Recent cuts to US government foreign assistance have destabilized global health programs, impacting some of the most cost-effective interventions we’ve found for saving and improving lives, such as malaria nets, malaria chemoprevention, and community-based management of acute malnutrition. This situation is a major focus of our research team at the moment, and we’re working to balance a targeted, near-term response to urgent needs with a broad, long-term perspective of needs that may emerge.
The US has historically provided roughly 20% to 25% ($12 billion to $15 billion) of the total global aid to support health programs, which combat malaria, tuberculosis, HIV, maternal and child health issues, and much more.[1] While the long-term effects remain uncertain and exact numbers remain difficult to ascertain, cuts of 35% to 90% of US foreign aid dollars are being publicly discussed by the administration.[2]
We’ve created a webpage to provide an overview of how we’re responding, and we’ve started to record a series of conversations with our research team that shares timely snapshots of this rapidly evolving situation. Our first episode shared a broad overview of the impacts of US government aid cuts and GiveWell’s initial response.
In our newly released second episode, GiveWell Program Officer Natalie Crispin joins CEO and co-founder Elie Hassenfeld to zoom in on a specific case, focusing on grants we’ve made to support urgent funding gaps for seasonal malaria chemoprevention (SMC). They discuss how SMC campaigns work, the impact of USAID funding pauses on SMC campaigns, and GiveWell’s response to keep SMC campaigns on track.
Listen to Episode 2: Addressing Urgent Needs in Seasonal Malaria Chemoprevention
This situation is changing daily, and we’re constantly learning more. You can listen or subscribe to our podcast for the latest updates and read a summary of key takeaways from each podcast conversation on our blog.
GiveWell has so far directed approximately $15 million toward urgent needs caused by cuts to US foreign aid, focusing on highly cost-effective interventions at risk of near-term disruption. Our research team is continuing to investigate more than $100 million of potential grants to support similar needs across a wide range of impacted programs. This is in addition to our normal grantmaking to support cost-effective interventions—many of which have also been impacted.
Our work to help donors do the most good they can with each dollar is as important and difficult as ever, and we believe the highest-leverage opportunities for impact may emerge as the full effects of these changes become clearer. We are actively fundraising for what we expect to be larger gaps to help people in need, and we expect to find far more excellent giving opportunities than we’ll be able to fund in the coming years.
If you want to help respond to this situation, donating to our funds based on your giving preference remains our recommendation. The funds enable us to respond in different ways, but both use 100% of your gift, after transaction fees, to support the best giving opportunities we find.
- Giving to our All Grants Fund provides us with more flexibility to respond strategically to the greatest emerging needs we identify. While we have less certainty about some of the individual programs supported by this fund, we think they collectively have the highest impact per dollar spent.
- Giving to our Top Charities Fund ensures your money is deployed quickly and exclusively to the four highly cost-effective programs that we have the most confidence in.
Visit our USAID Funding Cuts webpage to learn more about our response and how you can help.
- ^
According to KFF (chart 5), enacted US government global health funding was $12.2B for fiscal year 2022, $12.9B for 2023, and $12.4B for 2024. “Note: Represents total known funding provided through the State Department, USAID, CDC, NIH, and DoD. FY13 includes the effects of sequestration. Does not include emergency supplemental funding. Some global health funding that is not specified in the appropriations bills and is determined at the agency level is not yet known for FY23-FY24” KFF 2025, note for chart 5.
The Institute for Health Metrics and Evaluation estimates total US government health aid at $14.6 billion in 2023. See IHME, VizHub - Financing Global Health, DAH flows, 2023.
According to the Institute for Health Metrics and Evaluation, total global health aid spending for 2023 was $64.6 billion. See IHME, VizHub - Financing Global Health, Health Focus Areas of DAH, 2023.
- ^
On March 10, Secretary of State Marco Rubio tweeted that “83%” of USAID programs were being cancelled, with 5,200 cancelled and 1,000 retained. The Center for Global Development estimates that this represents a cut of approximately 34% of USAID programming by dollar value (Kenny and Sandefur, March 14, 2025).
“In his statement to the lower court, Pete Marocco, who is performing the duties of the deputy administrator of USAID, said each of USAID’s grants had been reviewed and Secretary of State Marco Rubio decided to eliminate about 92% worth of the agency’s grants. The State department also cut around 4,100 grants. The government claimed a total savings of nearly $60 billion dollars.” Tanis and Langfitt, February 26, 2025. $60B in cuts / $68B total obligations = total cuts of around 88%; if the total obligations are actually $79B and the government's other estimates are accurate, then total cuts would be around 76%.
The best rebuttal to this is that EA regularly tackles "longtermism" causes regularly, on the basis that they can use small bits of influence and money to help address major causes with disproportionate impact. AI is the biggest one the community is interested in.
And this is purely irrational.
The entire fabric of society is set to unravel by, say, next week. There's a near zero percent chance of anything good happening on any of EAs fronts, including AI. If the government either collapses or becomes unaligned there's absolutely no reason to think regulations or guidelines on AI will be followed or effective. There are few heuristics we can agree on with AI, but it should be absolutely obvious that an unaligned government creates an unaligned AI, and that government resources are orders of magnitude higher than anyone else.
Hence every cent of money or effort spent by EA on any non political long term cause is meaningless. Even if the money spent couldn't have mattered if it was political it's still an example of invalid and irrational spending; worrying about earthquakes while your house is on fire type logic. Nothing was more threatening than the collapse of democracy, including AI, not because AI is theoretically less destructive but because the risk was orders of magnitude more immediate.
Yes, the risk was known. No, pleading ignorance doesn't absolve anyone.
This could and was predicted a decade ago. Decades if you view EA as an offshoot of the rationalist community and lump their efforts; as early as the "politics is the mind killer" post on less wrong people have been criticizing the de facto political neutrality of the movement, and they were right. I won't say it's the original sin, that's absolutely the obsession with the highly degenerative silicon valley tech sphere at the expense of humanities and social sciences (that could have addressed this too) in recruiting, outreach, and messaging, but it's up there.
Basically, EA choose political neutrality and what it got was eaten by politics. Now it's irrelevant. Nothing that's been done or will be done matters.
You've lost.
EA is a zombie.
It's dead.