Funding cuts threaten to stall work on TB and other prevalent diseases.
AFP
Published May 6, 2025
Bangladesh hoped to celebrate progress towards eradicating tuberculosis this year, having already slashed the numbers dying from the preventable and curable disease by tens of thousands each year.
Instead, it is reeling from a $48 million snap aid cut by US President Donald Trump’s government, which health workers say could rapidly unravel years of hard work and cause huge numbers of preventable deaths.
“Doctors told me I was infected with a serious kind of tuberculosis,” labourer Mohammed Parvej, 35, told AFP from his hospital bed after he received life-saving treatment from medics funded by the US aid who identified his persistent hacking cough.
But full treatment for his multidrug-resistant tuberculosis requires more than a year of hospital care and a laborious treatment protocol — and that faces a deeply uncertain future.
“Bangladesh is among the seven most TB-prevalent countries globally, and we aim to eradicate it by 2035,” said Ayesha Akhter, deputy director of the formerly US-funded specialised TB Hospital treating Parvej in the capital Dhaka.
Bangladesh had made significant progress against the infectious bacteria, spread by spitting and sneezing, leaving people exhausted and sometimes coughing blood. TB deaths dropped from more than 81,000 a year in 2010, down to 44,000 in 2023, according to the World Health Organisation, in the country of some 170 million people.
Akhter said the South Asian nation had “been implementing a robust programme”, supported by the US Agency for International Development (USAID). “Then, one fine morning, USAID pulled out their assistance,” she said.
Starving children
More than 80 per cent of humanitarian programmes funded by USAID worldwide have been scrapped.
Tariful Islam Khan said the International Centre for Diarrhoeal Disease Research Bangladesh had, with US funding, carried out mass screening “improving TB case detection, particularly among children” from 2020 to 2024. “Thanks to the support of the American people… the project has screened 52 million individuals and diagnosed over 148,000 TB cases, including 18,000 children,” he said.
Funding cuts threatened to stall the work. “This work is critical not only for the health of millions of Bangladeshis, but also for global TB control efforts,” he said.
This photograph taken on April 23, 2025 shows people walking past the 250 Bedded TB Hospital, formerly funded by the US development agency USAID in Dhaka.—AFPGrowing rates of infectious diseases in one nation have a knock-on impact in the region. Cuts hit further than TB alone.
“USAID was everywhere in the health sector,” said Nurjahan Begum, health adviser to the interim government — which is facing a host of challenges after a mass uprising toppled the former regime last year.
US aid was key to funding vaccines combating a host of other diseases, protecting 2.3 million children against diphtheria, measles, polio and tetanus.
“I am particularly worried about the immunisation programme,” Begum said. “If there is a disruption, the success we have achieved in immunisation will be jeopardised.”
Bangladeshi scientists have also developed a special feeding formula for starving children. That too has been stalled. “We had just launched the programme,” Begum said. “Many such initiatives have now halted”.
Pivot to China
US State Department official Audrey M. Happ said that Washington was “committed” to ensuring aid was “aligned with the interests of the United States, and that resources are used as effectively and efficiently as possible”.
Bangladesh, whose economy and key garment industry are eyeing fearfully the end of the 90-day suspension of Trump’s punishing 37pc tariffs, is looking for other supporters.
Some Arab nations had expressed interest in helping fill the gap in Muslim-majority Bangladesh. China, as well as Turkey, may also step into Washington’s shoes, Begum said.
Jobs are gone too, with Dhaka’s Daily Star newspaper estimating that between 30,000 and 40,000 people were laid off after the United States halted funding.
Zinat Ara Afroze, fired along with 54 colleagues from Save the Children, said she worried for those she had dedicated her career to helping. “I have seen how these projects have worked improving the life and livelihoods of underprivileged communities,” she said, citing programmes ranging from food to health, environmental protection to democracy. “A huge number of this population will be in immediate crisis.”
Babies dying
Those with the least have been hit the hardest. Less dollars for aid means more sick and dead among the Rohingya refugees who fled civil war in their home in neighbouring Myanmar into Bangladesh since 2017.
Much of the US aid was delivered through the UN’s WHO and Unicef children’s agency.
WHO official Salma Sultana said aid cuts ramped up risks of “uncontrolled outbreaks” of diseases including cholera in the squalid refugee camps. Faria Selim, from Unicef, said reduced health services would impact the youngest Rohingya the hardest, especially some 160,000 children under five. Hepatitis C, with a prevalence rate of nearly a fifth, “is likely to increase in 2025”, Selim said.
Masaki Watabe, who runs the UN Population Fund in Bangladesh working to improve reproductive and maternal health, said it was “trying its best to continue”. Closed clinics and no pay for midwives meant the risk of babies and mothers dying had shot up. “Reduced donor funding has led to … increasing the risk of preventable maternal and newborn deaths,” he said.
After USAID
A NEOLIBERAL CRITIQUE
Saeed Ahmed
Published May 5, 2025
The writer is a former senior adviser of the IMF and has a PhD in economics from the University of Cambridge.
WHEN I started writing my book, The Shady Economics of International Aid, in 2023, I never anticipated that some of the issues I explored would surface so powerfully even before its release in 2025.
On his first day in office in January 2025, President Donald Trump signed an executive order freezing all USAID and State Department programmes for 90 days. Subsequently, several statements came directly from President Trump and senior officials citing numerous USAID-funded projects across countries that were labelled as ‘waste’, ‘abuse’, and ‘fraud’. In reference to Pakistan, Congressman Scott Perry alleged that USAID spent $840 million on education-related programmes in the last 20 years, including $136m to build 120 schools. He stated that there is zero evidence any single school was actually built. These revelations are startling and need to be substantiated.
Prima facie, the Trump administration’s allegations and its frustration with USAID seem plausible. The ‘insane’ priorities in some countries, including the multimillion-dollar funding for LGBT advocacy, sex changes, and media organisations, do not align with the professed objectives of international aid; ie, poverty alleviation or broader economic development.
WHEN I started writing my book, The Shady Economics of International Aid, in 2023, I never anticipated that some of the issues I explored would surface so powerfully even before its release in 2025.
On his first day in office in January 2025, President Donald Trump signed an executive order freezing all USAID and State Department programmes for 90 days. Subsequently, several statements came directly from President Trump and senior officials citing numerous USAID-funded projects across countries that were labelled as ‘waste’, ‘abuse’, and ‘fraud’. In reference to Pakistan, Congressman Scott Perry alleged that USAID spent $840 million on education-related programmes in the last 20 years, including $136m to build 120 schools. He stated that there is zero evidence any single school was actually built. These revelations are startling and need to be substantiated.
Prima facie, the Trump administration’s allegations and its frustration with USAID seem plausible. The ‘insane’ priorities in some countries, including the multimillion-dollar funding for LGBT advocacy, sex changes, and media organisations, do not align with the professed objectives of international aid; ie, poverty alleviation or broader economic development.
The decision, however, impacted activities worldwide totalling about $42 billion in 157 countries for over 6,100 activities covering all sectors. Those directly affected, particularly more than 10,000 USAID staff working all over the world, strongly criticised the decision. Six weeks into its suspension, Secretary of State Marco Rubio declared they were cancelling 83 per cent of USAID programmes. The surviving approximately 1,000 programmes will now be administered under the Department of State.
We don’t know how events will ultimately unfold in the US as legal battles are still ongoing. However, as things stand, the USAID has been dismantled and US aid to developing countries will be reduced substantially. The US isn’t the first country to shut down its international aid agency. In June 2020, Boris Johnson, the UK’s then prime minister, used budget-tightening as a ground to effectively close the DFID — Britain’s equivalent of USAID — and merged it with the Foreign and Commonwealth Office.
Following the USAID fiasco, UK Prime Minister Keir Starmer has announced the UK would increase spending on defence by cutting its aid budget from 0.5pc of gross national income to 0.3pc, much lower than the UN’s 0.7pc aid target. The UK aid budget is now at its lowest in decades. The UK is not alone — France and Germany have also cut aid budgets in recent years.
The demise of USAID could present developing nations with an opportunity to reduce aid dependency.
For recipient countries, these disruptions are unlikely to have any major sociopolitical or economic consequences. For instance, Pakistan will not experience a significant financial squeeze. In 2023, USAID committed only $132.6m across various sectors. This funding was reduced to $116m in 2024, primarily due to a decline in humanitarian assistance. These funding levels are negligible relative to the size of Pakistan’s $375bn economy. The same holds true for most African countries, where USAID’s spending is minimal. Nevertheless, the aid that actually reaches intended beneficiaries is only a small fraction of overall disbursement figures.
So, will these aid cuts have any significant impact on the developing countries’ overall economic growth? Research studies provide little convincing evidence of a positive relationship between economic growth and the volume of aid received. However, the situation could potentially change if the US also withdraws from the IMF, World Bank, and other multilateral development banks. Such decisions seem unlikely; however, if taken, they would be bad for the US. By abandoning the IMF and the World Bank, the US would surrender a key source of global influence and economic leverage.
The US has long maintained tight control over these institutions, shaping their policies and leadership to align with its own national interests. It has consistently appointed the World Bank’s president, approved Europe’s choice to lead the IMF, and selected the Fund’s first deputy managing director. Moreover, it remains the only country with the power to unilaterally block major decisions, as both institutions require an 85pc majority for approval.
The US also uses IMF as a ‘first responder’ to safeguard its economy and uses the World Bank to strengthen security and economic alliances and support postwar reconstruction in countries like Iraq and Afghanistan. Even so, the actual cost of US participation in these institutions is far lower than often assumed. Each year, the US Treasury assesses the financial impact of its contributions to the IMF; in 2023, it reported an unrealised gain of $407m.
Even if the US pulls out from the multilateral organisations, other countries will save the multilateral system. They may be alarmed, but they are not powerless. In doing so, however, the US would forfeit vital tools for supporting its allies and withholding financing from its adversaries.
Also, Western countries’ retreat from aid will leave an obvious opening for other powers to increase influence in developing nations. China continues to signal investment commitments in Africa. At the 2024 Forum on China-Africa Cooperation, it pledged $51bn over three years in loans and traditional aid. The Gulf states are also increasing aid, largely in strategically important regions.
In principle, the demise of 63-year-old USAID, while difficult for many people, could present developing nations with an opportunity to reduce aid dependency and achieve sustainable economic growth. Sometimes good things can come from adversity. Over time, as the system stabilises, donor agencies may become more accountable to the taxpayers who fund them.
Clearly, international aid is a broken system desperately in need of fundamental reforms, both within donor agencies and recipient nations. The mismanagement of aid is pervasive and extends beyond USAID. Donor agencies — funded by taxpayer dollars — are fraught with issues ranging from resource misallocation and misutilisation to a glaring lack of accountability for failed programmes. The USAID review has also exposed the high-handed culture prevalent within donor agencies, and should prompt other countries to scrutinise the operations of their own aid organisations.
dr.saeedahmed1@hotmail.com
Published in Dawn, May 5th, 2025
We don’t know how events will ultimately unfold in the US as legal battles are still ongoing. However, as things stand, the USAID has been dismantled and US aid to developing countries will be reduced substantially. The US isn’t the first country to shut down its international aid agency. In June 2020, Boris Johnson, the UK’s then prime minister, used budget-tightening as a ground to effectively close the DFID — Britain’s equivalent of USAID — and merged it with the Foreign and Commonwealth Office.
Following the USAID fiasco, UK Prime Minister Keir Starmer has announced the UK would increase spending on defence by cutting its aid budget from 0.5pc of gross national income to 0.3pc, much lower than the UN’s 0.7pc aid target. The UK aid budget is now at its lowest in decades. The UK is not alone — France and Germany have also cut aid budgets in recent years.
The demise of USAID could present developing nations with an opportunity to reduce aid dependency.
For recipient countries, these disruptions are unlikely to have any major sociopolitical or economic consequences. For instance, Pakistan will not experience a significant financial squeeze. In 2023, USAID committed only $132.6m across various sectors. This funding was reduced to $116m in 2024, primarily due to a decline in humanitarian assistance. These funding levels are negligible relative to the size of Pakistan’s $375bn economy. The same holds true for most African countries, where USAID’s spending is minimal. Nevertheless, the aid that actually reaches intended beneficiaries is only a small fraction of overall disbursement figures.
So, will these aid cuts have any significant impact on the developing countries’ overall economic growth? Research studies provide little convincing evidence of a positive relationship between economic growth and the volume of aid received. However, the situation could potentially change if the US also withdraws from the IMF, World Bank, and other multilateral development banks. Such decisions seem unlikely; however, if taken, they would be bad for the US. By abandoning the IMF and the World Bank, the US would surrender a key source of global influence and economic leverage.
The US has long maintained tight control over these institutions, shaping their policies and leadership to align with its own national interests. It has consistently appointed the World Bank’s president, approved Europe’s choice to lead the IMF, and selected the Fund’s first deputy managing director. Moreover, it remains the only country with the power to unilaterally block major decisions, as both institutions require an 85pc majority for approval.
The US also uses IMF as a ‘first responder’ to safeguard its economy and uses the World Bank to strengthen security and economic alliances and support postwar reconstruction in countries like Iraq and Afghanistan. Even so, the actual cost of US participation in these institutions is far lower than often assumed. Each year, the US Treasury assesses the financial impact of its contributions to the IMF; in 2023, it reported an unrealised gain of $407m.
Even if the US pulls out from the multilateral organisations, other countries will save the multilateral system. They may be alarmed, but they are not powerless. In doing so, however, the US would forfeit vital tools for supporting its allies and withholding financing from its adversaries.
Also, Western countries’ retreat from aid will leave an obvious opening for other powers to increase influence in developing nations. China continues to signal investment commitments in Africa. At the 2024 Forum on China-Africa Cooperation, it pledged $51bn over three years in loans and traditional aid. The Gulf states are also increasing aid, largely in strategically important regions.
In principle, the demise of 63-year-old USAID, while difficult for many people, could present developing nations with an opportunity to reduce aid dependency and achieve sustainable economic growth. Sometimes good things can come from adversity. Over time, as the system stabilises, donor agencies may become more accountable to the taxpayers who fund them.
Clearly, international aid is a broken system desperately in need of fundamental reforms, both within donor agencies and recipient nations. The mismanagement of aid is pervasive and extends beyond USAID. Donor agencies — funded by taxpayer dollars — are fraught with issues ranging from resource misallocation and misutilisation to a glaring lack of accountability for failed programmes. The USAID review has also exposed the high-handed culture prevalent within donor agencies, and should prompt other countries to scrutinise the operations of their own aid organisations.
dr.saeedahmed1@hotmail.com
Published in Dawn, May 5th, 2025
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