A storied US agency, one that began under President Kennedy in 1961 with the aim of providing global stability through a wide array of humanitarian aid and development programs, has now formally closed.
Since January, the Trump administration has systematically dismantled the US Agency for International Development (USAID), canceling thousands of contracts and firing or placing on leave thousands of employees within the U.S. and overseas.
In a public statement issued in early February, the U.S. State Department wrote that USAID "has long strayed from its original mission of responsibly advancing American interests abroad, and it is now abundantly clear that significant portions of USAID funding are not aligned with the core national interests of the United States."
To course correct, Secretary of State Marco Rubio was appointed as Acting Administrator of USAID. And as of July 1, the remainder of the aid agency will be absorbed into the State Department.
NPR interviewed four former high level officials within USAID, including previous heads of the agency during both Democratic and Republican administrations, to reflect on this milestone event: Atul Gawande, Dean Karlan, Andrew Natsios and Susan Reichle.
Reichle says that the reorganization amounts to "an absolute train wreck" and Natsios calls it "an abomination."
In addition, they all expressed concern that the State Department is not equipped to manage what's left of the agency's programming and staff. NPR reached out to the State Department for comment on the July 1 transition and this critique but did not receive a reply.
Andrew Natsios, the USAID administrator from 2001 to 2006 under George W Bush, thinks it will take at least five to seven years to tee up the infrastructure needed to run the complex global aid programs once managed by the agency.
"I think the State Department's the finest diplomatic institution in the world," he says. "However, it's not an aid institution. That's completely different." And with 94% of the some 13,000 USAID staff now laid off, Natsios questions how everything will be managed.
"Who is going to run this system?" he asks. "Santa Claus?"
The potential growth of famine
One of Natsios' areas of expertise is famine. Part of that interest is personal. His great uncle died during the famine in Greece that was brought on by the Nazi occupation and that wiped out at least 300,000 people.
Natsios explains that deaths due to famine have dropped over the last 40 years "and that's because of the evolution of [the] humanitarian response system in the world, which is dominated by [USAID]." Since the late 1980s, the agency has used its Famine Early Warning Systems Network to predict food emergencies and deployed its Disaster Assistance Response Team to manage the crises. Natsios says that at least a quarter of the $35 billion USAID budget has historically been allocated for disaster response, most of which was for food emergencies.
With the effective dissolution of the aid agency, he worries that hunger and famine — already on the rise for six consecutive years — may continue to grow with devastating consequences.
"During any famine, people start moving when they're dying. And where do they go? They go to countries that are rich where there's food," he says. "The way to stop migration, which President Trump ran for election on, is you stop the reason why people are moving." He argues that can be achieved by improving life in those places facing food insecurity, a task that he believes that USAID was designed to accomplish.
More broadly, instability forces people from their homes in search of something better despite the severe risk that migration involves. " I think we don't have the tools anymore to deal with these crises because we just eliminated them all," says Natsios, referring to the USAID shutdown.
"So by letting the international system collapse, we're going to increase the pressure on our borders," he says. "It's not what the President wanted, but that's what's going to happen. It's madness."
The slow death of USAID
Dean Karlan, who served as USAID's Chief Economist from late 2022 until February of this year, says that since President Trump's inauguration, the agency has been dying a slow death. The July 1 date simply confirms what many have known: "USAID stopped being what it was several months ago," he says. Currently, 83% of the agency's programs have been terminated.
During his time at USAID, Karlan and his team were tasked with designing more cost-effective programs. He believes the State Department may be able to save lives in a manner similar to USAID. "We're still waiting to see what they put in place," he says.
However, he says he has reason to be skeptical. "The political appointees leading State have done nothing to figure out what's working and what's not in order to fund the things that are more effective," he says. "Every indication and everybody I've been talking to is telling me that they are not putting those processes in place."
Take child mortality. For decades, there's been a steady year over year decline globally in the number of deaths of children under the age of five due to improvements in public health and reductions in poverty. The UN Interagency Group for Child Mortality Estimation calculates that since 1990, the under-five mortality rate has fallen by more than half. But 2025 may be a turning point.
"This is probably going to be the first year in decades that more children under five globally died than in the prior year," says Karlan, who's not confident that the absorption of what remains of USAID into the State Department will alter that projection. That's because programs focused on food insecurity have been canceled, including all of the $114.5 million of awards to the UN Food and Agriculture Organization and $108 million for the agency's Bureau for Resilience, Environment, and Food Security, along with "food sitting in warehouses literally going bad," he says. "That happened from the moment those stop work orders were put in place. So there's death that has happened that cannot obviously be reversed."
In addition, USAID staffing has been decimated since January. Susan Reichle, who worked as a Senior Foreign Service Officer with USAID in Colombia, Haiti, Nicaragua and Russia, says that fewer than 6% of the agency's original employees — 718 people — will be transferring into the State Department.
These individuals will help run the remaining programs, which represent a small fraction of the thousands that USAID was once responsible for. But many of those programs may well sunset in September, says Reichle, because the State Department does not currently have the authority or capacity needed to extend those contracts.
So in her new role running the Aid Transition Alliance, an initiative to support the USAID community of current and former employees through mental health, communication and career transition services, she has been focused on celebrating the many aid workers who've worked at USAID over the decades. "They have served heroically for this country," Reichle says. She points to their containment of the Ebola epidemic of West Africa that began in 2013. "They prevented migrants from migrating across the Western hemisphere by giving them opportunities for education. And they have saved 25 million lives just with PEPFAR," a program credited with helping to prevent HIV-related deaths that was started by George W. Bush and co-administered by USAID.
Fighting fights
Natsios points to one potential upside of the reorganization — navigating interagency politics.
"State knows how to fight fights with the Treasury Department, the CIA, the Defense Department," he says. "Usually, we're allied with them, but [State] wouldn't take our policies up as their first priority. They might do that now."
Still, Natsios doesn't think this merits the evisceration of USAID.
"Privately, if you talk to the State people, they want to control what [USAID] did," he says. "But they don't want to run it because they don't know how to do it."
Karlan and Reichle have both welcomed critical reviews of foreign assistance in the past to improve the effectiveness of programs and personnel. This merger, says Karlan, "is not inherently a bad thing," but the hasty manner in which it's happening isn't consistent with the spirit of those reviews.
Natsios says it would be as improbable as fusing two disparate corporations like Exxon and Microsoft. "I'm not comparing State and [USAID] to either of those companies, but the cultures are completely different," he says. That mismatch has led him to predict a failure at such a scale that within five years, there will be a call for a new independent aid agency.
A possible rebirth out of heartbreak
Atul Gawande, who led global health at USAID during the Biden administration, finds the demise of the foreign aid agency "heartbreaking."
"It's enabled us to have enormous impact and influence around the world," he says. "It's arguably saved more lives per dollar than any other agency" through disease prevention and eradication, stabilizing conflict, disaster response and international development.
He allows that the State Department will be able to carry on some of USAID's work, but it will be "a fraction of the impact and leadership that we have been able to provide around the world." And he worries that the aid efforts will become more politically oriented or inspired once they're no longer housed within an independent agency. (Though Karlan admits that politics has long been a force that seeps into foreign aid to some extent.)
Reichle calls 1 July a pivotal day. That's because it's also the date that the severance payments for many who have been laid off will stop, marking an official end to their tenure in government. "We are losing people that have developed decades of experience in how to not just manage these really important life saving programs but also how to build trust with with our partners on the ground," she says.
"It will be too late to save USAID, but I do pray that we can save development," she adds. "We're a very resilient community and development is not going away. It's not over."
Gawande agrees. He has spoken with foreign aid professionals who have told him, "Who knows, I might well have an opportunity to return to government. And even after all this, I would return again in a heartbeat — to be able to have this kind of impact in the world."
He argues that the chaos and destruction emerging from the changes to USAID are not necessarily permanent. That's why he says, "I have faith that this work will come back. I don't know if it'll take six months, two years, ten years. But this is work that humanity has been pursuing for decades, if not centuries, so we will come back to it."
Still, Gawande acknowledges that USAID as the world knew it will never return. "You can't rebuild that network built up over 60 years and destroyed in a matter of weeks," he says.
He pauses to reflect on what an appropriate epitaph for the foreign aid agency might be — to be chiseled on its tombstone on July 1.
"It lifted us up," Gawande says at last, "our country and the world."
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