If, on January 19, 2025, a day before Donald Trump’s inauguration, you had asked foreign aid experts, “does the US Agency for International Development (USAID) need reform?” most would have readily said “yes.” Not enough programs are evaluated for effectiveness; too much is run through a small number of private contractors; the foreign aid mission is fragmented across too many different departments, only some of which are under USAID’s purview.

Then the monkey’s paw curled. The Trump administration has not reformed USAID so much as eviscerated it: attempting illegal mass firings, canceling thousands of aid contracts, and announcing plans to close the whole agency and fold it into the State Department. The agency got change, all right, but not at all the kind that the aid community had been requesting.

The future of the agency, and foreign aid from the US in general, remains incredibly uncertain. Federal judges have issued injunctions against the administration’s firings, spending freeze, and attempts to dissolve the agency, but the administration is sure to appeal and we are likely months away from a final resolution at the Supreme Court. 

Some effects will be lasting even if the Court rules for USAID: Foreign aid groups reliant on its funding are running out of money and time, meaning that life-saving programs are on pause and many groups are on the verge of bankruptcy. But exactly how much of the Trump agenda will remain when the smoke clears is yet to be seen.

Perhaps the best way to understand where the foreign aid world is, as of late March, is through the stages of grief. The initial blitzkrieg against USAID in January had a feel of unreality: the natural reaction was denial. Once it became clear that the agency was under attack and that as a result, millions could die, the natural and correct reaction was anger.

Today, though, the dominant reaction I see in the sector is “bargaining.” No one thinks USAID or foreign aid generally are going back to where they were on January 19. While we don’t know what changes will last, it’s undeniable that some will. 

The imperative that many in the sector are now feeling is not merely to push back on the administration, but to adapt to the new reality in a way that hopefully preserves the best of USAID, while making some of the reforms that experts have been demanding for years.

“We should see this as a challenge, those of us who believe in the promise of aid, to put proposals on the table,” Ken Opalo, a professor of African politics at Georgetown who has studied the effects of aid, says. “I’ve had debates with people who say, ‘Now is not the time to talk about the bad aspects of aid, because these people are not acting in good faith.’ But from a low-income country perspective, I think now is the best time to talk about that. It creates an opportunity for everyone to rethink what’s possible in the aftermath of the Trump era.”

The fog of aid

This is normally the section in the article where I’d tell you where US foreign assistance stands today, but the truth is that absolutely nobody knows for sure.

The intentions of the Trump administration have been clear on at least two counts. One, they want to drastically cut back on US support. Secretary of State Marco Rubio, who is also acting administrator of USAID, announced earlier this month that he was canceling 83 percent of the agency’s total number of contracts. A leaked list of terminated projects implied a cut of one-third to USAID’s budget. And two, they want to eliminate USAID as an independent agency and move aid programs into the State Department proper.

But the details of what this actually means are much less clear. The leaked list of terminated projects, given to the Senate Foreign Relations Committee by a whistleblower, was 5,724 items long; Rubio claimed to only be shuttering 5,200 projects. Which was it? Since then, another list leaked, this one listing 909 projects that were still active. But that list included 373 projects that were on the 5,724 item list, seeming to confirm widespread rumors that Rubio and his team were un-terminating some projects that they had previously killed.

Then on March 25, yet another list leaked to the New York Times, showing 5,341 USAID awards that the administration sought to cancel and 898 that it intends to keep. According to this memo only 869 of the agency’s 6,000-odd employees would stay employed. Programs to help maternal and child health would see a 92 percent cut; over $1 billion would be cut from HIV/AIDS programs, and over $250 million from malaria.

The cuts detailed include ending support for Gavi, an international group financing vaccinations in poor countries that has saved many millions of lives, as well as ending many anti-malaria programs that have done the same by distributing bednets and medication. “By Gavi’s own estimate,” the Times’ Stephanie Nolen writes, “the loss of US support may mean 75 million children do not receive routine vaccinations in the next five years, with more than 1.2 million children dying as a result.” The State Department confirmed to Nolen, and to me in a statement, that this latest leaked document is authentic. Cuts like the Gavi measure, a State Department spokesperson told me, took place because Rubio “determined the award was inconsistent with the national interest or Agency policy priorities.”

Lest you think this puts an end to the uncertainty, there are still the courts. What the Trump administration is doing is, bluntly, illegal. They are refusing to spend money lawfully appropriated by Congress and are trying to shut down an agency whose existence Congress, in a 1998 law, mandated. They have terminated civil servants in violation of federal civil service laws. It should thus not be terribly surprising that multiple judges have issued injunctions against this behavior.

For aid supporters, the judges are a source of hope. But they also add uncertainty. Are the 5,341 projects that Rubio’s latest spreadsheet states are canceled…really canceled? Could they be switched back on by a final Supreme Court ruling soon? If the Supreme Court rules that USAID cannot be shut down, will Rubio and the Trump administration comply? Or will they defy the court, as Trump, Vice President JD Vance, and several other administration officials have threatened?

“We’re just in such a quandary now, in terms of the state of operations, that it becomes really hard to step back and think about what comes next,” Erin Collinson, director of policy outreach at the Center for Global Development, says.

But we do know a few things, or at least have good guesses on a few things. By the end of Trump’s term, or the end of his assault on aid, it seems likely that:

1. The US aid agency (whether USAID or something new) will be smaller, perhaps significantly so, in both funding and staffing than on January 19, 2025.
2. A significant number of companies and employees working in the aid contracting sector will exit it and/or go out of business. That will make it harder to ramp aid back up, assuming that will even be a possibility.
3. What aid does remain will face greater scrutiny from a conservative grassroots that’s strongly polarized against foreign assistance.
4. Former conservative allies of aid will be weaker and quieter, in part in reaction to 3.
5. Health and humanitarian relief programs with large, quantifiable positive effects, like PEPFAR, will continue to have loud defenders, and even the Trump administration will feel compelled to promise to protect them, though it’s unclear whether those promises will be fully honored.

The turn toward programs that are easy to defend from attack might be good for some things, like global health, but it might be harmful to other valuable efforts. W. Gyude Moore, who served as Minister for Public Works in Liberia from 2014 to 2018, argues that the aid we’ll miss most is “the part that helps governments become better in delivering services to their people. That’s the stuff that’s easy to make fun of — ‘$15 million to give Liberians confidence for elections,’ blah, blah, blah.” 

Some of that capacity-building funding was more effective than others, Moore concedes, but some of it worked: He points to how the choice of Western donors to condition government debt relief for poor countries on improvement on measures of inflation and economic growth led to many countries investing in ministries of finance that could reliably track those metrics. That’s a real, durable improvement in state capacity that aid can produce. But it’s harder to explain than spending money on life-saving HIV drugs, say.

That said, considerable uncertainty remains, even within these broad trends. USAID being “smaller” could mean 5-10 percent cuts to funding and staff, or it could mean the agency ceasing to exist in any recognizable form, independently or inside State, at all. The fight over programs like PEPFAR could keep them safe or fail and watch them lapse — Congress’s authorization for PEPFAR specifically has already formally expired. The latest leaked spreadsheet preserves much HIV funding but not funding for vaccines and malaria. But it seems very likely that this broad picture, of a shrinking USAID with global health programs having the strongest defenders, will hold.

Fight or reform?

I normally begin interviews with sources with a simple, “How are things” or “How are you these days”; I had to stop when talking to people in the foreign aid world, because literally no one could answer, “I’m doing well!” The world they know is being dismantled, at a cost of millions of lives, and everyone is processing that grief in their own way.

You can roughly divide the responses in two. One is a determination to keep fighting: beat the administration in the courts, rely on the Congressional support that has saved foreign aid in the past, and return aid to something as close as possible to January 19, 2025.

Charles Kenny, a senior fellow at the Center for Global Development, has been an eloquent exponent of this general view. “I can imagine a scenario in which it becomes pretty clear legally that the administration has to make a good-faith effort to spend the money,” Kenny explained to me. “They put forward a rescissions package [a set of cuts] to get around that. But it turns out there’s no version of the rescissions package that is big and can actually get enough votes for it, so it fails in Congress.” Something like that in fact happened in Trump’s first term.

Kenny is clear that this scenario is not good per se. USAID is already operating with much fewer staff, and its partners in the field are struggling or shutting down, so getting money out the door would be much harder in this scenario than one without the past couple months’ disruptions. 

“Programs can only go so long without funding and knowledge of what’s coming,” Colin Puzo Smith, director of global policy at the aid advocacy group RESULTS, says. “You can’t tell a program, ‘Just kidding, you’re not terminated!’ in six months, when they will have fired all their staff, shut down clinics, turned away patients.”

But with that said, Kenny’s is still a scenario where USAID survives, if not intact, then mostly intact.

Others in the sector are taking a different tack. What aid looks like is clearly in flux, and no one thinks the previous setup with USAID was absolutely, 100 percent perfect. So why not adapt to the moment?

It’s important not to exaggerate the disagreement here. Kenny and others in his camp have called for substantial reforms to USAID for years. And those arguing for seizing the moment for reform have been vocal in opposing cuts so far. This is a fight within a team that broadly shares the same goals. But the difference in emphasis is nonetheless striking.

The Modernizing Foreign Assistance Network (MFAN), a pro-aid coalition including prominent groups like Catholic Relief Services and Save the Children, released a proposal for how the Trump administration should structure aid within the State Department, provided it goes forward with plans to fold USAID into State.

“Our strong preference would be to retain USAID as an independent agency,” Tod Preston, MFAN’s executive director, told me. “We still maintain, as do many others, that USAID cannot be abolished without the consent of Congress. … But at the same time, given how quickly things are going and how reckless many of these actions have been, MFAN thought it was important to put out some guidelines for how, if it is going to be restructured, to do it in as thoughtful and as strategic as a way as possible, to preserve as much of its development and humanitarian capabilities as possible, and in a way that will improve coordination.”

Unlock Aid, another coalition that’s pushed for USAID to invest more in evidence-backed programs and diversify the contractors it uses, is treating the moment similarly, proposing what it calls a “third path.” 

“While the termination of programs has raised significant concerns about continuity in critical health and humanitarian efforts,” its leaders, Amanda Arch and Walter Kerr, wrote in a letter to Rubio, “this moment also presents an opportunity to address longstanding systemic challenges in how America engages with the world.” They call on Rubio to “stop programs without clear transitions,” “stop low-impact projects,” “stop funding middlemen,” and instead “prioritize results over process.” The immediately apparent goal is to try to cast a reform agenda in a light congenial to Rubio, and the administration’s overall worldview on aid.

The rhetoric also gels nicely with a memo leaked from within the State Department, appearing to outline some Trump-appointed officials’ visions for how aid should be restructured. The exact provenance and significance of the memo are unclear. It could be an omen of things to come, or simply one set of ideas that was discussed and rejected. Whatever it is, the leaked memo called for reforming payments so that contractors are only paid if their work generates results, and moving away from the large contractors who have dominated the sector.

“Candidly, there’s a lot in there that looks a lot like some of the things that we have proposed,” Kerr notes.

Here again, though, the tremendous uncertainty around the future of aid creates a problem. One smart, technical change recommended in the leaked memo is to allow USAID to defer to trusted international organizations when it comes to due diligence (that is, ensuring that organizations on the ground receiving funds are reputable). But at the same time, USAID is now pulling out of Gavi, one of the most important of those trusted organizations. It’s one step forward, five steps back.

Living in the fog

Basically everyone affected by foreign aid is facing unprecedented challenges right now, and no one more so than the people and countries who have relied upon that assistance. Whatever changes or reforms stick, the prescription for them is clear, says Opalo, the political scientist: they need to figure out how to live without aid.

This is easier for some countries than others. In many of sub-Saharan Africa’s most populous countries, foreign aid is fairly small relative to the economy: 2-4 percent of national income in Nigeria, Ethiopia, and Tanzania. But other places, especially areas that are currently or were recently undergoing civil war, are extremely reliant. In South Sudan, foreign aid makes up nearly half of national income; it is over a third of national income in Syria and Yemen. Some of the most damaged countries in the world could be worst hit by the retreat of aid.

In countries where aid is small relative to the economy, it will still be hard to abandon the systems that foreign aid has helped build. “Even countries that are fiscally strong, like Kenya, are still critically dependent on donors and consultants for huge swathes of their health planning, disease monitoring, immunization, and other systems,” said Opalo. “Even if the money is available, they’ll still struggle to onboard these systems onto government-run systems.” 

But the tremendous uncertainty left by the US’s chaotic retreat from aid gives recipient countries little choice but to try to strengthen their own state capacity. “I’ve lived in a weak state,” Moore, the former Liberian cabinet minister, says. “All this stuff about shrinking the state — it’s all theoretical. If you live in a state that week, it frightens you when people say ‘the state is too strong.’”

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