US aid cuts: Healthcare crises and security concerns

[Deeq A.]

The rise of right-wing politics in the US has significantly influenced both governmental and corporate approaches to humanitarian funding. Donald Trump and Elon Musk’s new honeymoon project is the dismantling of the US Agency for International Development (USAID). This has the potential to not only lead to real-world crises in aid-dependant countries but the United States’ longer-term geopolitical relations.

In January 2025, President Donald Trump signed Executive Order 14169, suspending all US foreign development assistance for 90 days pending review. While emergency food aid and military assistance were exempt, the order halted many humanitarian programmes in countries such as Somalia and Ethiopia. The administration argued that “the United States foreign aid industry and bureaucracy are not aligned with American interests and in many cases antithetical to American values”.

At the same time, major US corporations have scaled back Diversity, Equity and Inclusion (DEI) commitments. Adobe ended its DEI hiring targets, aligning with a broader corporate shift. BlackRock CEO Larry Fink notably omitted DEI and sustainable investing in his 2025 annual letter, reflecting financial firms’ retreat from diversity and climate-conscious strategies.

This rightward political shift has led to a significant decline in DEI-driven humanitarian funding from both the public and private sectors. This reduction disproportionately affects aid-dependent countries like Somalia and Ethiopia and raises concerns about the future of corporate social responsibility and global equity.

The impact on the ground
In Ethiopia, aid dedicated to HIV medications, vaccines, literacy programs and jobs creation has been cut, and even life-saving food deliveries have been halted. The country, with its strategic position in the African horn and its 125 million people, had been the biggest beneficiary of US aid in Sub-Saharan Africa, receiving $1.8 billion in 2023. The impact of such clickbait, shock-provoking and misanthropic policy will be short-term humanitarian crisis and the potential death of many of Ethiopians.

The recent suspension of US aid has raised significant concerns regarding the health and well-being of HIV/AIDS patients in Somaliland. Approximately 2,092 individuals in the region rely on monthly antiretroviral (ARV) medications funded by the Global Fund, a health financing body heavily supported by the United States. The cessation of this aid threatens to disrupt the supply of these life-saving drugs, potentially leading to severe health crises among the affected population.

Healthcare professionals in Somaliland have expressed alarm over the potential consequences of these funding cuts. Dr Mustafe Abdillahi Hussein, a physician at the Tuberculosis Hospital in Hargeisa, emphasised that the absence of ARV medications could result in a sharp increase in mortality rates, particularly among vulnerable groups such as pregnant women and children under five. Patients like Aamina, who has been living with HIV for years, reported that local clinics have already begun warning about dwindling drug supplies, highlighting the immediate impact of the aid suspension.

While Somaliland’s Health Minister, Hussein Bashir Hirsi, has assured the public that the government has contingency plans to procure the necessary medications independently, the outsized impact of aid in ensuring Somaliland’s stability. In conversations with Mr Cawaale Shirwac, Somaliland’s former Minister for Planning, he stressed the importance of assistance for a country like Somaliland, stating that a fledgling state which lacks de jure recognition needs all the help to ensure that its people have their basic needs met, especially given the region’s limited resources.

The suspension of US aid poses a critical threat to the health of HIV/AIDS patients in Somaliland. Immediate and coordinated efforts are essential to ensure the continuous supply of ARV medications and to prevent a potential public health crisis in the region.

Why foreign aid matters
The broader context of US aid suspension in Sub-Saharan Africa further exacerbates the situation. Historically, this region has been a significant recipient of US non-humanitarian assistance, regularly receiving 35%-40% of such aid worldwide. The sudden halt of these funds not only affects HIV/AIDS programs but also undermines overall healthcare infrastructure, leading to potential increases in preventable diseases and mortality rates.

Although cutting foreign aid seems to fit a certain rationale – following the political logic of prioritising your own (addressing domestic needs first) and echoing the broader pattern of cynicism displayed by Trump hitherto – it fails to consider a crucial aspect. Foreign aid should not be perceived as a mere charitable action, it is also a strategy for stability in a world marred by complex geopolitical relations. It plays a preventive role, in mitigating crises that could later escalate into costly interventions.

Development assistance acts as a guarantee of long-term security. For example, cutting aid in Ethiopia jeopardies years of work; USAID has historically helped counter Russian and Chinese influences, and now that it is gone, it has created a void for these actors to fill.

This could constitute the remoulding of world politics with long-term and expansive consequences. Thus, it should not only worry the most compassionate and generous of us, but also the most selfish ones.

This blog was written by students undertaking a Global Master’s in Management degree at LSE’s Department of Management as part of the MG448A Capstone Course – Management in Action.
This blog post represents the views of its author(s), not the position of the London School of Economics and Political Science Department of Management.

LSE

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