The mess inside Rubio's 'lifesaving' waivers

In Yemen, millions of children are on the brink of starvation. It’s the result of a decade-long conflict; one that has fractured Yemen’s health care system and led to soaring levels of inflation, poverty, and displacement. For years, one organization has been filling the gaps, connecting malnourished children with the treatment they need to survive. But on Jan. 24, that work was frozen by the U.S. government. And despite submitting a waiver — an exemption that supposedly would allow lifesaving assistance to continue — the organization hasn’t heard a word. “They meet with the moms. They measure the kids’ arm circumference. They try to track down kids that are malnourished and are falling through the cracks,” said a humanitarian official familiar with the program, who spoke on the condition of anonymity due to fear of retribution. “And they’re in limbo.” For some, it’s as simple as that: lifesaving programs are not receiving lifesaving waivers. For others, it’s more complicated: Waivers have come through, but there’s no money to do the work. Across the aid sector, organizations are owed tens of millions for programs delivered even before U.S. President Donald Trump’s funding freeze began, making it impossible for many to float the money needed for programs to continue — even with a waiver in hand. “With USAID not paying its bills, we simply can’t carry the costs anymore,” said the head of another organization working in Syria, which had to lay off 50% of its staff in that country last week. “There’s a complete lack of confidence in the U.S. government’s ability to repay.” The waiver process, and the lack of clarity around it, was raised by lawyers representing a group of USAID implementers who are suing the federal government. On Thursday, a federal judge issued a temporary restraining order in a pair of lawsuits requiring the government to reverse the stop-work order for existing aid projects. And as part of that order, Judge Amir Ali found that the blanket suspension of congressionally appropriated funds was causing financial and business harm and that it would likely continue even with a waiver policy in place. The order requires a resumption of work, not just for programs with waivers, but it’s unclear how quickly that will happen. In the meantime, there’s the program that once was stemming the spread of cholera in Haiti — no waiver. The mental health initiative that supported women who were raped while fleeing from the Democratic Republic of Congo — also no waiver. And the project that once provided food for 135,000 displaced Syrians — one that did receive a waiver, but is shutting down this week due to lack of funds. “We need a waiver, but we also need funding,” said a staff member at the latter organization, the Virginia-based nonprofit Blumont. “Neither the waiver on its own nor the funding is going to let the work continue — it’s both.” It’s a sharp contrast from how U.S. Secretary of State Marco Rubio has described the exemptions. Earlier this month, Rubio suggested organizations were “deliberately sabotaging” the waiver process for “purposes of making a political point.” “I issued a blanket waiver that said if this is lifesaving programs, 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,” he said last week. “I don’t know how much more clear we can be than that.” ‘I can’t do anything’ Rubio announced the waivers for lifesaving humanitarian assistance on Jan. 28. It came one week after Trump issued a 90-day freeze on foreign aid, and four days after a stop-work order halted programming across the world. In the days between, thousands of USAID staff members were torn from the agency, with many locked out of their accounts without warning. The staff members that were left were terrified, with even those working on emergency food assistance — a category that was supposedly exempt from the stop-work order — barred from talking to organizations to make that happen. “Our partners are asking: hey, can we continue providing emergency food assistance?” said one USAID staff member in the Bureau of Humanitarian Assistance, who spoke on the condition of anonymity for fear of professional retribution last week. “I see the email, and I can’t reply. I can’t acknowledge. I can’t do anything.” Soon after, that staffer was locked out of their USAID account. They heard that one of the organizations they’d worked with had submitted a waiver for lifesaving food assistance — one that would fall within the exemption laid out by Rubio late last month. But now, the staffer couldn’t even see the request. “It is literally sitting in my inbox, and my inbox is locked,” the staff member added. “I can’t log into my email. I can’t communicate with partners. So how is this waiver supposed to work?” In the days since, a court ruling returned account access to many USAID staff members, allowing waivers to trickle down to organizations across the world. Some have received partial exemptions, allowing an organization to resume some pieces of a program but not others; others have received waivers of varying timelines, from one week to the full 90 days. But having a waiver and receiving funding are entirely different things, the same staffer explained this week. Most USAID employees still do not have access to Phoenix, the agency’s financial system, and are still not receiving clear communication about which awards are exempt from the stop-work order and which are not. Another USAID staffer, with the pseudonym Walter Doe, provided more detail through his testimony in a recent court document. After the announcement of humanitarian waivers, Doe tried to process payments for work completed before Jan. 20 through USAID’s Phoenix system. But it wasn’t “functioning the way it had in the past,” Doe explained, stating that the payment would “never finish processing.” For several days, Doe and his colleagues repeatedly asked USAID’s acting deputy controller for guidance — but from Jan. 24 to today, he has been met with a multitude of error messages. “To my knowledge, worldwide there are no USAID financial management personnel, including controllers, that can access Phoenix,” Doe said. “After three weeks of a nearly complete freeze, we have pending payments to partners in the country where I serve amounting to $3.8 million including $1.3 million in overdue payments which are incurring interest.” Waivers were also a recurring issue at a House Foreign Affairs Committee hearing Thursday. Committee chairman Rep. Brian Mast repeatedly said that the administration had issued waivers for the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, Ebola response in Uganda, and beyond. Mast said applications have come in but only some had been approved, adding that he had a list of all the waivers. But other lawmakers — and former USAID Administrator Andrew Natsios — reported that while waivers may exist for some programs, the money isn’t flowing and they can’t resume. A USAID employee at the agency’s bureau for humanitarian assistance told Devex they’d also received conflicting instructions for which programs fall under the waiver, a back-and-forth that has paralyzed the agency’s contracting and agreement officers who are personally liable for the awards’ value. And on Thursday, the staffer said their team was told to hold off approving any more waivers at all — and that even a memo to request an exemption could not go ahead without approval from the highest levels of agency leadership. “I wanted to draft one and they said hold off, unless people die in the next few days and your project runs out of money, then wait,” they added, despite the fact that the program should have been exempt under Rubio’s definition of lifesaving aid. Another source was told by one mission that they have more than 20 waivers ready to go, the majority of which relate to money owed prior to Trump’s stop-work order on Jan. 24. But because they have been denied access to Phoenix, the mission cannot process those requests. All of that means money hasn’t moved — even for programs that fall into the categories Rubio defined as lifesaving humanitarian aid. The ripple effects Thousands of miles from D.C., organizations are feeling the effect. While the Trump administration and some Republican lawmakers tout the PEPFAR waiver as proof that lifesaving assistance has been approved, the reality for patients hasn’t changed. For one organization in Africa, the stop-work orders meant they immediately shuttered more than a dozen clinics treating HIV/AIDS patients. With no notice and no opportunity to advise patients or other parts of the health care system, one source who manages a program funded by PEPFAR in Africa who asked for anonymity for fear of retribution, told Devex. Patients — including those with advanced HIV infections and pregnant mothers — arrived at clinics only to find a note posted on the door advising them to try clinics run by the Department of Health. Those facilities are already overstretched and staff members often lack the training to help these patients, who also now have no access to their records, the source said. “They’re in absolute hell. Their world is coming to an end. It’s not just as easy as going to a normal clinic,” the source told Devex, adding that stoppages have created “a major clinical care gap that is completely unethical in any routine setting and completely immoral.” There was hope when a waiver for PEPFAR was announced. But implementers can’t act on a general waiver — they need specific directives about the scope of work, budget approvals, and paperwork to restart. Despite that, staff members at USAID were not there or weren’t allowed to communicate, so the waiver was meaningless and services remained suspended. “I think we’re all just hanging on to some threads of hope we will be able to go back to work. We need to see patients and continue providing services,” the source said. In southwest Uganda, another nonprofit has been managing the transit centers for thousands of Congolese refugees — a population that’s exploded in size since the conflict in the eastern DRC has escalated. Children are arriving in Uganda alone, split from their parents in the rush to escape. Women are entering Uganda in pieces, fleeing sexual violence and rape. Most are arriving with nothing but the clothes on their back — but after never hearing back about a waiver submitted on Jan. 30, the organization serving those refugees has had to cut both its mental health and livelihoods programs. “We’re dealing with people that have experienced severe trauma,” said a staff member at the organization, who would only speak on the condition of anonymity for fear that the nonprofit’s remaining funding would be cut. “They’ve either been raped or assaulted, or they’ve seen their parents or their husbands or their wives killed in front of them. And literally overnight, we’ve had to stop our mental health programming.” Those are the same programs that were reduced after funding shortfalls last year, the staff member explained. Back then, the cuts resulted in an increase of attempted suicides among refugees that were trying to start over again. And now, the organization has been forced to make those reductions once more — along with laying off a quarter of their Uganda-based staff. “Some staff collapsed when they heard the news,” said the staff member. “And then for the rest of us here, you’re stuck in this stage of uncertainty because you really just don’t know what’s happening.” That organization is far from alone. Another leader at yet another nonprofit, who also spoke on background for fear of retribution, said their team has received several waivers. But without the funding that corresponds to those programs, they still can’t do the work. “The tap is fully off,” they added. “Even though an increasing number of large-scale emergency humanitarian relief programs are covered partially or fully by waivers, the fact is that the U.S. government has turned off the payment system. We’re not going to be able to keep going for long.” Running up the tab In large part, that’s because many organizations have been floating the U.S. government for nearly a month. Larger nonprofits and contractors will often do the work, and then send an invoice to USAID for reimbursement. But that payment system has been frozen since Jan. 20 — meaning many organizations are out millions of dollars for work completed months before Trump returned to office. “It’s in the hundreds of millions of dollars owed for services already provided, and of course, some multiples of that when it comes to what is being asked to be floated during the 90-day review,” said Tom Hart, the president and CEO of coalition group InterAction. “That's why, at least in the INGO sector, we're seeing mass layoffs, country programs stopped, and some organizations looking at shutting their doors.” DAI is owed $120 million from the U.S. government, forcing them to furlough more than 60% of their staff. Chemonics is out $103.6 million, pushing them to furlough around the same portion of employees based in the U.S. In a recent survey by Humentum, a membership coalition of over 400 organizations, three-quarters of survey respondents said their teams hadn’t been paid for work completed before the stop-work orders began. It’s prompted court cases and chaos — but without funding, many organizations are worried they won’t make it through the 90-day freeze regardless. As a result, organizations are continuing to slice their programs away: A collection of small organizations in Sudan, for example, have had to shut down a water and sanitation program that previously, was reaching 1.6 million displaced by the conflict. A company monitoring USAID’s programs in the Middle East has had to lay off half of its Syrian-based staff. And an organization providing support for those affected by HIV/AIDS across Africa only got a limited waiver to continue doing so, meaning children living with an HIV-positive parent can no longer be regularly tested for the virus. “This isn’t like hitting pause in a video game and saying, I’ll come back and defeat the level later,” said another humanitarian official, whose organization has gotten a mix of full waivers, partial waivers, and program termination notices. “This is not something you can just get back.”