- Humanitarian leaders warn of ‘a highly negative impact’ in Pakistan as suspension of US-funded programs threatens some 1.7 million people, including 1.2 million Afghan refugees

- Some analysts argue USAID cut could force developing nations like Pakistan to rethink their dependence on foreign assistance

KARACHI, Pakistan

On a cold morning in late January, Moosa Tunio was immersed in his routine work at his office in Pakistan’s southern Shikarpur district when a sudden notification flashed across his computer screen.

It was not an office memo or a routine email but a suspension letter – an abrupt halt to his employment with an organization that had been implementing a US-funded tuberculosis control program in Sindh, Pakistan’s southern province.

Tunio, who served as a district coordination officer, is among more than 100 employees suspended “until further notice” following US President Donald Trump’s unexpected decision to pause all foreign aid and gut organizations such as the United States Agency for International Development (USAID).

Launched in November 2023, the tuberculosis control program aimed to support Pakistan’s efforts to combat the disease in 15 underdeveloped districts of Sindh by 2029.

Tuberculosis remains a significant public health challenge in Pakistan, which ranks sixth among countries with the highest burden. According to the country’s Health Ministry, more than 600,000 people contract tuberculosis annually.

“The suspension of the program has put thousands of poor patients at risk, while also leaving hundreds of employees jobless,” Tunio lamented.

Speaking to Anadolu, he emphasized that the program had been benefiting around 1,500 families every month, directly or indirectly affected by the disease.

“Under this initiative, tuberculosis patients from remote areas were brought to city hospitals for checkups, lab tests, and screenings,” he explained. “Not just the patients, but their family members and close contacts were also tested to prevent the disease from spreading.”

For Tunio, the issue transcends mere employment concerns. “It’s not just about my job; it’s about thousands of patients who will suffer due to this project’s suspension. It must be restored immediately,” he said.

Widespread impact on health care

The American aid freeze has also halted a US-funded HIV/AIDS control program in Sindh, leaving health authorities scrambling for alternatives, according to Sindh Health Minister Dr. Azra Afzal Pechuhu.

Thousands of patients across the province were receiving life-saving medications through the now-stalled program.

Pakistan, a South Asian nation of over 240 million people, has more than 210,000 individuals living with HIV, according to the HIV/AIDS Data Hub for Asia Pacific.

Mohammad Dittal Kalhoro, head of the Sindh Rural Support Organization, one of the US-funded program’s implementation partners, warned of the broader implications.

“Suspension of such crucial programs puts the lives of millions at risk,” he told Anadolu.

His organization was forced to shut down all three of its US-sponsored health initiatives in Sindh – two of which were in full swing, while the third had barely begun.

“This decision will undoubtedly have a highly negative impact, particularly in a country like Pakistan, where numerous programs across various sectors relied on USAID funding,” Kalhoro said.

The suspension, he added, affects not only healthcare but also humanitarian assistance, refugee support, nutrition, education, energy, trade, economic growth, infrastructure, and climate change efforts.

“We are just one of dozens of organizations that have already started firing or suspending employees since end-January,” he said.

1.7 million pushed further into crisis

According to the UN, around 1.7 million people in Pakistan, including 1.2 million Afghan refugees, will be directly affected by Trump’s decision and the consequent closure of over 60 US-funded health facilities.

In neighboring Afghanistan, the situation is even more alarming, as some 9 million people are expected to lose access to health and protection services due to the US funding crisis, Pio Smith, regional director for Asia and the Pacific at the UN Population Fund (UNFPA), warned in a statement.

The UNFPA has suspended services previously funded by US grants – services that provided a lifeline for women and girls in crisis-affected regions. According to Smith, the UNFPA requires over $308 million in 2025 to sustain essential programs in Afghanistan, Bangladesh, and Pakistan.

Mohammad Tahseen, executive director of South Asia Partnership Pakistan, a development organization with a focus on rights and justice, echoed concerns over the widespread disruption.

Several well-known organizations have already shut down operations due to the pause in US aid, leaving a significant number of people unemployed, he told Anadolu.

“This suspension has already created a crisis where millions of vulnerable people around the world are suffering. Urgently needed humanitarian relief is on hold, hospitals face supply shortages, schools are shutting down, and more communities are being deprived of resources,” he said.

The US Embassy in Islamabad, when contacted for comment, declined to respond.

“We have been directed to refer all media queries regarding the President’s Executive Orders and their implementation to the White House,” an embassy spokesperson told Anadolu via email.

Pakistan’s Foreign Ministry, on the other hand, has said that Islamabad hopes for a resumption of the assistance.

“Over the years, USAID has worked on a number of beneficial projects in Pakistan in the areas of energy, education, health and narcotics control. We hope that these programs will restart soon, and the two sides remain in contact on that,” ministry spokesperson Shafqat Ali Khan said at Jan. 30 press conference.

A shift in global aid dependence?

While the suspension of aid is devastating for humanitarian programs, some analysts argue it may force developing nations like Pakistan to rethink their dependence on foreign assistance.

According to Rashid Chaudhry, national coordinator at the Free and Fair Election Network (FAFEN), advocacy groups may not feel the impact as severely as health-focused NGOs.

“Advocacy groups like ours operate on a diverse funding model with limited expenses, so we won’t face the same hardships as those in health, education, development, women’s empowerment, and other sectors,” he told Anadolu.

However, Chaudhry warned that the primary victims would be the marginalized communities who rely heavily on US-backed programs.

“We may have to squeeze our operations, and of course, employees will be fired. But they have the skills that will ultimately land them jobs in some other sector. The real problem will be faced by the millions of marginalized people,” he went on to argue.

Veteran Pakistani economist Shahid Hasan Siddiqui believes the crisis could be an opportunity in disguise.

“I see this move as a blessing in disguise for developing nations like Pakistan,” Siddiqui told Anadolu.

“While it will cause immediate hardships, this crisis may incentivize us in many ways as well, mainly to discipline our economies, reshape priorities, and push the state to take back the responsibilities that have long been outsourced to NGOs and relief organizations.”

Siddiqui argued that US aid, though intended to support sustainable development goals, often functions as a political tool for Washington in the post-Cold War era.

“USAID does not, in fact, add to human resource investments in developing countries. Instead, many governments reduce their own spending or investment in human resources, particularly education, health, and human development,” he explained.

Siddiqui contended that aid money flowing into such countries ends up benefiting the rich and powerful elite who control the corridors of power.

He also argued that while Pakistan has received billions in US aid over the years, it has suffered far greater economic losses due to its involvement in the war on terror.

“Pakistan, which has been a partner in the so-called war against terrorism, has already suffered over $130 billion in economic losses … The aid and grants we receive from the US are only a fraction of that,” he noted.

To mitigate the impact of the aid suspension, Siddiqui recommended that Islamabad increase its GDP allocation for essential services, enhance tax collection without overburdening ordinary citizens, and invest more in health, education, and human development.