With Aid Cutoff, Trump Halts a Legacy of ‘Acting With Humanity’

Shock and grief rippled through the health community as lifelines for care were abruptly severed.

Funds from the world’s richest nation once flowed from the largest global aid agency to an intricate network of small, medium and large organizations that delivered aid: H.I.V. medications for more than 20 million people; nutrition supplements for starving children; support for refugees, orphaned children and women battered by violence.

Now, that network is unraveling. The Trump administration froze foreign aid for 90 days and has planned to gut the U.S. Agency for International Development to just 5 percent of its work force, although a federal judge paused the plan on Friday. Given wars and strapped economies, other governments or philanthropies are unlikely to make up for the shortfall, and recipient nations are too hamstrung by debt to manage on their own.

Even the largest organizations are unlikely to emerge unscathed. In interviews, more than 25 aid workers, former U.S.A.I.D. employees and officials from aid organizations described a system thrown into mass confusion and chaos.

A tower of blocks may take hours to build, but “you pull one of those blocks out and it collapses,” said Mitchell Warren, executive director of the H.I.V. prevention organization AVAC, which relied on U.S.A.I.D. for 38 percent of its funding.

“You’ve gotten rid of all of the staff, all of the institutional memory, all of the trust and confidence, not only in the United States but in the dozens of countries in which U.S.A.I.D. works,” Mr. Warren said. “Those things have taken decades to build up but two weeks to destroy.”

Small organizations, some with as few as 10 employees, have folded. Some midsize organizations have furloughed up to 80 percent of their employees. Even large organizations — including Catholic Relief Services and FHI 360, among the biggest recipients of U.S.A.I.D. funding — have announced large layoffs or furloughs.