The U.S. foreign aid system has undergone significant changes since the Trump administration disbanded the United States Agency for International Development (USAID), once the largest humanitarian organization in the world. Established in the early 1960s by President John F. Kennedy and Congress, USAID played a key role in promoting American interests abroad through aid programs that addressed global health, education, and development. Supporters argue that USAID was a vital tool of "soft power," helping the U.S. build international goodwill, prevent the spread of diseases that could affect Americans, and maintain stability in regions that might otherwise threaten U.S. security. The U.S. typically allocated about 1% of its federal budget to foreign assistance. A study in The Lancet credited USAID with preventing 91 million deaths — including 30 million of children under five — in the first two decades of the 21st century. However, critics, including former President Donald Trump, have argued that USAID was inefficient and mismanaged. The reduction in U.S. foreign aid has had severe consequences for vulnerable populations around the world. According to the Associated Press (AP), widespread hunger, shortages of essential medicines, and increases in child marriage, kidnapping, and child trafficking have been linked to the funding cuts. Experts warn that the full impact of these changes may not be fully understood for years, as the effects of malnutrition and untreated diseases take time to become evident. Additionally, the loss of funding has eliminated the jobs of many frontline workers who tracked mortality data, making it difficult to accurately assess the scale of the crisis. Despite the U.S. government’s claim that no one has died as a result of USAID's dissolution, the AP has documented deaths in several countries linked to the aid cuts. In Nepal, reduced funding for maternal health programs has led to higher rates of maternal and infant deaths. In countries like Myanmar, Nigeria, and Somalia, children have died due to cuts in food rations and nutrition programs. The Gates Foundation has warned that 2025 may be the first year in this century where child deaths will rise, due to global cuts in foreign aid. In a statement to the AP, the U.S. State Department said the Trump administration had restructured its foreign aid programs to be more efficient, effective, and focused on partnerships. The department also claimed that the U.S. spends more on health and humanitarian assistance than any other country. “The rest of the world needs to contribute more and share the burden,” the department added. The Trump administration’s new foreign aid strategy is more limited and focused on initiatives that align with U.S. interests. For example, health aid is increasingly directed through bilateral agreements with foreign governments rather than through non-governmental organizations (NGOs). This approach channels funds directly to foreign governments in exchange for concessions, such as access to health data, which could help detect disease outbreaks. The U.S. claims this model is more efficient, but some countries have raised concerns about the privacy of their citizens' medical records.