By Mary Alice Miller
On January 20, one of President Trump’s executive orders called for a 90-day pause on all foreign aid programs. No new projects are to be started, no contracts will be extended, and work is to be stopped on most existing programs.
According to the United States Agency for International Development (USAID) website, “On Friday, February 7, 2025, at 11:59 pm (EST), all USAID direct hire personnel will be placed on administrative leave globally, with the exception of designated personnel responsible for mission-critical functions, core leadership, and specially designated programs.
Essential personnel expected to continue working will be informed by Agency leadership by Thursday, February 6, at 3:00 pm (EST).”
USAID personnel currently posted outside the United States have 30 days to pack up and return to the United States.
Established by Congress in 1961, USAID is the international humanitarian and development arm of the United States government, assisting nations in conflict and other “strategically important countries” by alleviating poverty, disease and other crises.
The 2024 budget for USAID is $42.8 billion for foreign assistance. USAID has more than 10,000 employees, with additional contractors and foreign nationals. USAID provides assistance to approximately 130 countries.
Until recently, USAID was an independent federal agency that received overall foreign policy guidance from the Secretary of State. On Monday, Secretary of State Marco Rubio was appointed as Acting Administrator of USAID. Rubio froze operations at the U.S. Agency for International Development.
The Heritage Foundation’s Project 2025 has presented USAID as a test case for conducting a hostile takeover of the government by cutting and redirecting spending and amending staffing.
“Congress has the power of the purse. When Congress allocates funding, the Constitution requires that the funding be spent by the president and the administration,” said Rep. Hakeem Jeffries, the Democratic Minority Leader. “And the Constitution requires the president to take responsibility for the laws to be faithfully executed.
Spending agreements passed through the appropriations process are law. When those laws are being violated, the Constitution is being violated, which is why there has been a flurry of righteous litigation that has been unleashed. That will continue.”
Jeffries added, “We will never back down in pointing out what MAGA extremists are trying to do to hurt everyday Americans.”
Senate Minority Leader Chuck Schumer said, “Over the past few days, Democrats have warned the American people that DOGE is operating like a shadow government. Yesterday, I said DOGE is not a real government agency. It has no authority to make spending decisions, shut down programs, or ignore federal law. This is not debatable. This is an indisputable fact.”
Schumer and Jeffries announced legislation that would prevent unlawful meddling in the Treasury Department’s payment system.
Among the programs affected is the President’s Emergency Plan for AIDS Relief (PETFAR).
Professor Ntobeko Ntusi, President and CEO of South African Medical Research Council spoke about the impact of Trump’s abrupt stop work order for USAID.
“The recent disruption to these programs had a significant impact immediately on operations on the ground. Just to give you an example of the scale of PETFAR, for instance, South Africa receives about 20% of the annual disbursement from PETFAR, which comes to about US $350 million. The PETFAR program employs over 250,000 doctors in 55 countries and over a million nurses and community health care workers,” said Ntusi.
“With the stop work orders received between January 24 and 27, all the staff members were immediately told to cease operations, 15- to 20,000 of them based in South Africa.
This meant that patients primarily with HIV infections who need to receive life-saving antiretroviral therapy as well as other treatments could no longer access their therapies.
The same has been true for other programmatic care programs,” said Ntusi. “As you can imagine, this has caused significant furor around the country. Many people have rallied and tried to get the U.S. administration to change its position.
On Friday, they issued a waiver now saying that the continued treatment of HIV will now be permitted in the USAID and PETFAR programs.”
Ntusi explained the impact of disruptions in antiretroviral treatment for HIV patients.
Patients with HIV need to take their antiretroviral therapy daily. What this does is keep the immune system functioning optimally and suppress the levels of the virus in the body. Once you have an interruption in the treatment, the levels of the virus begin to increase. This increases the risk of opportunist infection and cancers.
Most importantly, you need to sustain a steady level of the drugs in your system, and when they dip below a critical threshold for sustained or repeated periods, you can then develop resistance to the antiretroviral therapy as the HIV virus mutates, resulting in decreased efficacy in the treatment.
“Patients who received a refill in their medication last week could not access services and could not receive treatment,” said Ntusi. “I hope that with the waiver issued on Friday, many of the services will be recontinued from tomorrow onwards.”