A Midnight Global Health Massacre
Life-saving programs, including George W. Bush’s cherished global AIDS initiative, were hit in the latest, harshest round of cuts.
Is W. Awake?
by Sam Stein
On Wednesday, reports began dribbling out that Secretary of State Marco Rubio had signed off on eliminating 92 percent of USAID grants, around 4,100 of them, with a savings of $60 billion. On Thursday morning, foreign aid officials woke up to see the details of those cuts. The reaction was justified shock.
Programs that the administration had suggested it believed were worth continuing were now being terminated. That includes efforts to combat the AIDS epidemic—such as George W. Bush’s famed PEPFAR program—that have been a source of bipartisan pride for decades.
One government notice, passed along to The Bulwark, showed that USAID was terminating its contract for the joint U.N. AIDS program, which is the primary mechanism for monitoring the disease globally. An official who works on the program estimated that Rubio had eliminated half of its funding.
That was just a small portion of the carnage.
Two sources familiar with the matter say USAID support for South Africa’s PEPFAR programs were also terminated overnight. The Trump administration had already moved to cut off all aid to the country, citing disagreement with social policies there. But this isn’t about social policies. Bhekisisa, a global health news outlet, reported that PEPFAR-funded organizations “woke up to letters that were sent overnight telling them their grants have been ended—permanently.”
The White House did not respond to a request for comment.
The full extent of the PEPFAR cuts is not entirely clear as of now, though one foreign official told The Bulwark that in addition to any cuts, some USAID employees who work on the program were put on administrative leave.
Even if the USAID spigot was fully cut off, there are other sources of funds into the program, including from the Centers for Disease Control and Prevention and the Department of Defense.
But the sheer magnitude of the damage was breathtaking for those in the field. A coalition of South African groups trying to raise awareness of the PEPFAR funding cuts have hastily organized a zoom call for Thursday. The advisory noted that “though PEPFAR funding support makes up around 17% of South Africa’s HIV budget, the entire programme is at risk, because so many critical projects, such as monitoring and testing, will be weakened.”
And it wasn’t just PEPFAR, of course. A fact sheet sent along by groups trying to undo the cuts noted that one of the contracts terminated was for “a project in the Democratic Republic of Congo that operates the only source of water for 250,000 people in camps for displaced people located in the center of current fighting.”
Adding to the shock was how the cuts transpired. USAID officials were operating under the impression that they remained in the 90-day review period, during which time all foreign aid contracts were to be scrutinized by Trump leadership. The administration is of course not 90 days old. But Rubio and Peter Marocco, the acting deputy administrator of USAID, went ahead anyway.1 It wasn’t lost on those inside the agency that news of the terminations was leaked to the Free Beacon, the conservative outlet that has become a clearinghouse for critical reporting on USAID functions.
As that news broke, much of the pro-USAID contingency was paying attention to a separate but related court matter. Grantees have been pushing the agency to release roughly $2 billion in contracts that Marocco has held up, despite those contracts having been agreed to long ago.
Earlier this week, a federal judge had ordered the Trump administration to resume USAID payments for those contracts no later than last night at midnight. But after the government appealed to the Supreme Court, Chief Justice John Roberts last night paused that deadline via an “administrative stay” giving the court a few days to review the case. Marocco and others had argued (persuasively to Roberts, it appears) that they couldn’t possibly pay all those contracts in such a short time frame.
But at the same time, they were working on terminating tens of billions worth of additional awards. That apparently required no time for thoughtful review.
Agency officials—angered over the cuts, but fearful that they’d be punished for speaking out publicly against them—leaked to The Bulwark a statement encouraging contractors to challenge them in court. It read:
The termination to contracts, grants, and assistance agreements that took place over the last two weeks and the huge bulk last night, were not done according to federal laws, regulations and procedures, and in many cases not done by the cognizant contracting and agreement officer of the awards with authority to do so. These terminations will not uphold under legal scrutiny, the implementing partners who received such termination should explore their outside legal options. The Agency’s internal mechanisms for such protests have been put on administrative leave or fired.