While the Trump administration is gutting U.S. foreign aid across the board, programs aimed at women and girls’ sexual and reproductive health will be among those hardest hit. Crisis Group expert Cristal Downing describes why those living in conflict settings could pay the heaviest price. 

What is happening?

Since taking office, President Donald Trump has implemented an unprecedented cutoff of U.S. foreign aid. On 20 January 2025, he froze international assistance for 90 days, claiming that this was so the federal government could review and ascertain whether U.S.-supported programs reflect U.S. interests and values. On 24 January, the State Department issued a “stop work” order, pausing all existing and new foreign aid. Secretary of State Marco Rubio initially provided for some exceptions to that order, including food assistance and military support for Egypt and Israel. On 29 January, he issued an additional waiver so that “life-saving humanitarian assistance” including medicine and other supplies would continue to flow, although it is unclear whether this has happened in practice. In early February, in an alleged effort to reduce federal spending, the administration subsumed the U.S. Agency for International Development into the State Department. Toward the end of the month, a flurry of contract cancellations and litigation added further to enormous global uncertainty about the future of U.S. foreign assistance – and led to disruptions in services ranging from famine relief to HIV treatment