What The Hell America!

The Trump administration’s foreign aid cuts have decimated global reproductive health programs, leaving millions without contraception and putting tens of thousands of lives at risk.

For nearly 60 years, the United States has been a leading force in global health, investing in international family planning and maternal, newborn and child health efforts. Yet, within the first two months in office, the new Trump administration has eviscerated nearly all foreign assistance, including critical global health programs.  

The move marked an aggressive attack on women’s health by dismantling U.S. investments in family planning assistance and putting essential reproductive care at risk—even though foreign assistance for global health represents just 0.1 percent of the U.S. federal budget … a negligible saving for the United States, yet a devastating loss for the world.

The freeze on U.S. foreign assistance funding and the subsequent stop work order has already taken an irreversible toll on global health programs, including family planning services, causing chaos across public health systems and forcing many sexual and reproductive health providers and programs to close doors permanently. Despite ongoing litigation to challenge these actions in court—including an important court victory that found this attack likely unconstitutional—most USAID partners are still waiting for government payments for work already completed. Adding to the upheaval, the administration gutted USAID staff and cancelled 83 percent of its aid contracts. 

Among the cuts was the termination of U.S. funding agreements for the United Nations Population Fund (UNFPA), the lead U.N. agency on sexual and reproductive health, and the largest provider of contraceptives in low-income countries. These actions erode women’s autonomy and will lead to a dramatic increase in pregnancy-related injuries and deaths. 

Trump’s rollback of foreign aid has underscored the fragility of global family planning funding. In FY 2024, the U.S. allocated $607.5 million for these programs, including $32.5 million in appropriated funding for UNFPA.

If these critical funds are not renewed and spent as appropriated, over the course of one year, 47.6 million women and couples will be denied modern contraceptives, resulting in 17.1 million unintended pregnancies and 34,000 preventable pregnancy-related deaths.

Every day without this aid, 130,390 women lose access to contraceptive services.  

Investing in family planning is a human rights issue that upholds bodily autonomy. It is also an economic and security imperative. Evidence shows that every $1 spent on contraceptive services in low- and middle-income countries saves $3 in pregnancy-related and newborn care costs.

Furthermore, for every dollar invested in family planning, there is a projected return of $60–$100 in economic growth. Family planning increases women’s and girls’ education and labor force participation, which positively impacts economic growth and stability, and builds stronger families, communities and countries.

Contrary to the Trump administration’s claims, cutting foreign aid for reproductive health is not a fiscal gain, but a significant step backward.  

The necessity of U.S. support for global family planning is particularly stark in humanitarian crises, where reproductive health needs are often overlooked. UNFPA plays a vital role in these settings, providing contraceptives alongside emergency medical supplies. In war zones, disaster-stricken areas and refugee camps, access to contraception is as essential as food and shelter. Women do not stop getting pregnant in emergency settings—if anything, they are more vulnerable to unintended and high-risk pregnancies due to the loss of regular health services and increased gender-based violence, including rape as a weapon of war. 

More than 60 percent of all maternal deaths occur in these unstable environments. In Syria, for example, women die while being transferred between hospitals due to the absence of critical supplies. In Haiti, where sexual violence is rampant, the collapse of the health system has left survivors without access to post-rape treatment, emergency contraception and STI prevention.

These crises make it clear that family planning is not only essential to saving lives but to restoring women’s control over their futures, reducing maternal deaths and preventing unsafe abortions. 

Even before the Trump freeze on foreign aid, international family planning programs have faced ideologically-driven opposition from anti-abortion and anti-rights advocates in the U.S. and globally. The Trump administration has already reinstated the global gag rule, and if it is implemented as outlined in Project 2025, it will apply to whatever remains of U.S. foreign assistance, including humanitarian aid. This policy restricts organizations receiving U.S. foreign assistance from providing, referring to or advocating for abortion services with their other non-U.S. funds, even in countries where abortion is legal.  

By stripping organizations of their financial independence, restricting health care services and censoring advocacy, this policy undermines their ability to operate effectively and severely limits access to sexual and reproductive health services. And if the policy is imposed in war-torn or disaster-ridden settings with fragile healthcare systems, these impacts will be even more devastating and inhumane. 

The Trump administration’s override of congressional spending decisions isn’t a financial or ideological victory. It represents a tragic loss of health care and life-saving protections for individuals globally. It is imperative that the administration follow court orders to restore all essential functions of USAID and to pay its bills. USAID employees must be able to return to work and terminations for family planning grants must be rescinded. And then we call on Congress to act boldly to prevent further damage and protect international family planning, with the understanding that it is a strategic investment that saves lives, strengthens families, communities and countries and promotes global stability.