USAID official dismissed after detailing ‘failure’ to give lifesaving aid

A senior official at the U.S. Agency for International Development was placed on leave Sunday, two days after he issued an internal memo stating the U.S. government had failed to deliver promised lifesaving assistance due to decisions made by U.S. President Donald Trump’s political appointees. “USAID’s failure to implement lifesaving humanitarian assistance under the waiver is the result of political leadership at USAID, the Department of State, and DOGE, who have created and continue to create intentional and/or unintentional obstacles that have wholly prevented implementation,” wrote Nicholas Enrich, the acting assistant administrator for USAID’s global health bureau, on Feb. 28. “This will no doubt result in preventable death, destabilization, and threats to national security on a massive scale.” Enrich’s memo came one month after U.S. Secretary of State Marco Rubio first announced that organizations delivering “lifesaving humanitarian assistance” could apply for a waiver to continue doing so. In theory, that waiver system would allow programs to sidestep Trump’s blanket freeze on foreign assistance and deliver critical humanitarian aid. “If it’s emergency lifesaving aid — food, medicine, whatever — they have a waiver,” said Rubio, speaking in Costa Rica on Feb. 4. “And if they’re not applying it, then maybe they’re not a very good organization and maybe they shouldn’t be getting money at all.” But in reality, the waiver process was a bureaucratic mess. Organizations delivering even the most critical types of lifesaving support — such as HIV/AIDS medication or emergency feeding for malnourished children — were blocked from accessing the waivers and funding to keep those activities afloat. And every day, the Trump administration sliced more staff away from USAID, dissolving those responsible for managing the waiver process. Enrich describes how Trump’s political appointees refused to pay for work already completed; blocked and restricted access to USAID’s payment systems; continually changed the definitions of “lifesaving” humanitarian assistance; and terminated “the most critical implementing mechanisms necessary” for bringing that foreign aid back to life. He pointed to USAID’s attempted response to Uganda’s Ebola outbreak as an example. One month ago, organizations were told they could resume their activities to prevent the spread of the disease — but the flow of funds was never turned back on. By Feb. 28, those organizations had still not received funding to respond to the virus’ spread. Enrich wrote that he was told his team should be “draconian” when it came to what should be approved under the waivers. And despite his team alerting USAID’s front office that partners needed access to funding to implement lifesaving assistance, access to USAID financial systems remained “completely turned off by DOGE,” he wrote, referring to the Department of Government Efficiency, which is run by billionaire Elon Musk. “With USAID having failed to make payment on past due invoices or to provide access to funds for newly approved activities, and with residual funds fully extinguished, partners had no funding to continue the work, so it stopped,” Enrich wrote in his memo, which was obtained by Devex Sunday night. For weeks, the back-and-forth about what was allowed — and who would allow it — spiraled. At first, there was no clear pathway to submit waiver requests. Then, the front office began compiling “tranches” of to-be-terminated awards. The global health bureau was told to review the lists, and then they were told to stop doing so. By Feb. 11, the global health bureau had been told to stop approving any awards for waivers altogether. And by Feb. 14, new guidance barred the bureau from approving any lifesaving programs at all. “From that point forward, zero lifesaving health activities have been approved by the Agency,” Enrich wrote. That was made more difficult as, week after week, more staff were severed from USAID. Enrich details that further in a second memo with the same date, stating that in just over a month, USAID’s global health bureau lost more than 90% of its staff. Nearly 450 people have been terminated, and another 260 have been placed on administrative leave, Enrich wrote. That resulted in “confusion, uncertainty, broken chains of command, and lack of operational staff needed to perform essential roles.” “These drastic staffing reductions have severely impacted GH’s ability to function,” Enrich wrote. Though Enrich’s team had identified 72 activities across 31 awards that entail lifesaving humanitarian assistance, not one of those programs has been approved by USAID’s front office — and not one of those programs has received payment for the work. That disconnect widened once the Trump administration began terminating grants, contracts, and awards across the agency, including those that had already received the lifesaving assistance waivers, Enrich wrote. DOGE officials warned Enrich and his team to stop reviewing awards slated for termination to see if they had received waivers, Enrich said, stating that doing so was “unacceptable.” By the time the Trump administration eliminated 90% of USAID’s awards, “all or nearly all” of the programs needed to implement lifesaving humanitarian assistance were slashed along with them, Enrich stated, “rendering impossible any efforts to implement activities under the waiver, even if they had been approved.” Forty-eight hours later, Enrich was placed on administrative leave — joining the ranks of dozens dismissed from their post after voicing dissent for USAID’s top leadership. The impact Enrich was compiling one more document before he was cut from the agency: A document detailing the consequences of the foreign aid freeze to date. The memo — which was pulled off Enrich’s Google Drive by another staff member, and remains unsigned — was noted in his earlier memos, but dated for March 4, two days after Enrich was placed on administrative leave. “The temporary pause on foreign aid and delays in approving lifesaving humanitarian assistance (LHA) for global health will lead to increased death and disability, accelerate global disease spread, contribute to destabilizing fragile regions, and heightened security risks—directly endangering American national security, economic stability, and public health,” Enrich wrote in the memo, which was obtained by Devex on Sunday. The senior official tried to calculate those risks. Halting USAID’s malaria programs, he said, would lead to an additional 12.5 million to 17.9 million cases per year, along with an additional 71,000 to 166,000 deaths — an increase of nearly 40%. Ending USAID’s polio eradication programs, he said, would lead to an additional 200,000 cases per year, and hundreds of millions of infections overall throughout the next decade. And stopping USAID’s nutrition programs, he said, would lead to one million children with severe acute malnutrition losing access to treatment. He divides the impacts into three areas: first, the deterioration of health across the United States and throughout the world; second, economic and health care systems strain; and third, national security and biothreat risks. He also lists a multitude of other impacts of halted foreign aid, from up to a 32% increase in multidrug-resistant tuberculosis across the world, to more than 127,000 cases of mpox — including 34,000 cases in the U.S. “Historical data demonstrate that reductions in funding for global health initiatives and lifesaving health programming correlate with surges in disease incidence, reinforcing the urgency of sustained support for these programs to protect both global stability and domestic security,” Enrich wrote. “The consequences extend beyond human health, impacting American businesses and families by increasing healthcare costs, disrupting international trade, and straining domestic resources.” Update, March 5, 2025: This article has been updated to clarify Nicholas Enrich’s memo was dated March 4, two days after he was placed on administrative leave.