These days, “How are you?” is a loaded question for anyone who works in humanitarian aid or development. Hundreds of programs are being shuttered worldwide as the Trump administration terminates USAID grants and contracts on a massive scale as it dismantles an agency that was once the world’s biggest aid donor.
Amid the furloughs and layoffs, there’s one concern I keep hearing: What will become of the millions of food-insecure people worldwide who rely on U.S. foreign aid to be fed — and particularly the treatment for severely malnourished children, tens of thousands of whom need round-the-clock care in inpatient stabilization centers?
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“Some of [these children] are going to have hours to live if they’re sent home. Some of them might have days, and some of them might survive. Most won’t,” says Jeanette Bailey, the global practice lead and director of research for nutrition at the International Rescue Committee. Last week, IRC received “a significant number” of cancellation notices for its stabilization centers and programs that were serving hundreds of children in Burkina Faso, Chad, South Sudan, and elsewhere — though some of those cancellations were later reversed.
“We've had to terminate a number of staff in the last week. We were all in tears,” says Shawn Baker, chief program officer at the nonprofit Helen Keller Intl, which works with countries to end malnutrition. “But all the staff we had to terminate, their first concerns were not that they're losing their jobs and livelihoods. Their first concerns were the moms and dads and children who would not be served.”
Helen Keller Intl estimates that terminations of its programs alone are estimated to place nearly 21 million people, including 11 million children, at immediate risk because of halted nutrition and health care support. And in an internal USAID memo last week, USAID’s acting assistant administrator for global health, Nicholas Enrich, wrote that stopping the agency’s nutrition programs would lead to 1 million children with severe acute malnutrition losing access to treatment. (He was placed on administrative leave two days later.)
The chaos of USAID’s dismantling is starkly illustrated in the tale of two U.S.-based producers of lifesaving peanut paste for severely malnourished children known as ready-to-use therapeutic food, or RUTF. Last week, Rhode Island-based Edesia and Georgia-based MANA Nutrition, both nonprofits whose products save millions of children’s lives annually, were forced to halt production lines as the U.S. government terminated their multimillion-dollar contracts. Those contracts were reinstated within days, with no explanation or apology. It comes on top of both nonprofits receiving stop-work orders last month that were later rescinded, too. It’s enough to give the two companies whiplash, with chaos and instability being no way to do business, their CEOs tell me.
But regardless of whether Edesia and MANA Nutrition can keep working, their RUTFs will now have great difficulty reaching kids in need. That’s because the Trump administration’s mass USAID contract terminations have disrupted vast swaths of a delicate supply chain. The ingredients for the peanut paste from U.S. farmers’ fields typically make it to Edesia and MANA Nutrition’s factories for production and packaging, and the RUTFs are then sent to ports and onward to children throughout Africa, Latin America, and the Middle East — where a health worker typically administers the product. A terminated USAID contract for any individual link in that chain affects the whole flow.
Tallying the losses of those contracts goes beyond malnourished children and their families.
“USAID has not just been a checkbook but has had, in-house, some of the world’s global experts on treatment of wasting — and supporting partners doing cutting-edge work,” says Baker, who also served as USAID’s chief nutritionist until 2023. The agency’s political leadership and ability to bring in other donors meant that 7.3 million children with severe wasting, the most severe form of acute malnutrition, were reached in 2023. That same year, USAID spent more than $1 billion on nutrition programming in more than 30 countries.
Much of that leadership and money is now gone.
Read: The Trump administration's flip-flop on treating malnourished children (Pro)
Background: ‘The system is breaking’ — US aid freeze threatens child malnutrition care
+ How can countries and organizations adapt to U.S. global health and nutrition funding cuts? Join our exclusive event today at 12 p.m. ET (6 p.m. CET). We’ll be joined by Olusoji Adeyi, president of Resilient Health Systems, to discuss the impacts and possible solutions. Register now.
Menu du jour
Here’s what else you need to know about USAID’s dismantling and broader foreign aid cuts, brought to you by our team of reporters around the world.
• The urgent need to rethink Africa’s health financing.
• Aid groups present case to U.S. Supreme Court as decision looms.
• Funding freeze on U.S. foreign aid is “over,” Trump administration claims.
• The U.S. aid freeze has left a funding gap. What if China steps in? (Pro)
• United Nations chief António Guterres: U.S. aid cuts make the world less healthy, safe, and prosperous.
+ Catch up on the latest news, in-depth analysis, and exclusive insights on how the Trump administration’s policies are reshaping global development.
Slow-mo progress on Cali
How’s this for a bright spot: Last week in Rome, Italy, the long-awaited Cali Fund officially launched, as part of the wrapping up of unfinished business from the U.N.’s COP16 summit on biological diversity in Cali, Colombia, last November.
The fund encourages large companies that use biodiversity's genetic data — or digital sequencing information on genetic resources — for their products to pay 1% of their profits or 0.1% of their revenue into a fund that gets shared with countries trying to conserve biodiversity. At least 50% is meant to go to Indigenous groups. But while that may be a great idea in theory, in reality there’s much enthusiasm and little in the way of actual commitments from companies, as my colleague Jesse Chase-Lubitz found while in Rome.
But perhaps the biggest news from the Rome meeting came at 1:42 a.m. local time on Feb. 28, when parties agreed on a finance strategy that guides countries on the previously agreed goal of raising $200 billion per year for nature finance and reducing harmful incentives such as government subsidies for logging by $500 billion per year, with a 2030 deadline. Though increasing nature finance will help defend against the climate crisis, this is different from the $300 billion dedicated to climate finance at the COP29 climate change conference in Baku, Azerbaijan, in November. It focuses specifically on nature issues like reforestation, sustainable agriculture and forestry, and ecosystem protection. They also decided on a financial mechanism; a monitoring mechanism for the Kunming-Montreal Global Biodiversity Framework; and a text on global progress and reporting, which will help improve transparency and accountability in biodiversity programming. Progress!
Still, as Jesse writes, the final agreement lacks details, and the most contentious part is yet to be decided: Whether the Washington-based Global Environment Facility would remain the primary financing mechanism, or whether a new fund will be created.
Read: Circus minimus — what happened at COP16 2.0 in Rome
Further reading: Cali Fund launches, calling on companies to fund biodiversity protection
See also: Industry groups say Cali Fund for biodiversity ‘not the right approach’
Background: At COP16 take two, delegates aim to finalize funding for biodiversity (Pro)
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Supercharge that bouillon
It’s been a century since the first major experiment in large-scale food fortification: putting iodine in salt to improve thyroid function, which has been wildly successful. And from a public health standpoint, the idea just makes sense: Boost the levels of micronutrients in popular, everyday foods to help surmount nutrient deficiencies that put people’s health at risk.
But micronutrient deficiencies persist, and ensuring fortified foods reach the people who need them is a complex process that involves getting a variety of players on board, writes Devex contributor Andrew Green. In Nigeria, for instance, fortification efforts have centered around bouillon, a seasoning cube of dehydrated broth and spices that is a daily staple in West African households. Organizations including the Gates Foundation and Helen Keller Intl are supporting the project.
Last year, the Nigerian government introduced voluntary standards for food manufacturers producing fortified bouillon that could include additional iron, zinc, folic acid, and vitamin B12. Researchers estimate that the policy change has the potential to save the lives of more than 57,000 children in Nigeria under 5 years old between 2023 and 2030.
Large-scale food fortification will feature prominently on the agenda of the Nutrition for Growth summit in Paris, France, later this month.
Read: New ways of fortifying staple foods could save lives. Here’s how
A nutrition double bind
Bringing home the bacon
Your next job?
Regional Director, Africa
Feed the Children
Africa (remote)
Yesterday was World Obesity Day, and the latest figures are staggering: A 150% rise in Class II obesity is expected by 2030, with Africa facing a 200% jump in adult obesity rates, according to the World Obesity Federation. The increase is powered by a surge in ultraprocessed foods. This escalating health crisis is also directly linked to major noncommunicable diseases like diabetes, cancer, stroke, and heart disease, which are responsible for 1.6 million premature deaths a year.
Many low- and middle-income countries in Africa face a “double burden” of malnutrition, where undernutrition and overweight coexist within the same populations, households, or even individuals, writes my colleague Ayenat Mersie. “The number of those who are overweight or obese is actually higher than those who are underweight in many cases,” points out Agnes Erzse, a nutrition specialist with UNICEF.
To combat the issue, UNICEF champions policy measures such as marketing restrictions and nutrition labels on food. But food industry lobbying has hampered many of these efforts: “Governments we work with consistently point to industry interference as a major barrier,” says Erzse.
Read: Obesity is on the rise in Africa. Here’s what UNICEF is doing about it
Background: Can warning labels help to guide consumers and counter obesity?
Chew on this
Advocates warn World Bank’s farm financing risks fueling the next pandemic. [Devex]
Afghanistan is descending toward famine, as U.S. aid cuts could trigger mass starvation. [RadioFreeEurope/RadioLiberty]
U.S. aid cuts make famine more likely and easier to hide. [International Crisis Group]
The World Food Programme is closing its southern Africa office in the wake of the Trump administration’s aid cuts. [Associated Press]
About the author
Tania Karas@TaniaKaras
Tania Karas is a Senior Editor at Devex, where she edits coverage on global development and humanitarian aid in the Americas. Previously, she managed the digital team for The World, where she oversaw content production for the website, podcast, newsletter, and social media platforms. Tania also spent three years as a foreign correspondent in Greece, Turkey, and Lebanon, covering the Syrian refugee crisis and European politics. She started her career as a staff reporter for the New York Law Journal, covering immigration and access to justice.
