These countries could lose the most, if U.S. stops aid

The U.S. Agency for International Development, Washington’s primary humanitarian aid agency, has been a top target of a government reduction program spearheaded by billionaire and Trump ally Elon Musk since President Donald Trump took office on January 20.

Hours after he was sworn in, Trump ordered a 90-day pause to all U.S. foreign assistance pending assessments of efficiencies and consistency with his foreign policy. Four days later, on January 24, the U.S. State Department issued a “stop-work” order for all existing foreign assistance and paused new aid with the exception of waivers for military financing for Israel and Egypt. While the government gave an exemption for emergency food assistance and issued waivers for certain life-saving aid, uncertainty around most other programs has put thousands of jobs and millions of dollars’ worth of aid material in jeopardy.

The effects of shutting foreign aid down permanently could have impacts globally, especially for countries in Africa and the Middle East. The U.S. has contributed the largest foreign assistance among countries, according to the Organisation for Economic Cooperation and Development.

Foreign assistance is provided by different agencies of the U.S. government. The U.S. Agency for International Development (USAID) was the primary foreign assistance agency between 2014 and 2024. The agency disbursed, or spent, $314.3 billion out of the total $635.2 billion in this period. The State Department disbursed $175 billion. Obligations are money that was owed.

The agency also disbursed a substantial amount to provide food, water, shelter, healthcare and other such services for communities affected by natural and human-made disasters such as hurricanes, earthquakes, drought and wars.

Reliance on the U.S. for foreign assistance

As many as 31 countries, the majority in the Asia and Oceania and Sub-Saharan Africa regions, were reliant on the United States for at least one-fourth of their total foreign aid. The Marshall Islands, Micronesia, and Thailand in Asia and Botswana and Eswatini in Sub-Saharan Africa were reliant on the U.S. for over half of their foreign aid.

Different regions, different priorities

The Middle East and North Africa region received nearly half of the aid disbursed for the Peace and Security sector. Israel, Afghanistan and Egypt were the top beneficiaries. The Trump administration exempted military aid to Israel and Egypt when it first decided to pause all foreign assistance.

The Sub-Saharan Africa region, which has received a bulk of the aid disbursed for the Health and Humanitarian Assistance sectors, may not be so lucky. Due to the sudden freeze in aid, anti-malaria programs in Kenya and Ghana have come to a standstill. They had received $434 million and $334 million respectively to combat the vector-borne disease. The vast majority of the world’s 597,000 malaria deaths in 2023 were African children aged under five years old, the WHO had said in December last year.

Although HIV/AIDS programs have been exempted from the freeze, the uncertainty around the future of the programs has caused widespread concerns. The United Nations AIDS agency has said that more than 6 million people could die from the disease in the next four years if funding is pulled from all programs. South Africa, Kenya and Tanzania have received the most aid to combat AIDS.

Ukraine, which has been dependent on the U.S. to rebuild its economy after its war with Russia, is likely to be affected as well. It has received more than $28 billion in assistance for Economic Development sector, nearly 90% of the total aid for the sector received by Europe and Eurasia.

Region by region breakdown

The charts below show the four countries which have received the most foreign aid from the United States, in each region, and the five programs for which the most aid was disbursed.Along with Israel and Egypt, Jordan and Iraq received the most aid in the Middle East and North Africa region. While Israel, Iraq and Egypt received the most military assistance, Jordan benefitted from assistance across all sectors including economic development, health and basic education. Investment bank JP Morgan noted that USAID has provided significant budgetary support in Ukraine and Jordan in particular and making up the lost support for healthcare, agriculture and infrastructure in those countries and elsewhere will be tough.

Ethiopia, Kenya, South Sudan and Nigeria received the most aid from the U.S. in the Sub-Saharan Africa region. The Health and Humanitarian Assistance sectors accounted for the highest aid disbursements for these four countries with the top health programs being assistance for HIV/AIDS patients and tackling Malaria. Kenya accounted for 9% of all deaths recorded due to HIV/AIDS in 2021, according to Our World in Data while Nigeria recorded 305 new cases of malaria per 1,000 people in 2022, which was among the highest in the world.

Protection, Assistance and Solutions, which was also a top program, aims to provide support on basic necessities in case of losses due to natural and human-made disasters. It also intends to identify risks and provide strategies to safeguard persons in possible harm.

Afghanistan has received $53.1 billion from the U.S., the highest for any country between 2014 and 2024. The majority of its aid was disbursed for the Stabilization Operations and Security Sector Reform program. It has also received significant assistance towards the Economic Development sector and Democracy, Human Rights, and Governance sector.

The United States’ assistance to Afghanistan significantly reduced over the years. Between 2014 and 2019, it disbursed $810 million on average every year. However, after it decided to pull out its troops from the country in early 2020, its aid has significantly reduced. Between 2020 and 2024, it disbursed $217 million on average every year.

Pakistan, Bangladesh and the Philippines were the other major beneficiaries in the region.

anistan, Ukraine has received the most foreign assistance from the U.S. However, unlike Afghanistan, Ukraine received the majority of its aid from 2022. Before Russia invaded Ukraine, the country had received just over $4 billion between 2014 and 2021. However, since 2022, this figure increased by over nine times. From 2022, it has received nearly $40 billion from the U.S. for all sectors. Now with aid frozen, non-military programs are severely affected as a lot of them depend on the U.S. for its finances.