Shockwaves

Doctors Without Borders/Médecins Sans Frontières (MSF) teams have decades of experience responding to all kinds of emergencies, from wars to disease outbreaks to natural disasters. But 2025 brought an unprecedented catastrophe caused by policy changes and massive cuts to international humanitarian aid by the United States government and other donors.

The US government has rescinded $12 billion in foreign aid from the 2025 budget, in addition to canceling United States Agency for International Development (USAID) contracts estimated to represent tens of billions of dollars over several years. These cuts are exacerbating already-dire conditions for people caught in crises. Foreign assistance typically represents only about 1 percent of the US federal budget, but it saves countless lives around the world.

While MSF is not directly affected by these cuts—we do not accept any US government funding—we work hand in hand with many local and international organizations that have been forced to scale back their work or halt activities altogether. When food aid is cut, our malnutrition treatment programs fill up. When vaccines go undelivered, our teams face the consequences when we respond to disease outbreaks.

Aid cuts are threatening efforts to fight AIDS, tuberculosis, and malaria—three of the world’s most harmful and widespread infectious diseases.

Our teams are seeing the impacts on the ground: vaccination campaigns disrupted, clinics closed, medications out of stock, drinking water in short supply, or doctors unable to tell their patients how to continue their treatment. The impact on US-funded family planning and reproductive health services has been particularly devastating, as the US has historically been the largest single donor in this area.

MSF remains committed to providing medical humanitarian aid wherever it’s needed—but we can’t do it alone. We urge the US government and other countries not to withdraw their support for global health and humanitarian aid—it can save lives.

Afghanistan

This year, the US administration canceled nearly all humanitarian assistance programs in Afghanistan, which faces some of the world’s largest humanitarian needs—especially for women and girls, who must contend with significant barriers to care. People in remote parts of the country, such as Bamyan province, often live hours away from medical care. MSF operates eight clinics to help reach these communities and launched emergency responses to a March 2025 outbreak of measles, which is endemic in Afghanistan, and a magnitude-6 earthquake that hit in August.

Democratic Republic of Congo

The resurgent conflict in northeastern Democratic Republic of Congo (DRC) continued to displace people this year, particularly around Goma, capital of North Kivu, which already hosted thousands of displaced people in camps on its outskirts. On top of violent attacks on civilians, infectious diseases like HIV and malaria also pose a serious threat in DRC, and sexual violence is rampant.

We are already seeing the fallout from aid cuts at a critical moment in the country: MSF teams have reported frequent shortages of diagnostic tests and medications for malaria, with deadly consequences for young patients. Distribution of essential medical supplies, such as post-rape kits that include medication to prevent HIV infection and other sexually transmitted diseases, has been disrupted across the country. Although some services have resumed, many have not, and people in already vulnerable situations remain uncertain about the future of the aid and care they depend on.

Mexico and Central America

Recent US policy changes have effectively suspended the right to seek asylum and left many vulnerable people stranded with nowhere safe to go. Many are trapped in a cycle of physical, emotional, and institutional violence.

MSF teams in the region, particularly in Mexico, have seen an increase in psychological needs among patients and a high proportion of people with severe mental health issues.

Aid cuts have affected HIV/AIDS treatment in places like San Pedro Sula, Honduras, where access to prevention measures like pre-exposure prophylaxis (PrEP) has been reduced at a time when needs are rising. And in places like Tecún Umán, Guatemala, where centers previously dedicated to vulnerable groups—such as Casa Violeta for women and children—have closed, with no alternatives available.

Nigeria

Since 2022, Nigeria has been experiencing an alarming malnutrition crisis, particularly in its northern regions. Cuts to international aid funding threaten to deepen the crisis: Between January and June this year, the number of malnourished children with nutritional edema (swelling of the body due to severe and deadly malnutrition) in Katsina state more than tripled compared to the same period in 2024. In July, the World Food Program announced it would suspend emergency food aid for 1.3 million people. Although some funding has since been restored, it remains below previous levels and insufficient to meet growing needs. The outlook for future funding also remains uncertain.

Pregnant and breastfeeding women are also affected. A screening of patients’ mothers in Katsina state in July revealed that more than half of adult caregivers were acutely malnourished, indicating the growing severity of the crisis.

Somalia

The suspension of USAID funding has led to the closure of at least 37 health and nutrition sites in both rural and urban areas around Baidoa, Somalia. Consequently, the number of patients has surged at remaining facilities like the MSF-supported Bay Regional Hospital, which has overwhelmed an already fragile health care system. Limited access to health care means that many patients arrive at hospitals with severe complications, sometimes resulting in preventable maternal and neonatal deaths.

South Sudan

South Sudan is facing a widespread cholera outbreak amid escalating violence and massive displacement. Many international actors are scaling back due to the funding cuts and insecurity. In hard-hit areas, for example, mobile clinic and water distribution activities were suspended by organizations mostly reliant on external funding. The reduction of vital services is compounding challenges responding to emergency outbreaks and further limiting scarce access to care.