A new Carnegie Endowment report finds that the termination of U.S. foreign assistance to independent media has gutted newsrooms, emboldened autocratic government crackdowns, and opened the door for Russian and Chinese influence to fill the vacuum.

The Trump administration's shuttering of USAID — which had injected roughly $200 million annually into Ethiopia's health care system — has left pregnant women paying out of pocket for ultrasounds, prenatal vitamins, and delivery room supplies that were once free, threatening to reverse decades of progress on maternal mortality, The Globe and Mail reports.

As the Trump administration's gutting of U.S. foreign aid sparks debate over America's diminishing global influence, NPR speaks with soft power scholars around the world to explain what the concept means — and what is at stake when aid dollars, once a tool for winning hearts and minds, disappear.

Global development aid fell by a record 23% in 2025 to $174.3 billion — the largest single-year drop ever recorded — with the U.S. alone driving three-quarters of the decline following the dismantling of USAID, according to new OECD data reported by Reuters.

The Washington Post reports that the Trump administration has quietly negotiated 28 bilateral health agreements with mostly African nations as part of its "America First" global health strategy, but its refusal to disclose the full terms publicly has alarmed transparency advocates and partner governments who fear disease-fighting funds are being leveraged to extract unrelated political and economic concessions.

Despite pledging to cut out "beltway bandits" in favor of local organizations, the Trump administration's overhaul of foreign aid funneled hundreds of millions in new dollars to a handful of large U.S.-based contractors in 2025, according to the New York Times.

As the U.S. dismantles its foreign aid infrastructure, China is seizing the opportunity to expand its global influence — pivoting away from large-scale infrastructure loans toward smaller, visible health and development projects designed to win hearts and minds in the very communities that U.S. aid once served, NPR reports.

Despite Congress appropriating nearly $6 billion for global HIV/AIDS work in 2026, NPR reports that the Trump administration's State Department is deliberately withholding funds from the CDC — threatening to shut down PEPFAR programs that serve more than 12 million people living with HIV across Africa and beyond, with one CDC official calling it "a controlled demolition."

The Trump administration is dismantling the decade-old Global Health Supply Chain Program — which delivered more than $5 billion in HIV and malaria supplies to 90 countries — and replacing it with a hastily planned new system, Reuters reports. The rushed transition has already triggered shortages of malaria drugs for children and gaps in HIV prevention.

New data reviewed by The New York Times reveals that the Trump administration's U.S. aid rescissions — passed through Congress on party-line votes and later executed unilaterally — overwhelmingly targeted programs that once enjoyed broad bipartisan support.

The Trump administration has been offering African countries bilateral health deals that critics say are exploitative — conditioning funding on access to sensitive health data, biological samples, and critical minerals. Al Jazeera reports that Zimbabwe walked away from negotiations and Zambia pushed back against "problematic" clauses, while countries like Kenya and Nigeria have signed undisclosed agreements.

With the U.K. set to cut aid to Africa by more than half over the next three years, organizations and countries are warning that on top of U.S. aid cuts, this compounding withdrawal could be unsurvivable, NPR reports.

U.S. aid cuts have pushed the 2026 humanitarian appeal for Bangladesh's Rohingya camps to just 18% funded, leaving over a million refugees facing school closures, deteriorating health care, and growing fears that worsening conditions will drive a new wave of dangerous departures, The Globe and Mail reports.

The New York Times reports that millions of dollars worth of USAID-funded contraceptives destined for sub-Saharan Africa were deemed unusable after being improperly stored in a Belgian warehouse.

In Kenya's Dadaab refugee complex, slashed aid, closed resettlement pathways, and terminated aid worker contracts are driving a rise in suicides among a population living in decades-long displacement, The New Humanitarian reports.

Humanitarian organizations crippled by the dismantling of USAID are scrambling to respond to the widening war in the Middle East, where an estimated 3.2 million Iranians and 1 million Lebanese have been displaced, reports the AP.

A new study finds that Republican presidencies are associated with a 10.5% increase in maternal deaths in countries with above-average reliance on U.S. family planning aid. According to The Guardian, over 90% of all USAID awards for reproductive health programs have been terminated since the start of 2025, deepening concerns that decades of progress are being rapidly undone.

Zimbabwe has become one of the first countries to roll out lenacapavir, a twice-yearly HIV prevention drug with near-total protection shown in clinical trials. But SBS News reports with community HIV response systems heavily dependent on foreign assistance now being cut, UNAIDS warns the funding gap could lead to 1.4 million new annual infections by 2030, casting doubt on whether scientific promise can translate into broad impact.

In the wake of USAID's closure, many are finding it nearly impossible to track which humanitarian programs — like key Sudan governance initiatives — were quietly preserved under the State Department. World Politics Review reports that this growing opacity around U.S. humanitarian spending makes it increasingly difficult to hold the administration accountable or understand the true scope of what has been lost.

The U.S. State Department has established a new Bureau of Disaster and Humanitarian Response — staffed by roughly 200 officials operating across 12 global hubs with approximately $5.4 billion in annual funding — marking the formal conclusion of the Trump administration's overhaul of foreign aid following the dismantling of USAID, according to Reuters.