When the Trump administration took over on January 20, Anne Linn was working as a senior community health adviser at the President's Malaria Initiative (PMI) – a government initiative to combat malaria implemented by the United States Agency for International Development (USAID).
She spent two decades building a career that she felt was "incredibly important" and "fulfilling", working closely with local health workers in 30 different sub-Saharan African countries.
Then in the span of a week, her career unravelled.
The first smoke signal came when Trump signed an executive order on day one of his presidency that paused new obligations for US foreign aid, meaning no new partners could be funded. Four days later, things quickly escalated for Linn and her colleagues.
The order came with a 90-day freeze on existing foreign development assistance to review whether or not the allocation of US aid is in line with Trump's foreign policy.
In a heartbeat, all the work that Linn was doing came to a halt. Community healthcare workers she collaborated with in countries like Nigeria, Kenya and Cameroon stopped their activities. Pipelines moving life-saving malaria medication from manufacturers to hard-to-reach populations shut down.
The USAID website went dark, as did the PMI website. And then on January 28, along with another 390 colleagues, Linn lost her job.
"I have never been more stunned by anything in my life," Linn recalled. "I don't know how anyone could possibly justify that. The cruelty and the waste of it all," she said, her voice trembling.
"My entire sector, everyone I've known professionally, just evaporated with the thoughtless stroke of a pen."
'Children will die'
The PMI website now reads: "In order to be consistent with the President's Executive Orders, this website is currently undergoing maintenance as we expeditiously and thoroughly review all of the content." It then redirects to the USAID website.
While Linn and many other USAID workers were locked in a whirlwind of confusion when the cable was first sent out, any sliver of doubt has now vanished. The USAID website now comprises a single page.
"On Friday, February 7, 2025, at 11:59 pm (EST) all USAID direct hire personnel will be placed on administrative leave globally, with the exception of designated personnel responsible for mission-critical functions, core leadership and specially designated programs," it reads.
Employees were barred by the Trump administration from entering the agency's Washington, DC, headquarters on Monday and now the future of USAID lies in the hands of billionaire Elon Musk, who is tasked with overseeing its efficiency. Musk has called the agency a "criminal organisation" and claimed it is "time for it to die".
Part of Linn's job was to report to Congress on the impact PMI was having in the fight against malaria, which sought to ensure the money was being well spent. Access to the latest PMI report is possible through an archived version via the Wayback Machine website. It states that the initiative helped save 11.7 million lives and prevent 2.1 billion malaria cases since 2000.
"Malaria is very seasonal, as mosquitoes flourish during the rainy season. Planning things like distributions of bed nets and preventive medicine for children has a precise timeline that will fall apart, making this work less effective, if it even happens at all," Linn wrote in a Facebook post that was shared over 2,000 times. "Children … will die unnecessarily."
USAID quite literally saved lives. The agency oversaw foreign aid, disaster relief and international development programmes.
And even though foreign aid makes up less than 1% of the total US federal budget, the country is by far the world's largest donor — contributing $4 out of every $10 that goes to humanitarian aid. According to the United Nations, the US provided about 42% of all humanitarian aid the organisation tracked in 2024.
Front-line aid workers and civilians who rely on US-funded programmes are among those bearing the brunt of the pause.
The global systems put in place by USAID to deliver life-saving assistance to those affected by deadly diseases – or to access clean water and sanitation, or support economic livelihood initiatives, or offer agricultural aid – have all been hindered by the pause. And as some countries scramble to fill the funding gap, many do not have the money to do so.
Finding new donors could take years, and those prolonged delays will surely impact non-profit organisations who rely on grants to carry out their work.
The work Linn did to help fight malaria was just one part of the vast efforts being carried out in sub-Saharan Africa, which was the largest regional recipient of US aid.
Now the acting leader of USAID, Secretary of State Marco Rubio, issued an additional waiver to the worldwide stop-work orders on January 29 for "life-saving humanitarian assistance" during the three-month review period.
It stated that the provision of life-saving medicine, medical services, food, shelter and subsistence help would continue to be funded. But neither Linn nor her colleagues on the ground have resumed their activities.
Health and humanitarian groups worldwide are still uncertain if and how they can continue working, and whether their programmes are covered by the exception.
"It's an absolute mess," said Jesse Marks, a senior advocate for the Middle East at Refugees International. "All of these organisations who received stop-work orders need to communicate with USAID about what it all means … But there is no one on the other line to answer."
"If there is a massive surge of waivers coming from Ukraine, the Middle East, Southeast Asia, Africa, who decides which are life-saving and which are not? Who is going to be approving the waivers?" Marks sighed.
"It is as if [the Trump administration] thought all USAID did was support abortions and give out condoms."
A blow to Ukraine
Ukraine is also reeling from the shock decision by the Trump administration to pause USAID programmes. The US was a key partner in a variety of projects on the ground, including regional humanitarian programmes to rehabilitate veterans, anti-corruption efforts, development assistance and media sponsorship.
Many local communities rely on aid or donor support to fund health, education, energy, agriculture or infrastructure initiatives.
But since Russia carried out its full-scale invasion in February 2022, Ukraine’s budget deficit keeps growing and the number of projects the government can support with its own funds is likely to be limited.
That is the case for independent media outlet Bihus Info, based in Kyiv. "Sixty-five per cent of our funding comes from USAID," according to its director, Denys Bihus.
"At the end of January we got several letters from the organisation that manages our projects with USAID saying they will all be stopped. It wasn't a day that was going to upend my life, but it was hard," he admitted. Shortly after the news came in, Bihus put out a call for new subscribers to show their support and the response was "very pleasant".
"Still, all that money will only get us through a few weeks," Bihus admitted.
In a media landscape constantly under threat due to the ongoing war and largely in the grip of oligarchs, where Ukrainian newsrooms in territories occupied by Russia are being silenced, many outlets that were already hanging by a thread are now unsure they will survive.
"The freeze completely eradicated regional media. Small teams all over Ukraine who were monitoring local budgets or things like that … already had a hard life," Bihus explained.
"Now I think many teams will have to find something else to do because people need to eat. Ukraine is losing specialists it will probably never get back."
Though military aid for Ukraine has not been stopped, Bihus insists that the US funding used to cushion the impact of war in areas like the energy sector, which has been repeatedly targeted by Russia, is what is most essential.
"I am grateful that people are talking about the impact this will have on Ukrainian media," Bihus said. "But most of this money is delivered to the state for … very important things."
Because of the war, Bihus never planned more than two months in advance. He now hopes he will be able to pay his team of around 35 employees for the next three months to pull through the review period using savings.
"We will try to survive," he said. "Ask me again how we are doing at the end of March," he joked.
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