen in October after being shuttered for essentially nine months. But it is not clear to them what their future is with the U.S. Trump has talked about trade over aid. We had AID or aid, as we sometimes call it, right to trade. and trade seems to be a foundation that I've been able to settle a lot of these disputes. We have closed the USAID group to eliminate waste, fraud, and abuse, which was tremendous waste fraud and abuse.

And we're working tirelessly to forge new economic opportunities involving both the United States and many African nations. What does that mean, you think, concretely? Yeah, I think everyone's still trying to understand that, us included. you know, yeah, they've made this sort of overarching argument that we should work on programs that make America safer, stronger, and more prosperous. They've been signing a series of memorandums of understanding with various countries, including Kenya very recently, that sort of offer funding in exchange for countries also committing a certain amount of funding, but they they really lack in detail at this point. And there's not a lot of information about kind of what

the plan is going forward. And they've, they've spoken about these, these MOUs that they're signing, but it's, it's not exactly clear what they, how exactly they'll, you know, function and what they'll look like. Yeah. Um, these arguments in defense of these cuts that we hear from the administration and from other kind of mega adjacent officials, as you say, like, you hear the argument about how the organization is calcified and how it needs to be modernized. I mean, sometimes they talk about these programs that I actually don't, sometimes they seem real, sometimes they don't, where they say they're not doing anything. And also you hear them kind of talk about how they need to be spending money at home

while Americans are on food stamps or something, right, and not abroad. And just how would the people you spoke to you who are very critical of these cuts, respond to all of that. We heard repeatedly from aid workers. And we also heard this from military people. They've military generals and officials have said this repeatedly in public over the years is that humanitarian aid and development programs make the U.S. safer, stronger, and more prosperous by reducing conflict, essentially that if we can help people be more comfortable, they're less likely to migrate. They're less likely to engage in, in war. the U.S. ultimately spends just a fraction of a percent of its annual budget on humanitarian need

and that the return on investment is very large. So that's been the argument from humanitarian for years and certainly we heard that a lot this year. Okay. Anna, thank you so much for this. Really appreciate it. Thank you so much for having me. All right. That is all for today. I'm Jamie Poisson. Thanks so much for listening. Talk to you tomorrow.