Trump’s Attacks on USAID Spark Fear That Lifesaving Care Will Become “Transactional”

Secretary of State Marco Rubio’s eyes bore into the camera as he excoriated the agency he now heads. “They’re completely un-responsive,” chided Rubio on Fox News, referencing the U.S. Agency for International Development, which he currently leads as acting administrator. “They don’t consider that they work for the U.S., they just think they’re a global entity and that their master is the globe and not the United States.”

The interview on Monday from the agency’s new leader signals a troubling new direction for USAID. The agency, which provides billions of dollars of humanitarian and development assistance around the world has been under constant bombardment from the new administration. Over the last two weeks, President Donald Trump has issued a broad 90-day freeze on foreign assistance, purged senior leadership, handed control of the agency to Rubio, closed the D.C. office, and announced that as of Friday, thousands of employees worldwide would be placed on leave and recalled stateside.

These moves have left the countless humanitarian and development organizations that rely on USAID funding in limbo. (Rubio, for his part, has refused to say whether he agrees with “Department of Government Efficiency” head Elon Musk that the agency needs to “die.“)

Promoting U.S. interests abroad, including global health and security, has always been an implicit part of delivering foreign assistance. The United States provides a small fraction of its immense wealth to provide lifesaving aid abroad, such as malaria and HIV prevention, as well as development programs. The thinking goes that the U.S. benefits in two ways: from a theoretically safer and more prosperous world, as well as the promotion of U.S. interests globally through this display of soft power.

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Now, amid a broader downsizing of foreign assistance and with Trump and Musk reportedly contemplating killing USAID entirely or moving what remains of it under the State Department, experts worry that any ongoing U.S. overseas aid efforts will become a more overt tool of U.S. influence. Such a shift would leave lifesaving programs at risk if they don’t have an immediate perceived benefit for Trump and his administration’s desires.

“All government assistance, development and humanitarian, it’s there to further a government’s interests,” said Paul Spiegel, director of the Johns Hopkins Center for Humanitarian Health. “Under this particular administration … they’re going to give a much more narrow interpretation of how aid should be used, and this kind of soft power or getting goodwill from countries to help you in the future will be diminished, and they’re going to concentrate much more on something that is perhaps more proximal or immediate in terms of the benefits to the United States.” 

While USAID certainly works in the interest of the U.S. government, Spiegel noted that it is chartered as independent from the State Department — which is explicitly a diplomatic and foreign policy body. Only Congress has the legal authority to dissolve USAID. But Rubio’s dual roles as secretary of state and acting administrator of USAID has fueled speculation that Trump plans to fold USAID into State. Rubio previously denied that he wants to get rid of the agency, but his Monday interview struck a different tone. Other members of the Trump orbit have called for its shutdown, including Musk after DOGE employees attempted to gain access to classified materials in the USAID office.

It’s unclear precisely what Trump will do next, Spiegel argued it’s likely that countries will lose out on foreign assistance if they have a lesser perceived immediate strategic advantage to the United States. 

“I imagine certain countries, African countries in Sub-Saharan Africa, may be less important to this administration because it may not have a direct effect on trade,” he said. Spiegel himself disputes the contention that these countries are not of strategic importance. “I think it still has a direct effect on the United States security,” he said, “but they may interpret it differently.”

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Jeremy Konyndyk, former director of USAID under the Obama administration and executive director of the agency’s COVID-19 response under President Joe Biden, agrees that U.S. foreign assistance will become much more directly “transactional.” 

“That’s certainly what they seem to be signaling,” Konyndyk told The Intercept. “Whatever is left in foreign assistance, if they succeed with this plan to kill USAID, will be basically transactional.”

Konyndyk compared this approach to the one taken by China, which has a much more openly transactional relationship with foreign assistance, relying more heavily on investments and loans rather than on direct aid.

A USAID contractor who did not want their name to be used for fear of retribution said that they and many of their colleagues share concerns about the further politicization of the agency. “I don’t think anyone at USAID is naive enough to that some of this isn’t to benefit the United States to a degree,” they said. “Moving it under the State Department, whose role is only to benefit the United States, I think that will make that much more explicit.” 

The contractor also shared that throughout the agency, there were concerns that the Trump administration would follow China’s model of foreign assistance and “turn the USA into more of a bank account, and it will loan out money in the China model, and pay back as you build your port, and then you will pay back the United States’ money with interest every year.” 

Even longtime critics of USAID like Jake Johnston, the director of international research at the Center for Economic and Policy Research, argue that these changes won’t solve the issues with U.S. foreign assistance. Johnston said the U.S. should have tried to overhaul aid “in a much more orderly and rational fashion. You can review programs as they are happening. … There are a lot of ways this could have been done that would have targeted the areas most in need of reform or change.”

Instead, Johnston argued that moving USAID under the control of the State Department is likely to exacerbate the already troubling politicization of foreign assistance.

A USAID implementing partner, who wanted to remain anonymous since they were not authorized to speak on behalf of their organization, worries that the vital programs helping billions of people around the globe will vanish under a Trump assistance model. 

“I don’t think there will be a USAID under Trump if he gets what he wants,” the partner said. They pointed to sexual health projects and environmental projects in particular. “We would definitely not be allowed to do the same kinds of projects.”