Reproductive health in developing countries in ‘chaos’ after Trump aid freeze

Experts speaking at a screening of The Independent’s documentary on abortion rights warn of the damage done by halting of US halting aid. Bel Trew reports

Donald Trump’s 90-day freeze on foreign aid has caused “absolute chaos” on the ground in developing countries, with vital reproductive health services being forced to halt treatment, charities have warned.

Immediately after his inauguration in January, US President Donald Trump announced an immediate 90-day freeze on all USAID including family planning, which, amounts annually to over $600 million, according to the Guttmacher Institute, a leading reproductive health policy organisation.

That will mean an estimated 11.7 million women and girls losing access to contraception, resulting in 4.2 million unintended pregnancies and, 8,340 maternal deaths, as well as a surge in unsafe abortions, according to Marie Stopes International, a non-governmental organisation providing contraception and safe abortion services in 37 countries around the world.

Speaking during a panel event at the London premiere of The A-Word, The Independent’s documentary about reproductive rights in America, Sarah Shaw, MSI associate director of advocacy, said in some developing countries USAID funding accounts for almost 70 per cent of the health budget.

“For us, [the freeze] means losing $14 million in funding… it’s absolute chaos,” Ms Shaw told the audience at the Frontline Club in London, which included NHS doctors, healthcare providers, researchers in reproductive rights, advocates, and journalists.

“The thing about the stop-work order – definitely for our teams in Zimbabwe – is that they literally have to stop. That’s it. We are done. They haven’t even been able to warn the communities that they’re working with that the mobile teams are not going to come out next time,” she said.

“Because no one is providing services now, entire health systems have just ground to a halt.”

MSI Reproductive Choices works in 36 countries worldwide, supporting over 93,000 people every day to make choices about their reproductive healthcare and futures.

Some countries rely on USAID for 70 percent of their health budget, Sarah Shaw (centre) from MSI says (Al Brown /The Independent)

The A-Word, described by CNN as an “unflinching” and “powerful”, looks at the state of reproductive rights in the US following the 2022 Supreme Court ruling that overturned Roe v. Wade, ending the nationwide right to abortion – and the growing anti-abortion movement’s influence.

A panel discussion afterwards explored the impact of the US anti-abortion movement globally as well as the Trump administration’s cuts to foreign aid, particularly reproductive healthcare.

The reach of USAID cannot be understated: in 2024, some 141 countries relied on some form of USAID, which the year before was worth $42.5 billion (£33.3 billion). Nearly a quarter of the yearly USAID budget went on health, and around $600 million has been spent on family planning. The abrupt halt of such a huge amount of assistance means no one can step in on that scale, and the impact is being felt worldwide, particularly for women and girls.

The A-Word documentary explores reproductive rights in the US post Dobbs (The Independent)

For every week without USAID, nearly one million women and girls worldwide are denied contraceptive care, according to analysis from the Guttmacher Institute.

“In a lot of these countries, USAID would be funding 50, 60, or even 70 per cent of the health budget, and it’s gone. So these governments are scrambling; they’re just having to take money from wherever to keep the most basic services running,” Ms Shaw said.

That usually means taking money out of the family planning budget line “because the entire health budget is gone,” she continued.

She described how right now, $150 million worth of sexual and reproductive health essential medicines are sitting in warehouses in countries with extremely high needs.

A panel discussion on reproductive rights following a screening of ‘The A Word’ at London’s Frontline Club (Al Brown/The Independent)

“There is literally no way of getting that stock from the warehouse into the clinics because the distribution systems have all ground to a halt because the US government didn’t just fund services, it funded the health infrastructure,” she added.

She said in Zambia, MSI’s teams showed up at a public sector hospital where they work to provide family planning services. There was no one there to hand out the supplies or to do the work, as the hospital had just fired 50 nurses because they couldn’t pay them.

Also speaking on the panel was Manna Mostaghim, a researcher on the provision and politics of sexual and reproductive health in the UK. She warned about the increasing influence of the US anti-abortion movement.

Sonia Adesara, an NHS doctor and communications head of Doctors for Life, said that this money had been plunged into “political lobbying [that has increased significantly in recent years].” She added that there had simultaneously been an “unprecedented surge in the UK of women being prosecuted and investigated for their terminations.”

The Independent receives funding from The Gates Foundation to help support its reporting on international aid, maternal health and the climate crisis in low and middle-income countries as part of its Rethinking Global Aid project. All of the journalism is editorially independent.