ArticleIn the flurry of executive orders issued by the 47th US president in his first 100 days, none is more devastating – or more deadly – than the suspension of USAID. The agency, founded by president John F. Kennedy in 1961, has been dismantled at the behest of Elon Musk, the world’s richest man, now imposing misery on the most vulnerable. More than 2000 USAID staff have already been dismissed.
USAID accounts for less than 0.5 per cent of the US budget, making its suspension ineffective in reducing the deficit but devastating for those who rely on it. I have just returned from Kenya and Uganda, where antiretroviral (ARV) drugs for HIV and tuberculosis treatments have vanished overnight.
USAID administers George W. Bush’s historic President’s Emergency Plan for AIDS Relief, which has been the backbone of AIDS treatment across Africa. To date, that plan has saved more than 25 million African lives.
It has been suspended without warning.
In Kenya, thousands of health professionals may lose their jobs, and aid dollars already approved by Congress have been frozen. NGOs and local communities are shocked by the suddenness and the savagery.
At a Nairobi clinic, an elderly Kenyan clinician who has spent 30 years building a hospital told us: “With ARV drugs and TB medication gone, I am terribly afraid for our patients.” Another doctor in a nearby slum clinic echoed the same concerns: “Without the medications supplied by USAID, how will these people live?”
Gutting USAID has also thrown Australian aid programs into chaos. The global aid sector works collaboratively to combat poverty and prevent duplication, with many of our agencies partnering with USAID programs. Not any more.
I travelled with the owners of Mountain Blue Farms – based near Lismore – who have donated more than $6 million in the past decade to build four rural hospitals in northern Uganda, a region once ravaged by the Lord’s Resistance Army.
At these hospitals, pregnant women awaited vaccinations and new mothers held babies whose survival depended on medicines that have now evaporated.
Our Kenya visit was to turn the sod on a fifth hospital, this time in rural Kenya. The total cost, including a water project to supply the hospital, is $2.2 million. But USAID, which had committed $300,000 for this project, has now broken that commitment. These Australian donors are scrambling now to meet that gap from their own pockets, so the project can continue.
Some may argue that it is not America’s role to save lives across the world; that its government should prioritise its own citizens. But for decades, the US has embedded itself deeply within the health systems of these nations, building trust, delivering care and becoming indispensable. Now, with its abrupt withdrawal, these nations are left searching for alternatives. And, of course, they will turn elsewhere – most notably to China.
This is a staggering own goal. Africa’s population is set to explode over the next century, becoming the world’s largest labour force and a dominant geopolitical player. Instead of ensuring the US is remembered as a friend and ally, Trump’s actions will be remembered as a betrayal. Mothers cut off from lifesaving aid. Children denied vaccines. Entire communities abandoned. This will reshape African perceptions of the US for generations.
For Australia, it is a stark reminder of why our engagement in the Pacific is so crucial. We have spent decades building deep partnerships with our neighbours—not just through aid, but through education, health, trade, and security ties. The Pacific nations see Australia as a trusted friend, but that trust must be continually renewed through action, not just rhetoric. If we fail to show up, others will fill the void.
This is not just about charity; it is about stability, security, and ensuring that Australia remains a valued partner in the region.
We must remember that a former Republican President’s commitment to the world’s poorest—particularly in Africa—has been trashed by another Republican President. One who is supposedly ‘pro-birth’ – he has pardoned individuals convicted of blocking access to US abortion clinics – but not pro-life when it comes to Africa.
Again and again, local staff asked me, “But we are Christian nations—we have had no quarrel with the U.S. Why is this happening?” I tried to give them hope, saying, “Maybe U.S. Christians will wake up to Musk’s outrageous claim that USAID is a criminal organisation.” U.S. citizens are generous in giving to organisations like Rev. Franklin Graham’s Samaritan’s Purse—Graham, the son of renowned evangelist Billy Graham, is a vocal Trump supporter—perhaps they will speak up.
How will I explain to my African friends that Trump understands he was elected to make the US a great Christian country, but that Christian sentiment and solidarity do not extend to them? The decisions made today will not be forgotten. America’s leadership in global health once saved millions, built trust, and strengthened its standing in the world. Now, that legacy is being dismantled. Australia would be wise to take heed.
Tim Costello is executive director of Micah Australia, a coalition of Christian development agencies, and a senior fellow at the Centre for Public Christianity. This article was first published in The Sydney Morning Herald.