Trump’s Attacks on Global Health: Devastating Impacts on Life-Saving Programs Around the World
As Donald Trump and Elon Musk continue their slash-and-burn rampage through the US government, perhaps no other set of programs has been as thoroughly devastated as foreign aid.
Only hours after taking office, Trump announced a 90-day “pause” on new aid commitments, claiming that all proposed programs would be reviewed to ensure they were compliant with his administration’s priorities. Days later, the implementors of existing programs began receiving “stop-work” orders requiring them to immediately suspend their operations.
Secretary of State Marco Rubio later issued a temporary waiver for existing “life-saving humanitarian assistance” programs, to include “core life-saving medicine, medical services, food, shelter, and subsistence assistance, as well as supplies and reasonable administrative costs.” However, despite the administration’s claims, experts in the field report that in most cases aid remains frozen.
The United States Agency for International Development (USAID), which has historically been the funding agency for most family planning programs, has been functionally dissolved, with thousands of employees fired or placed on indefinite leave and the agency’s headquarters closed. Additionally, in late February the administration announced that their review of current programs was complete and abruptly terminated more than 90% of USAID contracts.
All these actions are at best legally questionable and at worst outright illegal. Thus far, however, Trump’s congressional allies have declined to rein him in, and, indeed, many continue to cheer him on. There are multiple lawsuits pending before every level of the federal court system, but given the makeup of the Supreme Court, their outcome is uncertain—as is Trump’s willingness to abide by their rulings, should they go against him.
What Does this Mean for Family Planning Programs?
In FY 2024, Congress appropriated $607.5 million for family planning, including $32.5 million for the US contribution to the United Nations Population Fund (UNFPA). That funding is estimated to have provided 47.6 million women and girls with access to family planning in 2024. The contribution to UNFPA has officially been halted. Though there has not been official confirmation on the fate of the rest of the funds, given this administration’s ongoing hostility to reproductive health and rights generally, it seems safe to assume it has been or will be canceled.
The loss of the UNFPA funding was expected. Every Republican president since 1985, including Donald Trump during his first term, has withheld the US contribution to the organization. The cancelation of other contracts, however, is unprecedented.
Advocates are still trying to quantify the scale of the devastation that will follow. According to the Guttmacher Institute, an average of 130,390 women receive contraceptive care each day through US-funded programs. Over the course of a month, that number rises around four million. They calculate that the original 90-day “pause” would have denied care to 11.7 million women and girls and resulted in 4.2 million unintended pregnancies and more than 8,000 deaths due to complications from pregnancy and childbirth.
The full effect of a permanent loss of funding can’t yet be calculated, though it will clearly be profound. The cancelation of other programs that particularly benefit women and girls—including HIV/AIDS prevention and treatment programs; water, sanitation, and hygiene (WASH) programs; and girls’ education initiatives, to name a few—will only exacerbate the problem and increase the need for family planning and reproductive health services.
The Road Ahead
For family planning advocates, the way forward is uncertain. Lawsuits and public pressure may have some impact on the administration’s decisions going forward, but there is no way to easily repair the mechanisms that have been broken.
It is unclear if other donor countries will be willing or able to make up the shortfalls caused by the abrupt cancelation of US funds. It is certain they cannot do so quickly enough to avert many of the disastrous effects outlined above. At a bare minimum, the disruption of services will have a profound negative effect on the people who depended on these lifesaving programs.
Foreign aid has historically accounted for less than 1% of the US federal budget. The tiny fraction of that amount spent on family planning has delivered outcomes that have improved the lives and wellbeing of millions of people. In the name of cutting costs, the Trump administration has acted with the sort of breathtaking recklessness we’ve all come to know and expect.
And women and families around the world will pay the price.
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The text below is from before Trump took office and froze international family planning assistance. Assuming the United States will someday invest in international family planning programs again, our request for $1.74 billion in funding stands.
What Would $1 Billion More Buy?
Survival, Security, and Stability
United States funding for international family planning has decreased 45% from the 1995 level ($546 million) when accounting for inflation. At the same time, the number of women of reproductive age in the developing world has grown by over 540 million.
Today, there are an estimated 218 million women in the developing world who want to prevent pregnancy, but have an unmet need for contraception. There are approximately 111 million unintended pregnancies each year in developing regions.
Unintended births and the population growth they help accelerate contribute to a host of global challenges: maternal and child mortality, resource insecurity, and conflict and regional instability. To provide and improve contraceptive services to all women in the developing world who want them would cost $12.6 billion each year (the current expenditure is $7.1 billion). Achieving this goal would require developing countries, donor countries—including the United States—and other funders to increase their investments in family planning.
The total amount needed from the United States is $1.74 billion per year—including $116 million for UNFPA—roughly $1 billion more than the U.S. is currently investing. This figure represents the U.S. fair share of the total cost of satisfying unmet need worldwide, and it will bring enormous returns for people everywhere.
Maternal and Child Survival
Every year, millions of women suffer serious complications related to pregnancy and childbirth, and approximately 287,000 die as a result. Nearly all of these deaths occur in developing countries, and nearly all are preventable. Figures from the Guttmacher Institute estimate that if the U.S. increased its international family planning investment from $605.7 million to $1.74 billion, 49,000 maternal deaths would be prevented.
Unintended pregnancy leads all too frequently to unsafe abortion. Of the 68 million abortions in the developing world each year, nearly half (35 million) are unsafe, and 20 million women are treated for complications as a result. Fulfilling unmet need for family planning would reduce these numbers dramatically.
Lack of access to family planning also increases the risks to newborns. Birth spacing is critical to newborn health. Women who are unable to space or time pregnancies are at much higher risk of birth complications and of having babies with low birth weight. Every year, 2.3 million infants die in their first month of life, and a similar number are stillborn. Robust commitment to family planning and reproductive health services would save infant lives.
Real investment in family planning will save the lives of women and children around the world.
BY THE NUMBERS:
- 218 million women in the developing world have an unmet need for family planning.
- Unsafe abortion kills 23,000 women every year.
- Eliminating unmet need for family planning and providing essential health services for all pregnant women would prevent 186,000 maternal deaths each year.
Resource and Climate Security
Population growth increases greenhouse gas emissions and reduces communities’ climate resilience and ability to adapt to climate changes. Growing demand for food, fuel, and fresh water causes habitat destruction, depletes natural resources, and creates land, water, and air pollution. Increasing access to voluntary family planning and comprehensive reproductive health care is one way to help address these global challenges.
Real investment in family planning can help protect the environment, relieve pressure on natural resources, and aid in climate change mitigation, adaptation, and resilience.
BY THE NUMBERS:
- 771 million people lacked a basic drinking water service in 2020, half of them in sub-Saharan Africa.
- 691–783 million people were chronically hungry in 2022; about 900 million were severely food insecure.
- Slowing population growth could provide 16–29% of the emissions reductions necessary by 2050 to avoid dangerous climate change.
Peace and Stability
Today’s generation of young people is the largest in history, with 3.26 billion people under the age of 25. Nearly 90% of these young people live in the developing world, many of them in countries unable to meet the needs of their citizens. This reality places much of the developing world at a major crossroads. Ensuring that young people can expand their opportunities for education, employment, and a healthy, productive future will make their lives better and will strengthen the economic and social stability of developing nations.
Failure to address the needs of this “youth bulge,” however, is likely to expose rapidly-growing countries to the risk of civil unrest and conflict and to have dramatic consequences for the stability of the world for decades to come.
Real investment in family planning will encourage social progress and decrease the risk of conflict and instability.
BY THE NUMBERS:
- More than 108 million people had been forcibly displaced at the end of 2022.
- Millions of people are stateless—by being denied a nationality, they may also be denied basic rights such as water, sanitation, education, health care, employment, and freedom of movement.
- The number of people living in extreme poverty in sub-Saharan Africa is estimated at nearly 400 million—about 35% of the population in that region.
Real investment in family planning can create a more just and humane world and a healthier, safer, more prosperous future for all.
The Benefits of U.S. International Family Planning Assistance
The United States currently invests $607.5 million in assistance for international family planning and reproductive health programs. This results in:
- 47.6 million women and couples receiving contraceptive services and supplies;
- 17.1 million unintended pregnancies averted;
- 7.6 million unplanned births averted;
- 5.2 million unsafe abortions averted; and
- 34,000 maternal deaths averted.
Every $10 Million Decrease in Funding Results in:
- 1 million fewer women and couples receiving contraceptive services and supplies;
- 362,000 additional unintended pregnancies;
- 161,000 additional unplanned births;
- 110,000 additional unsafe abortions; and
- 718 additional maternal deaths.
This page was last updated in March 2025.