Early Saturday morning, hundreds of staff members operating a vast humanitarian effort at the Al-Hol displacement camp in northeast Syria received a stark directive: “Stop work.”
For those involved in the daily efforts to stabilize the camp—home to 40,000 people, primarily women and children displaced from areas once controlled by the Islamic State group—the abrupt order was both distressing and alarming.
According to a senior humanitarian worker familiar with its operations, the massive camp’s water, sanitation, and security systems were thrown into disarray. Another facility in northeast Syria, Al Roj, also faced disruption due to the sudden command. Both locations house suspected IS affiliates.
“All of a sudden, you [risked] real instability and violence rising, as well as, obviously, former ISIS on the street,” said Susan Reichle, a retired USAID Foreign Service officer.
The sweeping halt in operations followed President Trump’s decision to freeze all U.S. foreign assistance on his first day back in office. As the world’s largest aid donor, the U.S. contributes significantly to humanitarian efforts worldwide. Trump’s order called for a review to ensure that U.S. foreign aid aligned with his “America First” policy.
For days, aid officials and global charities awaited clarification on the order’s scope. By Friday night, the full extent of its impact became clear.
A leaked memo disclosed that Secretary of State Marco Rubio had implemented a 90-day suspension of all existing foreign assistance programs, with only a few exceptions: emergency food aid and military funding for Israel and Egypt.
As the aid community absorbed the news, stop-work notices began arriving en masse.
Projects covering everything from water sanitation to vaccination campaigns were suddenly in limbo, with contractors scrambling to interpret the directive’s implications. BRAC, the world’s largest non-profit, informed the BBC that it had been forced to suspend programs affecting 3.5 million people across four countries.
“It felt like an earthquake across the aid sector, with life-saving programs in ruins,” a veteran international aid worker told the BBC.
Supporters of the aid freeze, which affects approximately $70 billion in annual U.S. foreign assistance, argue that these programs are bloated and that Washington shoulders an unfair financial burden compared to other Western nations. They contend that too much money is sent abroad when it could be better spent domestically.
The administration has made it clear that it opposes funding for projects related to diversity and inclusion, transgender rights, family planning, and abortion access—issues long targeted by Republican administrations. The freeze, according to supporters, is intended to eliminate wasteful spending.
“Every dollar we spend, every program we fund, and every policy we pursue must be justified with the answer to three simple questions,” Rubio stated. “Does it make America safer? Does it make America stronger? Does it make America more prosperous?”
However, the reach of the suspension has been vast, prompting widespread shock and criticism from many corners of a global system heavily reliant on U.S. funding. Aid contractors, wary of jeopardizing future funding, have mostly voiced concerns privately, though some have spoken out.
On Monday evening, employees working on the U.S. government’s global HIV prevention program found themselves locked out of their systems, according to Dr. Atul Gawande, former Assistant Administrator for Global Health at USAID.
The President’s Emergency Plan for AIDS Relief (PEPFAR), launched by President George W. Bush in 2003, employs over 250,000 doctors, nurses, and other health professionals across 55 countries.
It is responsible for distributing antiviral medication and implementing critical preventive measures. The program is credited with saving millions of lives and curbing the spread of HIV and AIDS.
“The program is shuttered…. Services are shut,” Dr. Gawande told the BBC on Tuesday, noting that clinics serving 20 million HIV patients had been affected.
USAID Program (Photo: Kent Nishimura)Paul Jordan, an expert at the European Institute of Peace working on the repatriation of foreign nationals from Al-Hol and Al-Roj, said much of his U.S.-funded work had come to an immediate standstill.
“In terms of immediate impact, I’ve never seen anything as significant as this before,” Jordan told a UK parliamentary committee on Tuesday, warning that the camps were likely to remain “in limbo” for months while the review was conducted.
“In the last few days, basically nothing has been delivered within the camps,” he explained. “There was no camp administration, very little security, and food wasn’t delivered.”
By Tuesday evening, as aid organizations pleaded with the U.S. government for exemptions to keep their programs running, signs emerged that the State Department was working to mitigate the most severe consequences of the freeze.
The definition of “life-saving humanitarian assistance” was expanded to include not only emergency food aid but also essential medicines, medical services, shelter, and other basic necessities.
The change reportedly allowed PEPFAR programs to resume, though it remains unclear whether preventive HIV medications—as opposed to treatments—are included under the exemption.
Marco Rubio’s Role in the Policy Shift
Standing before an array of American flags, Secretary of State Marco Rubio defended the administration’s decision, arguing that it was necessary to re-evaluate foreign aid spending and ensure alignment with U.S. interests.
Dr. Gawande, who held a senior USAID position during the Biden administration, warned that numerous critical programs remained in limbo, including efforts to combat an Mpox outbreak in West Africa, monitor bird flu in dozens of countries, and counter fentanyl trafficking.
“It was immediate, and my immediate reaction was: this is catastrophic,” he said of the freeze’s impact.
When questioned about these specific programs, a State Department spokesperson responded, “We are judiciously reviewing all the waivers submitted. The Secretary of State has the ultimate responsibility… to protect America’s investments.”
Blumont, the U.S. contractor overseeing aid operations at Al-Hol and Al-Roj, confirmed that it had received a waiver late Monday from the State Department allowing it to continue “critical activities” at the camps for two more weeks. However, beyond that timeframe, the future remains uncertain.
In response to BBC inquiries about the Syria camps and other projects, the State Department stated that “critical national security waivers have been granted,” but did not specify whether any applied to Syria.
Additionally, the department clarified that the new waiver does not cover activities related to abortion, family planning conferences, administrative costs, diversity and equity programs, transgender surgeries, or other non-essential aid.
Fallout at USAID Headquarters
In Washington, USAID headquarters have been thrown into disarray by the freeze.
Employees were explicitly warned not to attempt to circumvent the directive and were given strict instructions not to discuss the freeze outside the agency. An internal memo cautioned that violations would “result in disciplinary action.”
Unnamed staff members have been accused of attempting to bypass the president’s executive order, leading to dozens of senior officials being placed on administrative leave.
In the halls of the agency, picture frames that once showcased images of field projects now stand empty.
Dr. Joia Mukherjee, an infectious disease expert from Harvard Medical School and an advisor on the creation of PEPFAR, described the freeze’s impact in stark terms.
“It’s taking 20 years of goodwill and turning it into an instrument of terror, where people fear that if they touch the drugs or see a patient, they might get fired,” she said.
As criticism mounted, the State Department doubled down on its position, asserting on Wednesday that the 90-day freeze and review of foreign aid were already “paying dividends” for the U.S.
“We are rooting out waste. We are blocking woke programs. And we are exposing activities that run contrary to our national interests. None of this would be possible if these programs remained on autopilot,” the department stated.
Explaining why a complete halt was necessary rather than a more selective approach, the department added, “It is impossible to evaluate programs on autopilot because the participants—both inside and outside of government—have little to no incentive to share programmatic-level details so long as the dollars continue to flow.”
“A temporary pause, with commonsense waivers for truly life-threatening situations, is the only way to scrutinize and prevent waste,” it concluded.
Uncertainty for Those Affected
Thousands of miles away, in the Ugandan town of Masindi, Teddy Ruge is struggling to cope with the fallout. On Monday night, he was told to “stop work,” and the waivers issued so far do not appear to cover his USAID-funded farming initiative.
Ruge employs small-scale farmers who cultivate Moringa, a nutrient-rich leaf exported to North America and Europe for use in food fortification.
His farmers rely on a modest monthly wage of $70, supplemented by a yearly USAID grant of approximately $250,000. But just a week after Trump’s executive order, that financial lifeline has been severed.
“We were actually preparing to have a meeting with all the farmers about the new planting season,” Ruge told. “But now it’s more like a funeral.”
He remains unsure whether he can continue employing the farmers or if they can even show up for work. “It’s really disheartening. So I have a few sleepless nights ahead of me,” he said.