The dismantling of the United States Agency for International Development (USAID) is reportedly responsible for the deaths of more than 600,000 people worldwide, according to a recent report by the Impact Metrics Dashboard and an article in The New Yorker authored by physician and former agency official Atul Gawande.
A significant portion of the victims—two-thirds—are children under the age of five, impacted by the cessation of vital health and nutrition programs.
This shutdown was initiated in January 2025, just hours after President Donald Trump's inauguration, when he signed an executive order to "pause" all international aid.
Secretary of State Marco Rubio issued a directive halting all active programs, leaving thousands of workers without pay and suspending the distribution of medicines and food, including supplies that were already in warehouses.
Gawande describes the decision as "an unprecedented blow that turned American cooperation into a man-made public death machine."
The Impact Metrics Dashboard, updated on June 26, 2025, estimates that the total program disruptions and cancellations resulted in 198,000 adult deaths and over 412,000 child deaths, occurring at a rate of 88 deaths per hour.
The hardest-hit initiatives include those battling malaria, HIV/AIDS, tuberculosis, childhood malnutrition, and pneumonia. Specifically, in the realm of childhood malaria, there have been over seven million additional cases and more than 53,000 deaths due to the absence of treatment and prevention measures.
The New Yorker’s report showcases the human consequences of this policy through the documentary Rovina’s Choice, filmed in Kenya.
At the Kakuma refugee camp, where World Food Programme supplies were cut to 40% of the minimum required, acute malnutrition rates soared, and two-thirds of community healthcare workers were laid off. One of the main subjects, Rovina Naboi, struggles to keep her daughter Jane Sunday alive in an overwhelmed clinic.
Before its closure, USAID was instrumental in controlling over twenty epidemic outbreaks, sustaining Ukraine's health system during the war with Russia, and reducing maternal and child mortality in numerous countries.
An analysis published in The Lancet calculated that the agency had saved 92 million lives over the past two decades, with an annual budget of just $24 per American taxpayer.
Gawande’s article also condemns the removal of the data monitoring system and the firing of inspector generals, which he warns is intended to obscure the true extent of the damage.
Experts liken this lack of transparency to the data suppression during Mao Zedong’s “Great Leap Forward,” when millions perished without official documentation.
The full impact of USAID's closure may take years to measure, as deaths from HIV, tuberculosis, or preventable diseases emerge gradually.
However, experts are united in their assessment: the agency's dismantling has undone decades of global health progress and stands as one of the largest humanitarian disasters brought about by political decision-making in peacetime.
"Every statistic represents a life cut short by political choices," the Impact Metrics Dashboard report concludes. As Gawande warns, "the cruelty and lethality will only increase if the rollback of public health advances persists, both abroad and within the United States."
Impact of USAID Shutdown on Global Health
What was the immediate impact of the USAID shutdown?
The immediate impact included halting active programs, leaving thousands of workers without pay, and suspending the distribution of essential medicines and food.
How did the USAID closure affect children?
Two-thirds of the victims were children under five, affected by the suspension of crucial health and nutrition programs, leading to increased cases of malnutrition and disease.
What are some of the long-term effects of the USAID shutdown?
Long-term effects include increased mortality rates from preventable diseases and a significant setback in global health progress, which may take years to fully assess.