Tom Ellum, our Director of Consultancy, shares his thoughts on the US foreign aid crisis – and some reasons to be hopeful.
Last week's speculation becomes this week’s reality: USAID, as we know it, is no more. Two weeks into Trump’s presidency, I’d like to share some personal reflections and stories that give me hope.
Unless Congress acts, USAID will be subsumed into another department – much like AusAid and the UK’s Department for International Development (DFID) before it. While those restructures did not mean the end of Australian or UK aid, they did shift focus from purely global development towards foreign policy. In the UK government’s own words, their restructuring was designed to ‘safeguard British interests overseas’.
However, the USAID restructure is different for three reasons.
Most obviously, its size. At $40bn a year, no other government or philanthropist comes close—not just in the dollar amount but also in the multi-country, multi-sectoral, ecosystem-level support and influence USAID can bring.
Secondly, the rhetoric and process surrounding these changes appear impulsive rather than deliberate. Insufficient consideration has been given to the legal implications of these decisions and their impact on the world’s poorest women, men, and children.
Finally, the way it has been carried out has caused avoidable distress for those working for USAID and the people across the world who were fortunate enough to benefit from American generosity. Those who rely on American aid have not had the opportunity for consultation, due process, or advance notice.
Despite this and many other Trump decisions, global poverty and inequity will not go away. Therefore, we at SRI Executive stand with global development leaders who we know are doing everything possible to preserve their organisation's culture, capability, and resilience.
Against this bleak backdrop, I wanted to share two stories of hope I’ve experienced first-hand.
Firstly, eight years ago, I remember sitting in front of my TV watching the rolling news of Trump's first victory. At the time, I led MSI Reproductive Choices' outreach channel, which provided reproductive choice to millions of women across 30 countries and was heavily supported by the US government.
Shortly after the inauguration, Trump reinstated the Mexico City Policy – better known as the ‘Global Gag Rule’ – which prohibits US funding from going to international organisations that support safe abortion, regardless of whether US funding is actually used to provide that service. Materially, this meant that, over the course of Trump’s first presidency, tens of millions of dollars in funding were immediately at risk.
Fast forward to today, and MSI is a more dynamically funded organisation, totally un-reliant US government politics and funding. Trump’s first term was a wake-up call, both to MSI and the global sexual and reproductive health community about the need to diversify funding and build resilience. Today, this allows MSI to stand independently and confidently.
Secondly, in 2020, I was at Sightsavers leading one of DFID’s flagship global health projects: Accelerating the Sustainable Control and Elimination of Neglected Tropical Diseases (ASCEND) – a £200m programme eliminating six neglected tropical diseases (NTDs) in 25 countries.
After two successful years, as DFID and the Foreign Commonwealth Office merged to become the Foreign Commonwealth & Development Office (FCDO), the programme was first paused and then cancelled—with just three months to complete any priority activities, including a responsible exit.
Six months later, Sightsavers and her partners had gone above and beyond to mitigate the impact of FCDO’s cuts: mobilising existing and new donors and using their own, limited unrestricted funding to plug the gaps. That meant that, despite the turmoil created by cancelling ASCEND at short notice, no treatment was missed in any of the West and Central African countries where Sightsavers was a partner.
Crucially, Sightsavers, her partners and governments were able to maintain momentum and preserve their capabilities meaning that they were able to continue the fight: three years after one of the world’s largest NTD projects was cancelled, the global community came together at the Reaching the Last Mile (RLM) Forum in Dubai to pledge US$777 million towards eliminating neglected tropical diseases.
Now, I won’t lie. Neither of these outcomes was assured in the first weeks after Trump’s first election victory and the FCDO merger. There was a long way for us to go and a lot of funding to replace in such a short time. So, there were closures, lay-offs and difficult trade-offs to make. But, over time, the international community rallied, existing philanthropists stepped up, and new ones stepped in.
So, what do we learn from these examples, and how does that inform what we do today?
Firstly, the importance of agility and adaptability. The outreach channel and MSI didn’t survive in the same state as it was before Trump was elected. Rather than direct service delivery, MSI outreach teams are increasingly finding themselves closely supporting government health workers in delivering services rather than doing it themselves.
Secondly, trade-offs. Sightsavers had to prioritise treatments over other activities in the short term. If they had been missed, diseases might have recrudesced, undoing decades' worth of hard work in some countries. By maintaining this momentum, the opportunity to beat NTDs remained alive, which allowed them to rekindle interest and mobilise new funding.
Finally, MSI and Sightsavers could have done anything if they didn’t preserve their organisational culture, capability and resilience – and that of their partners. By being agile and adapting, and making difficult decisions when the going got tough, both organisations were able to stay true to their mission and, when things improved, could continue, scale and accelerate their good work.
Many of the organisations we support at SRI will confront similar challenges over the coming years. We have seen organisations progress and make extraordinary impact despite the impossible odds against them. I’m confident we’ll see that again. History gives me hope that with the right tools and support, organisations in our sector can keep doing their essential work.