U.S. foreign aid changed in 2025 – and it was felt around the world

Summary

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Consider This from NPR

Episode: "U.S. foreign aid changed in 2025 – and it was felt around the world"

Aired: December 26, 2025
Host: Juana Summers
Key Contributors: Fatma Tanis, Gabriela Emanuel, Zach Mack

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Overview

This episode examines the sweeping changes made to U.S. foreign aid policy in 2025 under President Trump. With an executive order freezing almost all international assistance and a subsequent State Department "pause" on funding, the U.S. halted billions in foreign aid. The episode explores how these decisions rippled across aid-dependent countries, impacting health programs, refugees, and global perceptions of America. NPR’s correspondents discuss the motivations behind the overhaul, humanize its consequences through personal stories, and describe what the new approach to foreign aid looks like today.

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Key Discussion Points and Insights

1. The Executive Order and Initial Reactions

• [00:00–01:42]
  • On inauguration night, President Trump signed an executive order freezing most international aid for 90 days.
  • Secretary of State Marco Rubio expanded this with a memo halting all foreign aid spending and issuing stop work orders.
  • Billions of dollars in programs were suspended, from infrastructure to vaccinations and conflict zone relief.
  • Abby Maxman (Oxfam America): "It's having seismic impacts for the entire global aid system. And really, frankly, it's a cruel decision that has life or death consequences for millions of people around the world." [00:47]

2. Immediate Global Impact

• [01:19–02:04]
  • Programs targeting neglected tropical diseases in countries like Mali shut down.
  • Mamadou Kouybali (Mali Ministry of Health): "It was like a thunderbolt. This lack of financing has stopped our activities." [01:19]
  • Countries attempted to fill funding gaps but could not fully compensate, risking a resurgence of preventable diseases.
  • In southwest Uganda, refugees reduced food purchases after U.S. funding for the UN World Food Program ceased.
  • Dean Carlin (anti-poverty economist): "Because of the cutbacks in aid, there was less economic activity going on. The markets were not as thriving..." [01:58]

3. Changing Landscape of U.S. Foreign Assistance

• [02:06–04:04]
  • By the end of the Trump administration’s first year, some aid resumed but at much-reduced levels.
  • The overhaul has long-term consequences for those needing help and for America’s global reputation.

4. Global Shock and Policy Motivations

• [04:04–05:25]
  • Gabriela Emanuel: "Reaction globally was what at the beginning, total shock. Some people we spoke to called this kind of a cataclysmic event." [04:10]
  • Fatma Tanis explains: The Trump administration viewed foreign aid as unnecessary, costly, and at odds with “America First” ideals. Critics labeled USAID as advancing a “woke agenda.” [04:27]
  • Max Primorak (Heritage Foundation): "We were spending money every year. It was never changing. We weren't solving problems. We were not putting Africans in the lead." [05:25]
  • The administration wanted to dismantle and rebuild foreign aid to align with conservative ideologies and economic goals.

5. Catastrophic Human Impact

• [05:40–08:19]
  • Reports from Zambia and elsewhere revealed clinic closures and loss of life-saving medications.
  • Gabriela Emanuel: "One woman ... her son had died because their US funded hospital had closed. Another whose baby had died because she could no longer get the treatment for severe malnutrition." [06:05]
  • Specifically, HIV clinics established under PEPFAR (started by George W. Bush) shut down, leaving patients without meds overnight.
  • Human story: Teresa Mwanza and her 10-year-old daughter in Zambia ran out of HIV medication when their clinic closed, leading to visible decline in the daughter’s health. [07:01–07:28]
  • "This is not an isolated event. I met many others who this was happening to as well..." [07:28]
  • Alarming statistic: "One study ... found that this is the first year this century that child deaths under age 5 went up instead of down. And that is directly due to aid cuts." [08:19]

6. Erosion of U.S. Global Image

• [08:19–09:51]
  • Loss of aid confused and disappointed many in countries that had relied on American support.
  • Fatma Tanis: "I saw that when I was in Uganda in August and there was confusion about why the US a global superpower ... would suddenly stop giving money." [08:51]
  • Okot Bosco (South Sudanese refugee): "America benefits, but they don't know that they are benefiting. They benefit. They trust people, trust them so much." [09:34]
  • U.S. aid was seen as building goodwill, trust, and projecting 'soft power' abroad.

7. The New Model: Direct Government Partnerships & Business

• [09:51–11:00]
  • The U.S. now prioritizes working directly with foreign governments, supporting American businesses and faith-based organizations, departing from the previous focus on NGOs and nonprofit partners.
  • Example: $150 million grant to American drone company Zipline to expand deliveries of health supplies in Africa.
  • Max Primorak: "This administration is being a far better steward of American taxpayer monies than previous administrations were. So it's recognizing we have a debt, recognizing that we have to be effective around the world with less and taking the steps to do so." [10:42]

8. Glimmer of Hope: Local Government Response

• [11:00–11:28]
  • The Zambian government, upon hearing NPR’s reporting, intervened to ensure that certain communities regained access to HIV medication.
  • Gabriela Emanuel: "The Zambian government heard our reporting...made sure that they could access their HIV meds. It's a small number of people, relatively speaking, but it was a good sign." [11:09]

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Notable Quotes & Memorable Moments

• Abby Maxman (Oxfam America) [00:47]:
  "It's having seismic impacts for the entire global aid system. And really, frankly, it's a cruel decision that has life or death consequences for millions of people around the world."

• Mamadou Kouybali (Mali Ministry of Health) [01:19]:
  "It was like a thunderbolt. This lack of financing has stopped our activities."

• Dean Carlin (Economist) [01:58]:
  "Because of the cutbacks in aid, there was less economic activity going on. The markets were not as thriving..."

• Gabriela Emanuel [04:10]:
  "Reaction globally was what at the beginning, total shock. Some people we spoke to called this kind of a cataclysmic event."

• Max Primorak (Heritage Foundation) [05:25]:
  "We were spending money every year. It was never changing. We weren't solving problems. We were not putting Africans in the lead."

• Gabriela Emanuel (on Zambian clinic closures) [07:01–07:28]:
  "I was with them at their house. The little girl was confused about what was happening...the daughter was already showing visible signs of the virus of HIV returning because she wasn't on her meds."

• Okot Bosco (South Sudanese refugee) [09:34]:
  "America benefits, but they don't know that they are benefiting. They benefit. They trust people, trust them so much."

• Max Primorak (Heritage Foundation) [10:42]:
  "This administration is being a far better steward of American taxpayer monies than previous administrations were...recognizing that we have to be effective around the world with less and taking the steps to do so."

• Gabriela Emanuel (on Zambian government action) [11:09]:
  "The Zambian government heard our reporting...and made sure that they could access their HIV meds. It's a small number of people, relatively speaking, but it was a good sign."

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Important Timestamps

• 00:00–01:42: Executive order and global aid freeze, initial humanitarian fallout
• 01:42–02:04: On-the-ground consequences in Mali and Uganda
• 04:10: Global “shock” at the announcement
• 05:25: Conservative rationale for the policy overhaul
• 06:05–07:28: Personal stories of loss, clinic closures, health emergencies
• 08:19: Rise in child mortality directly linked to aid cuts
• 09:34: Reflections from an aid recipient on American trust and influence
• 10:01: New direct-government partnership approach to aid
• 11:09: Positive local government reaction following NPR’s reporting

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Tone and Language

The podcast conversation is urgent, empathetic, and fact-driven, amplifying firsthand stories and expert analysis while holding policy decisions accountable. Reporting is clear-eyed about the devastation caused while highlighting resilience and adaptive responses in affected countries.

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Summary Takeaways

• The unprecedented foreign aid freeze and overhaul under President Trump’s 2025 administration caused severe humanitarian disruptions, reversing decades of health and development progress.
• Rationale for the cuts was rooted in “America First” politics and a conservative agenda, sparking both controversy and strategic shifts toward direct government and business involvement.
• The fallout was immediate and far-reaching: healthcare systems crumbled, diseases resurged, and humanitarian aid vanished.
• Resentment, confusion, and loss of goodwill replaced the trust and positive influence the U.S. had built abroad.
• The episode powerfully humanizes policy impacts and raises challenging questions about America’s future role and reputation in the world.

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Transcript

[Juana Summers]

On the night of his inauguration, President Trump signed an executive order that froze almost all international assistance for 90 days. Shortly after that, the State Department has.

[Zach Mack]

Issued an expansion on President Trump's executive action Monday to freeze foreign assistance for 90 days.

[Juana Summers]

In a memo, Secretary of State Marco Rubio ordered a pause on foreign aid spending and a stop work order for any existing humanitarian and development projects. 1 what followed was the termination of billions of dollars in aid, which funded everything from infrastructure building to vaccination programs to getting supplies into sensitive conflict zones. Experts like Abby Maxman, president of Oxfam America, warned at the time that this move could have a destabilizing effect in countries where that aid's critical.

[Fatma Tanis]

It's having seismic impacts for the entire global aid system. And really, frankly, it's a cruel decision that has life or death consequences for millions of people around the world.

[Juana Summers]

One US foreign aid program working to eliminate so called neglected tropical diseases was shut down this year. Those diseases affect more than a billion people worldwide and can be debilitating. Mamadou Kouybali coordinates several disease elimination programs for the Mali Ministry of Health.

[Zach Mack]

It was like a thunderbolt. This lack of financing has stopped our activities.

[Juana Summers]

He says the country has used its own money to fill the financial void, but it just isn't enough.

[Zach Mack]

These are diseases that make someone completely invalid. They have a very heavy impact on the development of the country. There could be a return of these diseases if we're not careful.

[Juana Summers]

Over in southwest Uganda, locals note that refugees are spending less on food. That's because the US has not renewed its contributions to the UN's World Food Program that helped them buy groceries. The economist Dean Carlin works on anti poverty programs in the region.

[Zach Mack]

Because of the cutbacks in aid, there was less economic activity going on. The markets were not as thriving, and.

[Fatma Tanis]

They could actually see that difference.

[Juana Summers]

As the Trump administration ends its first year, some foreign aid money is flowing again, but much less than before. And the future of US foreign assistance now looks very different. Consider this. The complete overhaul in foreign aid policy is affecting people on the ground who need assistance now, and it may come to affect the reputation of the United States worldwide. From npr, I'm juana summers.

[Nora Ramm]

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[Zach Mack]

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[Nora Ramm]

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[Zach Mack]

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[Juana Summers]

It's Consider this from NPR the cuts to foreign aid and the shutting down of USAID had widespread impact on countries and programs that relied on that assistance. NPR spot Matanis and Gabriela Emanuel have been following this all year and spoke with my co host Mary Louise Kelly about it.

[Fatma Tanis]

Gabriela, just reaction, the Trump administration makes this move right out of the gate.

[Gabriela Emanuel]

Reaction globally was what at the beginning, total shock. Some people we spoke to called this kind of a cataclysmic event.

[Fatma Tanis]

Okay, so Fatma, the why question why did the Trump administration a feel they need to do it and b do it so quickly?

Well, it became clear quickly that the Trump administration viewed foreign aid as a big fat problem, that it was not aligned with the national interest, it cost too much money, even though, you know, foreign aid was about 1% of the overall federal budget. So they wanted to really take the whole thing apart and recreate it in a way that fits the the America first foreign policy. Usaid, as the agency that led foreign aid, was seen by Trump Republicans as a bastion of the left. And some of its programs that supported gender equity or LGBTQ rights or climate solutions or even reproductive health, they were seen as part of this woke agenda that taxpayers should not be funding. And the president even accused the agency of waste, fraud and abuse, even though the White House hasn't provided evidence of that so far. I spoke with Max Primorak. He's with the Heritage Foundation. It's the conservative think tank that was behind Project 2025. Primorak has held several senior roles at USAID in the past. Here's how he would put it.

[Max Primorak]

We were spending money every year. It was never changing. We weren't solving problems. We were not putting Africans in the lead. And it just through inertia, spending a lot of money without really seemingly to get the kinds of results that we wanted.

[Fatma Tanis]

Other global health experts disagree. We talked to people who said USAID could have been certainly Improved in many different ways. But they also said that you burning it all down as the administration did, was arbitrary and irresponsible.

Well, and Gabriela, say more about the burning it all down and the consequences. You were starting to describe this as you were hearing from people. Chaos, words like cataclysmic. What was the impact?

[Gabriela Emanuel]

Yeah. So we talked to people all over the world. One woman who her son had died because their US funded hospital had closed. Another whose baby had died because she could no longer get the treatment for severe malnutrition. When I went to Zambia about eight weeks after the foreign aid freeze went into effect, I met people who were on HIV medications and found that overnight their neighborhood clinics had shut down. These were clinics funded by the US that had been part of this kind of massive decade long effort that was started under George W. Bush to control HIV AIDS. The U.S. put over $100 billion into this. It's credited with saving 26 million lives. And then suddenly the doors are locked, electricity turned off and people could no longer get their daily meds.

[Fatma Tanis]

Okay, so just make this specific, like is there one human story you would tell that brings us home?

[Gabriela Emanuel]

Yes. So one mom I met, Teresa Mwanza. She had a 10 year old daughter. They were both HIV positive. They got their daily medication from one of these local US funded clinics in their neighborhood. And then one day her daughter went to get their medications. Here's Teresa Mwanza.

[Fatma Tanis]

So she'll run to the clinic and then she'll come back home and say.

Oh, the clinic is closed, they're not there anymore.

What are we going to do?

[Gabriela Emanuel]

I was with them at their house. The little girl was confused about what was happening. And at that point when I met the two of them, they had completely run out of their medications. And the 10 year old girl, the daughter, was already showing visible signs of the virus of HIV returning because she wasn't on her meds. And this is not an isolated event. I met many others who this was happening to as well. People losing weight, developing these open sores, flu like symptoms, all signs that HIV was progressing to aids. And I'll just add here that the scale is hard to overstate. One study out of the Institute of Health Metrics and Evaluation found that this is the first year this century that child Deaths under age 5 went up instead of down. And that is directly due to aid cuts.

[Fatma Tanis]

Fatma. It's so interesting because it wasn't that long ago that you would have found a largely bipartisan consensus that in fact foreign aid was in America's Interests. It was a tool of power that America could project abroad. A soft power, but making friends, building goodwill, spreading ideals about America and American democracy. I know this is hard to answer, but are you able to track how this year's developments have changed the way people see the United States?

It is hard to track, like you said, but in speaking to people when we were out there on the ground overseas, you could see that it had had some impact on the way people viewed the United States. I saw that when I was in Uganda in August and there was confusion about why the US a global superpower, as people put it, would suddenly stop giving money. Some people thought it was a sign that the US was struggling financially or that it wasn't as strong as it used to be. But it was also clear that years of had bought the US some goodwill among people like Okot Bosco. He's a refugee from South Sudan who lost his job with an aid group because of the US cuts. And he told me America's foreign aid money was not just a one way street. It wasn't just the recipients like himself who benefited.

[Zach Mack]

America benefits, but they don't know that they are benefiting. They benefit. They trust people, trust them so much.

[Fatma Tanis]

Bosco grew up in a camp for displaced people and he told me he never forgot the food and medicine that he and his family got that carried the USAID logo, the American flag with the words from the American people on it.

Okay, so we're at this moment now, Fatma, where the US is spending less money on foreign aid and they're also spending it differently. There's a new approach they've rolled out. What is it?

That's right, they rolled it out in September. And instead of working with nonprofits or aid groups like the old model, the US is now prioritizing, working directly with governments, creating opportunities for American businesses and also faith based organizations. So the State Department recently announced one of its first major grants, $150 million to the American drone zipline, to expand their operations in Africa, delivering medicine, blood supplies, other health supplies. They also made agreements with Kenya, Uganda and Rwanda, where the US will be investing hundreds of millions of dollars to those countries. And those governments will be also putting in money as well. Here's how Primorak with the Heritage foundation sees this new strategy.

[Max Primorak]

This administration is being a far better steward of American taxpayer monies than previous administrations were. So it's recognizing we have a debt, recognizing that we have to be effective around the world with less and taking the steps to do so.

[Fatma Tanis]

Okay, so the argument there for this new approach. Gabriella, one more question to you just before I let y' all go. What happened to the little girl who couldn't get her HIV meds?

[Gabriela Emanuel]

So we have good news here, actually. The Zambian government heard our reporting. They went to the villages where we had profiled the community, and they re interviewed them, saw the situation, and made sure that they could access their HIV meds. It's a small number of people, relatively speaking, but it was a good sign.

[Fatma Tanis]

NPR's Gabriela Emanuel and Fatma Tanis, thank you so much for your reporting.

Thank you.

[Gabriela Emanuel]

Thank you.

[Juana Summers]

This episode was produced by Mallory Yu with additional reporting by Jonathan Lambert. It was edited by Patrick Jaranwattanan and Rebecca Davis. Our executive producer is Sammy Yenigun. And thanks to our consider this + supporters who make the journalism you hear on the show possible. Supporters also hear every episode without messages from sponsors. Learn more at plus.NPR.org. It's Consider this from npr. I'm Juana Summers.

[Nora Ramm]

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[Zach Mack]

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