American-funded aid efforts to tackle diseases such as malaria, as well as preventing newborn baby deaths and treating severe malnutrition, should resume, according to a memo from the United States government reviewed by Reuters.
President Donald Trump moved to freeze international aid pending the results of a 90-day review hours after taking office last month. Secretary of State Marco Rubio issued a waiver a week later, clarifying that “lifesaving” efforts were exempt during this period, but organisations on the ground remained confused over what was included.
The memo seeks to clarify what can now restart.
“These lifesaving activities must resume or continue in the next 30 days of the 90-day pause on foreign assistance to prevent imminent mortality among USAID beneficiaries,” the memo states.
It lists activities tackling tuberculosis, malaria, acute risks of maternal and child mortality, including severe acute malnutrition, and other life-threatening diseases and health conditions.
It also said efforts to combat disease outbreaks, including mpox, avian flu and Ebola, should restart, and global health supply chain activities.
USAID did not immediately respond to a request for comment.
The memo is dated Feb 4, cleared by email on Feb 6. One aid group said they had received it on Friday.
However, two sources said it was still unclear what could restart, and with what funding, especially given the hollowing out of the United States Agency for International Development (USAID), both in Washington and globally.
The Trump administration plans to keep just 611 staff at USAID out of its worldwide total of more than 10,000, according to a notice sent to the agency on Feb 5 and reviewed by Reuters. (Story continues below)
A woman leaves flowers next to a USAID sign that has been covered over with duct tape, which was documented in a video shared on X by Donald Trump’s billionaire budget-cutter Elon Musk, at the agency’s headquarters in Washington, on Feb 7. (Photo: Reuters)
Martin Edlund, CEO of the Washington-based global non-profit group Malaria No More, said the memo was an important step towards resuming programmes.
“Even short-term interruptions of malaria prevention and treatment lead to outbreaks and deaths,” he said. But he added that “start-work” orders would also need to be issued to all programmes to begin indoor spraying, net distribution, testing and treatment for malaria.
A separate clarifying memo, dated Feb 6, also attempted to give more detail on a waiver issued last week for the United States President’s Emergency Plan for Aids Relief (Pepfar). In red at the top, it outlines that the care, treatment and prevention of mother-to-child HIV transmission “should be resumed as soon as possible”.
Myanmar faces ‘mayhem’
Two workers with aid organisations in Myanmar told Reuters they didn’t know whether US-funded food distribution in the country was covered by a waiver and would continue. One of the workers described the situation as “mayhem”.
Myanmar faces a severe food crisis due to natural disasters and a spiralling civil war. An estimated two million people in the country are on the brink of famine, according to the UN.
In Thailand, the aid freeze forced the International Rescue Committee, which funds health clinics with US support, to quickly shut down the hospital and clinics it ran in seven refugee camps on the Myanmar-Thai border.
The IRC was told by US officials they couldn’t reopen before receiving another notification, which hasn’t arrived, said an aid worker.
Many were discharged from the IRC facilities, leaving people including pregnant women and children unable to access medication or medical equipment, said Francois Nosten, director of the Shoklo Malaria Research Unit, a field station in the border camps run by Mahidol University.
An elderly woman, who had been hospitalised with lung problems and was dependent on oxygen, died four days after being discharged, according to her family. Reuters could not independently confirm her cause of death.
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