I remember one of those intense days when my team and I were racing against the clock to organize a health policy workshop in Bangladesh. We were developing evidence briefs on urgent issues -- skyrocketing rates of C-section deliveries, the drivers behind the decline in under-five mortality, persistently high fertility despite widespread contraceptive use, and how women’s empowerment intersects with mental health.
At the same time, we were working tirelessly on a project to strengthen local health systems by empowering local authorities to contribute meaningfully to national-level decision-making. I also recall diving deep into the data and realizing something sobering, while coverage statistics looked impressive on the surface, they dropped drastically when adjusted for the quality of services. That had serious implications for health system planning.
The organization I work for, icddr,b, is known for its credibility to support better data use to improve health outcomes around the world and within Bangladesh. Along with its state-of-the-art works in maternal, newborn, child health, nutrition, and reproductive health, icddr,b also led game-changing efforts to expand tuberculosis detection and treatment in hard-to-reach areas.
Thousands of field workers were mobilized across the country for this mission. Most of these works were made possible because of support from the US Agency for International Development (USAID).
Then, suddenly, came the stop-work order. With one directive, everything came to a halt. Projects dissolved overnight.
Despite decades of progress and tireless efforts, many of the core challenges we tackled, health systems, fertility, mortality, or women’s health -- persist. The funding stopped, but the problems didn’t. In fact, they’ve only become harder to respond to. It was a stark reminder that, too often, politics can overpower purpose, undermining years of progress in just one sweep.
The recent USAID funding cuts have triggered a major employment crisis in Bangladesh’s development sector, with estimates suggesting that over 50,000 development professionals have lost their jobs across NGOs and INGOs previously supported by USAID projects.
The abrupt termination of the majority of the USAID-funded initiatives has left thousands of skilled workers, project managers, researchers, field staff, and administrative personnel suddenly unemployed, many without career pivoting options.
Dedicated professionals were left perplexed to reimagine their futures. This wave of job losses not only threatens the livelihoods of individuals and families but also undermines years of progress in health, education, and social development programs that relied on their expertise.
It feels like I was dreaming in another timeline, where our efforts to improve lives, save lives, and contribute to global well-being were seen and valued. Is public health disappearing just when we need it most?
I remember just about two years ago, we came out of a global pandemic, with the World Health Organization (WHO) officially declaring the end of Covid-19 as a public health emergency of international concern. In a world that is still recovering from the aftershocks of a global pandemic, the idea of cutting international health aid seems not just shortsighted but extremely dangerous.
Immediate dangers
A new study published in The Lancet in June 2025 revealed that over 91 million lives have been saved in the past two decades, including 30 million children. Now, with all these sweeping funding cuts, we risk reversing that progress.
The study, which analyzed data from 133 countries, found that USAID support was associated with a 32% reduction in under-five mortality, a 65% drop in HIV/AIDS-related deaths, a 51% decline in malaria deaths, and a 50% reduction in deaths from neglected tropical diseases.
Marked declines were also recorded in deaths caused by tuberculosis, malnutrition, diarrheal illnesses, lower respiratory infections, and maternal and perinatal complications. These are not abstract percentages. They represent children who lived to see their fifth birthday, mothers who survived childbirth, and communities spared the devastation of preventable diseases like malaria and tuberculosis.
But the most alarming part of the analysis lies in its forecast: If current defunding trends continue, the world could see over 14 million additional deaths by 2030, an average of more than 2.4 million lives lost each year, including 4.5 million children, or more than 700,000 child deaths annually.
USAID’s impact has been most profound in low- and middle-income countries like Bangladesh, where its support has helped build health systems, train frontline workers, and deliver lifesaving interventions. These were not just development programs, they were strategic investments in global stability, economic resilience, and our shared humanity.
That is not the end of bad news. Soon, unfortunately, we may also lose the tools to even measure health progress.
A study published in BMC Medicine in April 2025 raised the alarm about the termination of the USAID-supported Demographic and Health Surveys (DHS) program, which includes household surveys, malaria indicator surveys, and service provision assessments across more than 90 countries.
With USAID halting both funding and technical support, this suspension threatens to leave a critical gap in population-level health monitoring. Ongoing and planned data collection is now at risk, existing datasets may become outdated, and evidence-based policy-making will suffer. Without urgent restoration, or a viable alternative, the global health community faces the alarming prospect of operating in a “data dark” era.
The US government’s decision to enact sweeping foreign aid reductions, culminating in the closure of USAID, is part of a broader policy shift prioritizing domestic spending and internal restructuring. But as policymakers debate the value of global health investments, they must ask: What is truly at risk here? The answer is not dollars, it’s lives.