Halting U.S. Foreign Aid Puts American Health and Security at Risk
An expert in global aid and human rights explains some of the ways disengaging from global health partnerships may impact the U.S.
Photo: Jay Directo/AFP via Getty Images
On January 26, the U.S. State Department announced a pause on all U.S. foreign assistance “funded by or through the State Department and U.S. Agency for International Development (USAID),” pending review. Since then, the 64-year-old agency has effectively been dismantled—programs around the world have been halted, the majority of staff has been put on leave, and the future of U.S. foreign aid funding is uncertain.
These policy shifts will not only impact the health of people abroad, says Joseph Amon, PhD, MSPH, distinguished professor of the practice in Epidemiology and director of the Center for Public Health and Human Rights. They will also have long-lasting effects on health and security in the U.S.
In the February 28 episode of Public Health On Call, Amon spoke with Josh Sharfstein, MD, about why helping other countries fight disease benefits Americans. This Q&A is adapted from their discussion.
How did you get involved in the field of global health?
After public health school, I joined the Peace Corps and spent two years in West Africa working on Guinea worm eradication. After that, I worked on a number of HIV programs in sub-Saharan Africa, Asia, and Latin America. I also worked on a range of parasitic diseases known as neglected tropical diseases, environmental health issues, and nutrition issues. Throughout these experiences, I've had fantastic partners in ministries of health, nongovernmental organizations, and community groups.
What impacts are the drastic changes to USAID-funded health programs having?
From infectious disease to chronic disease care, this has created a crisis for many people in many countries. People aren’t able to sustain medical treatments or access supplies like oxygen or drugs that prevent infections.
People are unclear whether programs they manage can continue or whether they should be laying off staff.
How does this cutback on foreign aid affect the U.S.’s ability to respond to a potential health threat?
U.S. foreign assistance has built up the capacities of ministries of health, including their ability to identify emerging infectious diseases that could come into the U.S. or become pandemics. That work isn’t easy to do. It requires a lot of vigilance, training, and research capacity.
For example, the work we’ve done on polio eradication has been used to quickly pivot and identify cases of Ebola in Nigeria.
How does foreign assistance for health contribute to the U.S.’s security?
Climate change will introduce new infectious diseases—mosquito-borne and tickborne diseases, for example—that currently don’t cause many cases in the U.S. Our partnerships with countries where those diseases are more prevalent allow us to do research to better understand how we can prevent these diseases worldwide, including when these diseases start coming into the U.S.
For example, malaria is rare in the U.S., but we’re starting to see some cases of it. There are also mosquito-borne infections like Zika and Oropouche, which have been present in Latin America, but are starting to be seen in some parts of the U.S. as well.
How do these research partnerships affect the relationship between those countries and the United States?
Our partnerships foster incredible goodwill and a sense of solidarity that really benefit our long-term national security.
At the personal level, I and others have built relationships with researchers in different countries who sometimes come to the U.S. for fellowships or further research training. These also provide us with opportunities to send students abroad for more public health training.
At a community level, these partnerships foster a positive reputation for the U.S. There are also benefits at a political level, where the contributions of the U.S. are appreciated by foreign governments and help the stability of those countries—by providing public health and other opportunities for individuals and the community—which leads to a greater chance for peace and security.
With USAID being cut back severely, a lot of these programs will go away. What does that mean for U.S. security and the goodwill this work has generated?
There's a lot of confusion right now among our global partners—about why and how this long history of support can be suddenly cut off without any opportunity for transition to other resources. It also opens the door for other actors—including China and Russia—with political interests in these countries to come in and exploit the resources in these countries. That jeopardizes the long-term investment we’ve made in building these relationships.
How do people in the U.S. perceive these global health investments?
A lot of people recognize the value of these investments, in part because it reflects on American values of being charitable and having solidarity with others. And from a pragmatic perspective, our foreign assistance partnerships go beyond public health; it's also about economic development. American farmers benefit from ensuring food aid to places where there are droughts or famine.
How long will it take to feel the consequences of losing these partnerships?
We’re going to see some immediate impacts, including a lack of preparation, and an inability to understand, anticipate, and respond to potential threats.
Note: This conversation was recorded in February 2025. Litigation with respect to the government’s directives to pause foreign development assistance funding is ongoing.
This Q&A was edited for length and clarity by Aliza Rosen.
