In January 2025, the Trump Administration announced a 90-day freeze on all United States Government (USG) foreign aid, which subsequently became a permanent shutdown of USAID in July 2025. New research finds that the abrupt cessation of foreign aid disrupted health and humanitarian systems worldwide, with disproportionate impacts on women, girls, and other marginalized populations.

Researchers from Columbia University Mailman School of Public Health collaborated with partners to document these negative impacts. The findings appear in the journal BMJ Public Health.

The researchers examined the impacts of the funding freeze during its early months. They conducted 53 interviews with NGO leaders, clinicians, community health workers, government officials, and humanitarian actors in Nepal, Kenya, and Colombia. Interviewees were selected based on their direct or indirect involvement in U.S. government-funded health programs. Ninety-eight global health practitioners also completed an online survey.

The study revealed immediate disruptions across sexual and reproductive health and rights (SRHR), HIV service interruptions and treatment access, the collapse of referral networks and service ecosystems, a mental health crisis among clients and health workers, and the rising vulnerability of marginalized populations—notably, LGBTQ+ populations, sex workers, people living with HIV, and migrants. Both survey and interview data highlighted growing inequities and anticipated reversals in longstanding health gains.

“The abrupt termination of foreign aid in 2025 was a systems-level shock” exposing weaknesses in global health financing, stated first author Sarah Branoff, MPH’25, research assistant at Columbia Mailman’s Heilbrunn Department of Population and Family Health.

“Documenting the lived experiences of practitioners provides critical insight into real-time consequences of funding disruptions,” added senior author Sara E. Casey, DrPH, associate professor of population and family health at Columbia Mailman.

“Each data point represents a real person: a health worker facing financial ruin, a girl without contraception, a mother without prenatal care,” explained co-author Julia Kosgei, MA, from Kenya’s policy/strategy group.

“The impact of the funding freeze has been devastating, especially for grassroots NGOs” lacking alternative funding sources, noted co-author Anand Tamang, M.Phil., director of CREHPA in Nepal.

The study’s authors propose several ways to respond to the crisis, both short and long term. They call for diversified and resilient global health financing, stronger domestic preparedness, and rights-based approaches to global health. They also emphasize the importance of rapid-response research mechanisms and localization strategies to mitigate future policy shocks.

Additional study authors include Thoai D. Ngo, Sarah Engebretsen, and Claire Greene at Columbia Mailman School; Livia Merlim at policy/strategy group in Kenya, Achala Shrestha and Jyotsna Tamang at the Center for Research on Environment Health and Population Activities (CREHPA) in Nepal, and Camilo Ramirez at HIAS Colombia.

The study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors declare no conflicts.

---

Journal: BMJ Public Health
DOI: 10.1136/bmjph-2026-004904
Article Title: Global health consequences of the 2025 US foreign aid freeze: rapid assessments in Colombia, Kenya and Nepal
Publication Date: 21-Jul-2026
Funding: The study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Source: EurekAlert