SAMS recognizes the U.S. Government’s (USG) right to review its foreign assistance programs to enhance efficiency, effectiveness, and coordination with global partners. We all strive to improve. However, the USG’s recent decision to pause most aid during this review is putting lives at risk and triggering a cascade of detrimental global consequences—including harm to America’s own reputation.

On January 24, SAMS and many other humanitarian organizations received stop-work orders on USG-funded programs designed to save lives, alleviate suffering, and prevent global health crises. Since then, the USG has asked some aid groups to determine on their own whether their work constitutes life-saving assistance—leaving them to proceed at their own financial risk. Most organizations lack the resources to shoulder this burden, and many critical interventions do not fit neatly into a narrow “life-saving” category.

A responsible review of U.S. foreign assistance should not come at the cost of halting critical aid. In fact, continuing aid during the review process would allow for a clearer assessment of program effectiveness. The stakes are too high to pause assistance for even a single day—let alone for the proposed three months. To illustrate: The January 24 stop-work order would have meant unplugging incubators in our maternity ward in a war-torn region. We refused to let that happen, but it forced us to absorb the unexpected cost of keeping that ward running.