The recent decision by President Donald Trump to freeze all foreign aid has significant and sometimes life-threatening implications for some of the poorest people in the global south. The USA has not been a generous aid donor relative to its income since the 1960s; but it has always been the largest in absolute terms. In 2023, USAID –  America’s aid arm –  distributed nearly $43.8 billion in aid. Of the 26 poorest countries in the world there are eight that are reliant on USAID for more than one fifth of their assistance: South Sudan, Somalia, Democratic Republic of Congo, Liberia, Afghanistan, Sudan, Uganda and Ethiopia. 

A recent study by the Center for Global Development (CGD) suggested that if USAID funding were paused for a year, the resulting shock would exceed 1% of the Gross National Income (GNI) in 23 economies, with eight experiencing a devastating hit of 3% or more. GNI is the total amount of money earned by a nation’s people and businesses. No insignificant sum.

The implications for research – especially health research – are profound: HIV treatments and other services have been disrupted in 50 countries; and Health experts have warned of the spread of disease, as well as delays to the development of vaccines and new treatments as a result of the cuts. 

The CGD report looks at vulnerable low- and lower-middle income aid recipient countries who are exposed to USAID cuts. For each recipient country they identify its largest non-US provider of development assistance to indicate who is now best-placed to take a lead role among providers.

The report is important, not only for its rigorous analysis, but for its strident message: it is not enough to point the finger and condemn the actions of others, we must ourselves step up to fill the gaps.