This rapid mixed-methods assessment examined the immediate impacts of the 2025 US foreign aid freeze on health systems in Kenya, Nepal and Colombia, documenting widespread disruptions to HIV, sexual and reproductive health, referral networks and services for vulnerable populations.
This rapid mixed-methods assessment documents the immediate impacts of the 2025 US foreign aid freeze on health and humanitarian systems, revealing widespread disruptions across HIV, sexual and reproductive health, mental health, referral networks, and services for marginalised populations.
The policy challenge:
In January 2025, the US Government announced a 90-day freeze on foreign aid, which subsequently became the permanent shutdown of the US Agency for International Development (USAID). The sudden withdrawal of funding disrupted health and humanitarian systems worldwide, exposing the fragility of programmes heavily reliant on a single donor. Essential HIV, sexual and reproductive health, humanitarian and mental health services were interrupted, referral networks collapsed, and women, girls and other marginalised populations experienced disproportionate impacts. The findings highlighted the urgent need for more resilient financing models, stronger domestic preparedness, and health systems capable of withstanding external policy shocks.
The strategic approach:
In partnership with the Heilbrunn Department of Population and Family Health at Columbia University, the Center for Research on Environment Health and Population Activities (CREHPA) in Nepal, and HIAS in Colombia, policy/strategy group conducted a rapid mixed-methods assessment to document the early consequences of the funding freeze. The research combined a global online survey with qualitative case studies in Kenya, Nepal and Colombia, capturing perspectives from health practitioners, community health workers, government officials, humanitarian actors and civil society organisations. By documenting both immediate service disruptions and broader systems-level impacts, the study provides some of the earliest empirical evidence on how abrupt donor policy shifts affect health systems, informing recommendations for more diversified financing, stronger domestic preparedness and resilient global health governance.
“The findings illustrate how the sudden cessation of US Government funding generated profound and multilayered disruptions, affecting not only individual health services but also the systems, partnerships and workforces that sustain global health delivery.”
The collaborators:
This study was led by the Heilbrunn Department of Population and Family Health at Columbia University in collaboration with policy/strategy group (Kenya), the Center for Research on Environment Health and Population Activities (CREHPA) (Nepal), and HIAS (Colombia). The research also drew on the perspectives of non-governmental organisations, clinicians, community health workers, government representatives, humanitarian actors and civil society organisations across the three case study countries, providing a comprehensive picture of the immediate impacts of the funding freeze.
The SDGs:
This work aligns particularly with Sustainable Development Goal (SDG) 3 (Good Health and Well-being), SDG 5 (Gender Equality), SDG 10 (Reduced Inequalities), SDG 16 (Peace, Justice and Strong Institutions), and SDG 17 (Partnerships for the Goals). By documenting the effects of abrupt funding disruptions and highlighting the need for diversified financing, stronger domestic health systems and rights-based approaches, the study contributes to building more resilient, equitable and sustainable global health systems.
For more:
Read the full paper: Global health consequences of the 2025 US foreign aid freeze: Rapid assessments in Colombia, Kenya and Nepal, published in BMJ Public Health.
