Last updated: March 18, 2025
January 2025 brought significant changes to US government foreign assistance, including to the government’s funding for global health programs. Foreign aid grantees and contractors have received stop-work orders, payments have been frozen, projects have been terminated, and staff have been laid off.1 While the long-term effects remain uncertain and exact numbers remain difficult to ascertain, cuts of 35% to 90% of US foreign aid dollars are being publicly discussed by the administration.2
The US government spends about $70 to $80 billion annually on foreign assistance.3 About $12 billion to $15 billion of this is dedicated to global health.4 This represents roughly 20% to 25% of the total global aid to support health programs, which combat malaria, tuberculosis, HIV, maternal and child health issues, and much more.5
These first few months of the US aid freeze have been destabilizing for global health programs. These include some of the most cost-effective interventions we have found for saving and improving lives, such as malaria nets, malaria chemoprevention, and community-based management of acute malnutrition. If the changes to the US government’s foreign aid funding hold, they could substantially reshape global health and development.
We’ve created this page to share how we’re responding and answer the most common question we’re hearing right now: How can donors help?
Latest podcast update
This situation is changing daily, and we’re constantly learning more. We’ve started to record a series of conversations with our research team to share timely snapshots of this rapidly evolving situation. You can listen or subscribe to our podcast for the latest updates and read a summary of key takeaways on our blog.
How we’re responding
Navigating a fracturing system
This situation is a major focus of our research team at the moment, and we’re regularly speaking with our contacts in governments and nonprofit organizations to understand and adapt. Disruption to US foreign assistance has created significant gaps in implementation capacity. Even if we were to fund one component of a program, the program might remain inoperable if related elements were to stay unfunded—such as having malaria drugs but no distribution system or trained personnel to administer them. These implementation realities shift regularly, and our research team is working to understand them so that we can deliver funding to most cost-effective opportunities we find.
Targeted, near-term response
We have so far focused on addressing urgent gaps in high-impact program areas we’re familiar with, such as malaria prevention and malnutrition treatment. In recent weeks, we have expanded our investigations beyond our core programs to adjacent areas, such as data collection infrastructure and malaria therapeutics. We’re currently investigating approximately $100 million in urgent funding needs. For these investigations, we’re focused on filling time-sensitive gaps. That includes supporting implementers with cash-flow challenges for programs where US government funds may eventually be released, because we believe that preventing promising programs from collapsing before funds are unfrozen is a particularly cost-effective strategy. In some of these cases, we plan to provide funding as forgivable loans or phased disbursements to help mitigate risks during this volatile period.
Broad, long-term perspective
Today’s disruptions represent only a small portion of what could emerge, and we're also preparing for the needs that could arise due to sustained reductions in foreign assistance from the US and other donor countries.6 The potential wave of new, long-term, and highly cost-effective funding opportunities may lead us to raise our cost-effectiveness threshold so that we can direct our limited donor dollars to the most cost-effective programs we identify. We also think these emerging needs may cause us to expand into previously relatively well-funded areas, such as HIV or tuberculosis treatment. That said, GiveWell makes grants on the order of $300-$400 million annually, and we will not be able to significantly mitigate the harms of a very large drop in foreign health aid spending.
Holding to core approaches
While the scale and scope of this situation is unprecedented, we think it’s vital that all our actions remain guided by our standard approach:
- Search for highly cost-effective giving opportunities, even in uncertain circumstances
- Rigorously evaluate those opportunities and share our research publicly, while acknowledging that timely action sometimes requires accepting higher uncertainty
- Direct funds to where they'll do the most good, considering both immediate needs and long-term implications
How donors can help
We have heard from many donors who feel urgency to help, and we believe giving now has a greater potential impact than before the freeze and cuts in US foreign aid funding.
We continue to research and fund highly cost-effective programs that now have an increased need for support. And as we evaluate them alongside the many emerging and urgent needs, we are also considering the future opportunities we might fund with donors’ support. Our work to help donors do the most good they can with each dollar is as important and difficult as ever, and we believe the highest-leverage opportunities for impact may emerge as the full effects of these changes become clearer.
We are actively fundraising for what we expect to be larger gaps to help people in need, and we expect to find far more excellent giving opportunities than we’ll be able to fund in the coming years. Raising more money to distribute to the most cost-effective programs we find is imperative.
If you want to help respond to this situation, donating to our funds based on your giving preference remains our recommendation. The funds enable us to respond in different ways, but both use 100% of your gift, after transaction fees, to support the best giving opportunities we find.
- Giving to our All Grants Fund provides us with more flexibility to respond strategically to the greatest emerging needs we identify. While we have less certainty about some of the individual programs supported by this fund, we think they collectively have the highest impact per dollar spent.
- Giving to our Top Charities Fund ensures your money is deployed quickly and exclusively to the four highly cost-effective programs that we have the most confidence in.
Grants we’ve made
Below is a list of grants that we have made so far in direct response to the 2025 cuts to US foreign aid spending. These grants are in addition to our normal grantmaking—much of which has also been impacted.
- $250,000 grant to CHAI to quickly plug very time-sensitive and high-impact malaria funding gaps emerging from the USAID stop-work order.
- Approval for Evidence Action to pull forward up to $142,515 of grant funding to carry out healthcare worker training for screening and treating syphilis during pregnancy. The training had been canceled by the freeze on US foreign aid funding.
Please note that this list is not exhaustive; we aim to update the list twice monthly and may, in some cases, delay sharing grant information for strategic reasons.
- 1
- “The chaos began with a stop-work order for employees and contractors of the United States Agency for International Development and a freezing of all funds, including reimbursements for hundreds of millions of dollars already spent. That was followed by a process allowing organizations that provided lifesaving medical treatment and food aid to seek a waiver allowing them to continue their work.
Then came terminations, last Wednesday, of more than 5,000 projects and programs. Since then, some projects have been told they were fully restored, and others that they are restored only to the terms of their original waiver, which runs out next month. Almost none have seen any of the funds they are owed unfrozen.” Nolen 2025.
- For a timeline (up to March 2, 2025) of cuts and legal orders related to the United States Agency for International Development (USAID), the primary US government agency responsible for providing foreign assistance, including global health programs, see Schoenfeld Walker and Lai, March 5, 2025.
- “The chaos began with a stop-work order for employees and contractors of the United States Agency for International Development and a freezing of all funds, including reimbursements for hundreds of millions of dollars already spent. That was followed by a process allowing organizations that provided lifesaving medical treatment and food aid to seek a waiver allowing them to continue their work.
- 2
- On March 10, Secretary of State Marco Rubio tweeted that “83%” of USAID programs were being cancelled, with 5,200 cancelled and 1,000 retained. The Center for Global Development estimates that this represents a cut of approximately 34% of USAID programming by dollar value (Kenny and Sandefur, March 14, 2025).
- “In his statement to the lower court, Pete Marocco, who is performing the duties of the deputy administrator of USAID, said each of USAID’s grants had been reviewed and Secretary of State Marco Rubio decided to eliminate about 92% worth of the agency’s grants. The State department also cut around 4,100 grants. The government claimed a total savings of nearly $60 billion dollars.” Tanis and Langfitt, February 26, 2025. $60B in cuts / $68B total obligations = total cuts of around 88%; if the total obligations are actually $79B and the government's other estimates are accurate, then total cuts would be around 76%.
- 3
According to the Foreign Assistance website, the US had $68 to $79 billion in foreign aid obligations for fiscal year 2023, and $76 billion in fiscal year 2022.
- 4
- According to KFF (chart 5), enacted US government global health funding was $12.2B for fiscal year 2022, $12.9B for 2023, and $12.4B for 2024. “Note: Represents total known funding provided through the State Department, USAID, CDC, NIH, and DoD. FY13 includes the effects of sequestration. Does not include emergency supplemental funding. Some global health funding that is not specified in the appropriations bills and is determined at the agency level is not yet known for FY23-FY24” KFF 2025, note for chart 5.
- The Institute for Health Metrics and Evaluation estimates total US government health aid at $14.6 billion in 2023. See IHME, VizHub - Financing Global Health, DAH flows, 2023.
- 5
According to the Institute for Health Metrics and Evaluation, total global health aid spending for 2023 was $64.6 billion. See IHME, VizHub - Financing Global Health, Health Focus Areas of DAH, 2023.
- 6
Other donor countries have also announced cuts to or intentions to cut foreign aid. For example: “Yesterday, the UK’s Prime Minister Keir Starmer announced that he would fund an increase in the UK’s defence spending by cutting its aid budget from 0.5 percent of gross national income (GNI) now, to 0.3 percent in 2027.” Mitchell and Hughes, February 26, 2025.