The Trump administration plans to end U.S. financial support for Gavi, the global organization that has helped procure life-saving vaccines for children in developing nations and saved millions of lives over the past 25 years.
Also, the administration is significantly scaling back funding for malaria prevention efforts, targeting one of the world’s deadliest diseases.
Despite these cuts, the administration will maintain key grants for HIV and tuberculosis treatments, as well as food aid for nations facing crises like civil war and natural disasters.
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These funding decisions are outlined in a 281-page spreadsheet sent to Congress by the U.S. Agency for International Development (USAID) on Monday night. The New York Times obtained the document, along with other materials detailing the administration’s foreign aid reductions.
The documents reveal the administration’s sharp departure from a decades-long U.S. commitment to global health and humanitarian aid, particularly in combating infectious diseases. The cover letter describes a dramatically downsized USAID, with its budget slashed and only 869 of its more than 6,000 employees still active.
In total, the administration has opted to continue 898 USAID-funded projects while terminating 5,341. The letter states that although these remaining programs are valued at up to $78 billion, only $8.3 billion remains unobligated—spread across multi-year awards—marking a drastic reduction from USAID’s previous $40 billion annual budget.
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A State Department spokesperson confirmed the accuracy of the terminations, stating that each award was reviewed individually for alignment with agency and administration priorities. Secretary Rubio, the spokesperson said, determined that terminations were necessary when programs conflicted with national interests or policy objectives.
The memo to Congress presents the aid cuts as a unilateral decision. However, because funding for programs like HIV treatment and vaccinations is allocated by Congress, the administration’s legal authority to halt them remains uncertain and is currently subject to multiple court challenges.
Among the terminated programs is U.S. funding for the United Nations Food and Agriculture Organization, which monitors zoonotic diseases—such as bird flu—in nearly 50 countries. Major malaria prevention efforts, a leading cause of child mortality worldwide, have also been cut.
Dr. Austin Demby, Sierra Leone’s health minister, expressed deep concern over the loss of U.S. funding for Gavi, warning of global consequences. “This is not just a bureaucratic decision—children’s lives and global health security are at stake,” he said.
Sierra Leone, which relies on Gavi for vaccine procurement, is also battling an mpox outbreak, for which Gavi has provided vaccines and logistical support. “The U.S. has long been a global leader in public health,” Dr. Demby added. “Funding Gavi isn’t an expenditure—it’s an investment.”
Since its founding 25 years ago, Gavi has helped save an estimated 19 million lives. The U.S. has historically been a top donor, contributing 13% of Gavi’s budget. The now-canceled $2.6 billion grant, pledged through 2030, was critical to Gavi’s next funding cycle.
With U.S. support in jeopardy, Gavi’s ability to maintain core immunization programs—including those for measles and polio—is at risk, let alone expand efforts to distribute new vaccines for severe malaria and cervical cancer prevention. The organization estimates that without U.S. contributions, 75 million children could miss routine vaccinations in the next five years, leading to 1.2 million preventable deaths.
While European nations and Japan have also been major donors, shifting geopolitical priorities and economic pressures—such as the war in Ukraine and currency fluctuations—have strained their aid budgets.
Gavi CEO Dr. Sania Nishtar urged the Trump administration to reconsider. “Gavi’s work protects everyone, including Americans,” she said. Beyond safeguarding individual children, widespread vaccination helps prevent large-scale disease outbreaks. The organization also maintains emergency vaccine stockpiles for threats like Ebola and cholera.
Gavi’s funding model requires recipient countries to contribute a portion of vaccine costs, with their share increasing as economies grow. Middle-income countries eventually transition off aid.
Despite the administration’s public claims that its foreign aid review is complete, internal documents suggest that some program terminations remain in flux. For instance, a major malaria initiative that was recently canceled—and listed as defunded in the congressional report—was unexpectedly reinstated this week.
However, malaria response cuts remain severe. While funding for essential supplies like bed nets and medication purchases has been preserved, many programs responsible for delivering these tools in high-burden nations such as Cameroon and Tanzania have been terminated. Some organizations awaiting funding for months have already shut down, leaving no one to transport treatments from ports to clinics or distribute them to children in need.
As of last Friday, USAID reported just 869 active personnel, while 3,848 staff members remain on administrative leave and 1,602 are in the process of being laid off. A court ruling temporarily blocked the dismissal of 270 out of 300 probationary employees initially let go.
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