AYESHA RASCOE, HOST:
When President John F. Kennedy set up the United States Agency for International Development or USAID, it was the height of the Cold War. Kennedy envisioned the agency as a critical humanitarian tool and a way of countering the Soviet Union around the world.
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JOHN F KENNEDY: The people who are opposed to aid should realize that this is a very powerful source of strength for us. It permits us to exert influence for the maintenance of freedom.
RASCOE: One of the people now opposed is President Trump. Over the years, USAID has faced accusations of inefficiency and waste. It has also helped fund and support humanitarian work in more than 100 countries on behalf of the U.S., the world's largest donor of humanitarian aid. Now that the Trump administration has begun to dismantle the agency and freeze foreign aid, we'll turn to Diaa Hadid in Mumbai, Kate Bartlett in Johannesburg, Eyder Peralta in Mexico City and first up, Joanna Kakissis in Kyiv.
JOANNA KAKISSIS, BYLINE: Ukraine is the largest recipient of USAID funds. It's received $37 billion in the last three years since Russia's full-scale invasion. That aid has touched practically every aspect of Ukrainian life, says Oleksandr Merezhko, a member of parliament from President Volodymyr Zelenskyy's party.
OLEKSANDR MEREZHKO: There are lots of programs which are very useful, including support of our war veterans, programs related to health care, support of parliament.
KAKISSIS: And paying the salaries of emergency service workers. It's also kept farmers in business, and it's helped rebuild Ukraine's power grid after repeated Russian strikes. Now that the Trump administration is dismantling the agency, the chaos has left many in limbo, including Olena Tolkachova (ph), who runs a medical charity in the southern city of Mykolaiv. She says programs providing treatment for tuberculosis and HIV have shut down for now.
OLENA TOLKACHOVA: (Through interpreter) We paid to deliver antiretroviral therapy to HIV patients who could not get to a hospital or see an infectious diseases specialist. We worked with medical institutions so nurses could send out those parcels every month.
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KAKISSIS: The cuts have also hit local Ukrainian media. The news website Cukr in the northeastern city of Sumy relies on USAID funding.
DMYTRO TISHCHENKO: More than 60% of our budget.
KAKISSIS: Dmytro Tishchenko is Cukr's editor.
TISHCHENKO: So now we have a big challenge. We're trying to communicate with our European partners to cover that.
KAKISSIS: He says Cukr has enough money for just another month. And Sumy, a front-line city frequently attacked by Russia, depends on facts, he says, not unfiltered social media compromised by Russian propaganda. Merezhko, the lawmaker, says he hopes the Trump administration will revive USAID after reviewing or overhauling it.
MEREZHKO: It's important not only for Ukraine. I think it's important for the United States, and besides, let's not forget about information war on the part of Russia and China.
KAKISSIS: He says without USAID, the United States will leave a void that will quickly be filled by Russia and China.
I'm Joanna Kakissis in Kyiv.
DIAA HADID, BYLINE: USAID used to do a lot of heavy lifting in South Asia, as well as in Afghanistan, where there's been an ongoing humanitarian crisis. Now, amid chaos in Washington, the aid agency's education projects are suspended in Afghanistan. That includes secret schools for hundreds of Afghan girls after the Taliban banned them from learning beyond Grade 6. USAID funded other work to support Afghan women, including a project to train female journalists. That was through a news outlet called Zan Times. The editor, Zahra Nader, tells NPR this project is now on hold.
ZAHRA NADER: The notification actually came on the day that we were supposed to start our first online class, and we couldn't dare to tell to these women journalists who were joining us online from Afghanistan.
HADID: Nader says it feels like Afghan women are being abandoned. In Bangladesh - a fairly poor country of about 170 million people - USAID had all sorts of projects, including a popular local version of Sesame Street. USAID last year shared a video of one of the Bangladeshi puppets, Halum, the tiger.
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ASHRAFUL ASHISH: (As Halum, non-English language spoken).
HADID: USAID also took on quite big public health issues in Bangladesh, like a project to screen and treat tuberculosis patients. And NPR producer Ahmede Hussain spoke to a doctor who worked on that project. He requested anonymity. He wasn't allowed to speak to the media, fearing his group will be denied future funding from Washington. He told NPR that Bangladesh likely has about 3.7 million people infected with tuberculosis or TB. It's a highly contagious bacterial infection that can be deadly.
But many Bangladeshis don't know they're infected, so USAID funded a program to teach medics to screen for the illness that included training around 3,000 pediatricians because it's often children who aren't diagnosed. USAID was also funding TB centers to treat patients. And the doctor NPR spoke to says more people will be infected as a result, and he says more lives are going to be lost.
I'm Diaa Hadid in Mumbai.
KATE BARTLETT, BYLINE: South Africa has the highest number of people living with HIV in the world, over 8 million by some estimates. In recent years, it's made great inroads with prevention and treatment, and much of that is down to the support of USAID with its funding of the President's Emergency Plan for AIDS Relief or PEPFAR.
I'm standing on the street in Johannesburg outside the Engage Men's Health clinic. It's sponsored by PEPFAR and there's a notice saying, regrettably, our clinic is temporarily closed because the funder has pulled their services.
ALEX: So I just came today just to do collection of my PrEP medication.
BARTLETT: I bump into 30-year-old Alex (ph) on the street outside the clinic. He's been coming here for years to collect his pre-exposure prophylaxis or PrEP. We're not sharing his second name for medical privacy reasons. PrEP medication prevents HIV infections in people at high risk.
ALEX: This place is also catered for LGBT. So a lot of people, they can be in, you know, in the closet, and they don't want their family to find out. They would come to this clinic.
BARTLETT: HIV-positive people in South Africa are bracing themselves for tough times ahead. While the government here provides the antiretroviral drugs, about 17% of its other HIV funding comes from PEPFAR. That's about $440 million a year. The government here says 15,000 health care workers stand to lose their jobs.
SALIM ABDOOL KARIM: The way we will see an impact is in areas of prevention.
BARTLETT: Professor Salim Abdool Karim, an award-winning epidemiologist, has spent his career fighting HIV in South Africa. He says people can still receive ARVs at government hospitals. While South Africa is one of the richest countries on the continent, places like Mozambique and Malawi depend almost entirely on PEPFAR.
KARIM: The entire aids pandemic will be under threat, and that we could now see a resurgence of AIDS infections because patients are stopping their medication.
BARTLETT: He also says HIV research will be hit hard. Several large programs he was involved in have already come to an abrupt halt. Back outside the shuttered clinic, Alex is trying to work out how to get his medicine.
ALEX: I am devastated that the infection is going to skyrocket. Yeah, it has actually affected us in a great way.
BARTLETT: We're now living in fear, he says.
For NPR News, I'm Kate Bartlett in Johannesburg.
EYDER PERALTA, BYLINE: In Mexico, President Claudia Sheinbaum did not mourn the loss of USAID money.
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PRESIDENT CLAUDIA SHEINBAUM: (Speaking Spanish).
PERALTA: "If the U.S.," she said, "actually wanted to help develop countries, it should be transparent."
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SHEINBAUM: (Speaking Spanish).
PERALTA: "But USAID has so many parts, that the truth is, it's better that they close it down." On the platform X, the president of El Salvador, Nayib Bukele, rejoiced at the news, saying the majority of USAID funds are, quote, "funneled into opposition groups, NGOs with political agendas." In Colombia, President Gustavo Petro said the U.S. shouldn't be funding public employees in his country.
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PRESIDENT GUSTAVO PETRO: (Speaking Spanish).
PERALTA: "Trump is right," Petro said, "take your money." I asked Jake Johnston at the Center for Economic and Policy Research if this surprised him.
JAKE JOHNSTON: Not one bit. No.
PERALTA: Johnston wrote "Aid State," a book critical of USAID's role in Haiti, and he says, this reaction across Latin America comes because of two main reasons.
JOHNSTON: These "democracy promotion," quote-unquote, things, which are political interventionism in sovereign countries, is a part of what USAID does.
PERALTA: In both Mexico and El Salvador, for example, USAID has funded investigative journalism outfits that uncovered vast corruption or human rights abuses by the sitting governments. Both countries have bitterly complained that USAID is funding the opposition. The second reason is more complicated - USAID rarely awards money directly to governments.
JOHNSTON: The USA funding goes almost entirely to contractors, NGOs or multilateral agencies like the U.N.
PERALTA: It means that USAID programs with serious overheads run in parallel to public institutions like hospitals and schools.
JOHNSTON: And that often, runs in direct contradiction to or undermines those public systems.
PERALTA: In Haiti, for example, as USAID pumped free rice into the country, local production couldn't compete and went bankrupt. It means today, Haitians import rice from U.S. companies, and this, says Johnston...
JOHNSTON: It forces people off of their land into either the city to search for low-wage employment or to leave the country altogether and migrate to the United States or elsewhere.
PERALTA: Johnston says USAID has created toxic dependencies and does need an overhaul. But...
JOHNSTON: But that's not what's happening here. And instead, you're just going to cause a bunch of people to lose their jobs and a bunch of people to lose life-saving support.
PERALTA: In Haiti, for example, the end of USAID could mean the end of HIV medicine or even lifesaving food.
Eyder Peralta, NPR News, Mexico City.
RASCOE: And we also heard from Kate Bartlett in Johannesburg, Diaa Hadid in Mumbai and Joanna Kakissis in Kyiv. Transcript provided by NPR, Copyright NPR.
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