oIn the first act of the first 100 days of President Trump’s administration, NE is an executive order that led to massive U.S. cuts in foreign aid. Through the United States Agency for International Development (USAID), now on the verge of dissolution, the United States has funded 40% of the world's foreign aid, including programs designed to combat disease, malnutrition, maternal deaths, totalitarianism and climate change. According to KFF's analysis, 80% of all global health awards in the United States have been terminated, including jewelry in the U.S. foreign aid royal family, the president's AIDS Relief Emergency Plan (PEPFAR). Medecins Sans Frontrees (MSF), also known as Doctors Without Borders, provides emergency medical assistance almost anywhere in the world during crisis times and does not rely on any funding from the U.S. government. But its field workers have front-row seats in the consequences of global loss of aid. Avril Benoît, CEO of MSF, talked about the ripple effect the organization has seen, and the cuts to the biggest.

For clarity, this interview has been condensed and edited.

MSF is an emergency response organization with no government funding. Was it immediately affected by a callback from U.S. foreign aid after being elected Donald Trump?

We are not directly affected by financially, but we are affected indirectly. We provide independent and impartial medical humanitarian assistance in areas of humanitarian crisis. Around us, we see the collapse of various services subsidized by the U.S. government.

The groups we work with have been scrambling to do lifesaving services without the money, the staff or any certainty that will happen next. We have seen the meaning of life threatening. HIV, AIDS and tuberculosis treatment, sexual and reproductive health care, disease outbreak response, and malnutrition programs are the most compelling. People have appeared in clinics in South Africa, for example, clinics they have been cared for over the years and only see the “closed” sign hanging on the door. Now, treatment foods available in many places are available to sit in warehouses because children suffering from severe acute malnutrition have been fired because the work of the implementation partner is to distribute them. We are seeing more and more patients entering hospitals that are already super-capacity.

Can you give me a specific example of what changes MSF workers noticed?

Our nutrition program in Baidua in Somalia reports that malnutrition admissions have increased since funding cuts. We admit that suddenly, in March alone, there were 195 children with severe acute malnutrition. Severe acute malnutrition means that if the child is not treated, they may die within weeks. Baidua's MSF-supported Bay Area Hospital has hosted patients, especially women, from 120 miles away. When the wider network of healthcare services is closed, it means people have to go further to where our program is, and that distance, as you can imagine, for someone who is sick or sick, you might mean life or death. This is one of the reasons why community health programs are so important.

One of the predictions is the spread of infectious diseases. Did that happen?

In the border areas between South Sudan and Ethiopia, cholera has exploded due to escalation of violence. Our team said that many organizations, including Save Children, have suspended mobile clinic activities in Arcobo County due to USDA cuts. Save the Children reported earlier this month that at least five children and three cholera adults died while trekking in the Heat for treatment. Therefore, local health authorities are now facing significant restrictions on their ability to respond effectively, while cholera is also increasing in many other parts of South Sudan. Worryingly, people are moving in conflict. They bring disease to new locations and provide new camps for displaced people, where resources are scarce. From October 2024 to now, we have treated more than 7,800 cholera patients and supported local health systems, local clinics and health positions. Often, you will put other organizations in trouble, provide help, support oral vaccine contact activities or oral funnel locations, which increases the risk of cholera transmission when suddenly and suddenly brings these places out of commissions.

MSF is essentially an emergency organization. You go to an emergency. Are you seeing the existence of the United States during these crises or something the United States can respond to?

In the first few weeks after the aid freeze, we saw several organizations stop displaced people in conflict-affected areas (including Darfur in Sudan, Tigri in Ethiopia) and the Haitian capital, where you have levels comparable to any war zone of violence. We have a lot of presence in Port-au-prince: trauma, hospital, emergency, etc. We had to pick some cutting programming in terms of running the water supply system through tanker trucks to provide 13,000 people to all these displaced people living in camps in the capital. People are trying to escape violent clashes between armed groups and police, and end up in these camps where absolutely no resources and no water for them. So, in addition to focusing on medical services for victims of violence, we have to add water. But even our organization has absolutely no way to cover these gaps, which is too huge. There is no organization that can do this alone.

Anything that happened in the last 100 days totally surprised you?

Before the election, every aid organization working internationally learned that there could be policy shifts and reductions in humanitarian aid funds provided by the U.S. government. What we didn't expect was that this destructive ball completely destroyed the infrastructure, the ability to follow up, and the availability of the world's most vulnerable resources in one go. We think maybe there will be 90 days of comments and then things will return online. But nothing we see is. And, for the contribution of the U.S. government to humanitarian aid, we cannot accept the new normal. That's dangerous to the world.

Have you seen any new emergencies appear or is it mainly an intensification of existing crises?

The earthquake in Myanmar will be the latest natural disaster. Of course, as reported, in all the chaos, the U.S. International Development emergency responders received orders to pack their luggage and go home. Myanmar is not an easy place to work, so those organizations that already have good, reliable activities and some kind of relationship with the local population will be the ones to focus on. On the contrary, the United States did not respond

Now, the United States no longer has that kind of infrastructure and can even reset it quickly in an emergency. If you have fired everyone who usually does a quick assessment, even if you want to activate an emergency humanitarian response, monitor and evaluate and push the button to traffic, even if you want to activate the capability, that capability has been eliminated.

I've interviewed everyone about the situation of foreign aid in the United States and said that USDA is an imperfect system that needs reform. Do you agree?

The MSF is primarily funded by generous support from individual Americans. One-third of our global operating budget comes from people in the United States, which is a huge commitment from the American people to this issue. Honestly, we always have very healthy, productive conversations with people at the U.S. International Development Agency for Humanitarian Affairs, where we are able to remind them that because they are the number one responders in crisis areas, we can pay attention to what we see locally. At different times, we expressed frustration at the slow and unresponsiveness of the aid system to emergencies. So, it is certain that there are some things that need improvement and we welcome discussion because getting along with it is absolutely urgent.

USAID is known as inefficiency and wasteful. What will MSF do to improve efficiency? What is the efficiency of the aid department?

Frankly, relying heavily on our efficiency and effectiveness, having that independent, unrestricted funding that allows us to go where demand is the greatest, our assessment determines that we can have added value and that these programs can be designed with the community, rather than geopolitical or economic drivers. I think our DNA is just baked, too, and it's a sense of urgency - we don't have time to do bureaucracy. Of course, we are enviing some jealousy right now because of our independent funding, but we are very worried because we can’t do it alone. We cannot bear the burden of organizations that lose up to 80% of their funds. We are looking at how to organize ourselves because we know the dollar needs to be extended further now. We will have to try our best to fill the gap.

Do you personally express your condolences?

These cuts are heartbreaking in the already high maternal and infant mortality rates. The MSF team is in Rohingya, Bangladesh in Bazar, Bangladesh, home to the world's largest refugee camp, and other health providers are unable to provide supplies such as emergency birth kits and birth control pills. Post-exposure prevention after medical emergencies such as post-abortion care has also been disrupted, thus increasing urgent need and therefore many will die.

Why don’t local governments step up their efforts under certain circumstances? Why must it come from the US government?

Now, any capacity that local governments have is now much less. Vaccination is one of the biggest public health measures you can take. Globally, more than half of the vaccines we use in our program come from the local health ministry and are sourced through the Vaccine Alliance Gavi. We work with the Ministry of Health because they may not have the capacity to implement, or they do not have the budget to pay nurses and healthcare providers for vaccination campaigns, so we pay for it. The decision by the U.S. government (Gavi’s third largest donor) to cut funds to Gavi could have catastrophic consequences for children around the world. There are some predictions that if you refuse the approximately 75 million children’s vaccines that benefit from the program, you could cause 1.2 million children to die. We can see the impact that the Democratic Republic of the Congo (DRC) has already had, where we have given the most vaccination of children with measles and cholera as well as early immunization programs. Can the Government of the Democratic Republic of the Congo do this? Does the Government of the Democratic Republic of the Congo have skilled staff? Yes. Do they have their own resources and political will to truly rise to some areas of countries that are more likely to conflict, such as Kivus? This remains to be seen.