An abrupt freeze of USAID operations ordered by President Donald Trump and overseen by Secretary of State Marco Rubio fractured a global health pipeline that provides HIV and malaria medications to more than 40 countries, leaving shipments stuck in warehouses, staff furloughed, and clinics without lifesaving drugs.
The halting of the Global Health Supply Chain Program was among the administration’s first foreign aid actions. Rubio said that many USAID programs “run counter to what we’re trying to do in our national strategy” and moved to end operations. Portions of the program resumed within days, but “the suspension had lingering effects that left aid deliveries severely disrupted for months,” according to The Washington Post’s investigation.
By the end of June, medical supplies worth more than $190 million were scheduled to reach distribution warehouses. Instead, nearly $76 million never arrived, including the majority of malaria medications. Additional shipments worth $63 million did arrive but were delayed on average by 41 days, long enough for clinics to run out of stock. Many supplies sat idle in warehouses instead of moving to hospitals and clinics.
In the Democratic Republic of Congo, where malaria is a leading cause of child mortality, the disruption proved deadly. Five-year-old Suza Kenyaba fell ill with a high fever from malaria while the medication she needed sat in a warehouse just seven miles from her clinic. She died less than a week after her symptoms began. “The medication that USAID sent was seven miles away due to Trump chaos and suspensions,” said Sen. Amy Klobuchar (D-Minn.). “It would have saved her life. Shame. This is not leadership. This is callous arrogance.”
The Post also documented the case of seven-year-old Gilbert Kayombo, an HIV-positive child in Kolwezi who ran out of antiretroviral medicine when shipments were delayed. Without treatment, he weakened and later contracted severe malaria. His mother repeatedly checked clinics for his prescriptions but found shelves empty. Gilbert died in March, just four miles from a warehouse that held his medication. “One month of missing the medicine is a lot to cause damage to the body of a child,” said Dr. Frederick Naya, his physician.
Public health data from Congo shows the toll. In Suza’s province, malaria deaths nearly tripled in the first half of the year. In Lualaba province, preliminary figures show at least 219 HIV-positive people died between January and June, up from 164 during the same period the previous year. In Haut-Katanga, more than 600 people died from malaria in the first six months of 2025—exceeding all malaria deaths recorded there in 2024.
Oxfam America called on Congress to restore aid, saying, “The Trump administration’s claim that no one has died from cuts to USAID is devastatingly and disastrously untrue. Their attacks on USAID stranded lifesaving medication and children died waiting.”
But Rubio has denied any link between aid cuts and deaths. On ABC News, he said, “No one has died because the United States has cut aid.” He has argued that programs are being restructured for efficiency, insisting in February that “we’re not walking away from foreign aid. We are walking away from foreign aid that’s dumb, that’s stupid, that wastes American taxpayer money.”
The suspension, however, triggered cascading operational failures. Chemonics, the contractor that runs the supply chain, lost access to government payment systems, leaving it unable to order suppliers back to work. The company furloughed 750 U.S. workers and laid off local staff. It warned in court filings that the payment freeze “directly inhibits our ability to order suppliers to resume work.”
An internal February 28 memo from Nicholas Enrich, acting assistant administrator for USAID’s Bureau of Global Health, warned that political leadership had created obstacles to restarting programs. “This will no doubt result in preventable death, destabilization, and threats to national security on a massive scale,” Enrich wrote. He later said he was pushed out of the agency for whistleblowing.
Ambassador Lucy Tamlyn, in an April 21 cable, warned that the “abrupt elimination” of PEPFAR programs in Congo “could also lead to the development of new, drug-resistant strains of the virus that pose a direct threat to our homeland.”
Meanwhile, warehouses filled with unused medicine. In Haut-Katanga, about 249,000 vials of Artesunate—the gold-standard treatment for severe malaria—sat idle. Provincial health chief Janvier Kubuya pressed for action in an April 24 letter: “Some supplies run the risk of expiring. It goes without saying that needs are increasingly growing, shortages have been observed.”
The State Department defended the administration’s actions, saying in a statement that “the most critical elements of our global health response continue to operate and contribute to saving lives.” It added, “Under an America First approach to foreign assistance, we are engaging more directly with recipient governments. We anticipate soon sharing updates on our strategies to cultivate a more durable and lasting supply chain and health infrastructure globally.”
But for families like those of Suza and Gilbert, the damage was irreversible. Suza’s mother told The Post she moved away from the clinic because she could not bear to be reminded of her daughter. Gilbert’s mother, Lauraine Kapalanga, recalled watching his strength slip away. Nurse Joseph Lenge Mukungwa said simply, “When Gilbert came, we realized he had grown weak over some time as a result of not taking [pediatric HIV medicine]. The deep breathing, the fast death, that was the malaria, but the big problem was HIV.”
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