100 Days of Harm: Jeopardizing Global Progress and U.S. Interests

In just 100 days, the Trump administration’s second term has upended global systems, dismantled decades of bipartisan foreign policy, terminated thousands of staff, shuttered massive components of America’s soft power architecture, and terminated over 80% of foreign assistance programming. Through these executive decisions and actions, critical funding streams have been cut, alliances have been weakened, and the lives of millions — particularly women and girls — have been callously and forever harmed. Below are just some of the seismic impacts that have already reshaped U.S. foreign assistance and undermined sexual and reproductive health and rights (SRHR) globally:

The Trump Administration’s Harmful Policies and Executive Actions:

• Foreign Aid Cuts and Freezes: As one of the administration’s first actions, Trump’s January 20th executive order froze funding for all foreign assistance for what they said would be a 90-day review for alignment with “America First” policies. The abrupt decision had immediate and long-term impacts on global health, humanitarian, and development programs. Although life-saving humanitarian aid was meant to be separate from this review, family planning was singled out as not eligible for that waiver. Additionally, the waiver process was so chaotic that few implementers could receive the waiver and the funding to implement life-saving aid. After review, approximately 80% of US-funded foreign aid programs were eliminated, and the State Department has absorbed the remaining programs.
• Politicization of USAID: Without consulting Congress and in a move that has since been deemed “likely unconstitutional” the so-called Department of Government Efficiency (DOGE)—which is not a government department—placed thousands of USAID staff on leave, began a process to absorb USAID into the State Department, and halted the majority of foreign aid. Once a premier development agency grounded in evidence and humanitarian principles, the administration began politicizing USAID, calling it a “criminal organization” and specifically uplifting programs focused on family planning, LGBTQ issues, and child development as being un-American in official remarks.
• Global Gag Rule: Reinstated the 2017 expanded global gag rule, prohibiting foreign non-governmental organizations receiving U.S. funding from providing, counseling, or advocating for abortion services — even with their own funds. This resulted in the closure of clinics and reduced access to contraception and HIV prevention efforts.
• Termination of UNFPA Funding: Canceled all contributions to the United Nations Population Fund (UNFPA), the UN sexual and reproductive health agency. The nearly 50 grants to over 25 countries removed life-saving care from many crisis settings where no other maternal, family planning, or post-rape services are available. This severely disrupts maternal health services in humanitarian settings.
• Rejoining the Geneva Consensus Declaration: Realigned the U.S. with a small group of countries opposing the recognition of abortion rights as human rights, signaling a retreat from decades of progress in advancing women’s rights globally.
• Withdrawal from the World Health Organization (WHO): Initiated U.S. withdrawal from WHO, halting critical funding for global health emergencies, disease surveillance, and pandemic preparedness, and support for their SRHR research, which has implemented new technologies and commodities to improve SRHR outcomes across the life course.
• Defunding UNESCO: Ceased all U.S. funding for UNESCO, weakening global educational, scientific, and cultural initiatives, and retreating from vital programs supporting girls’ education, including adolescent reproductive health and rights education.

The Broader Impact on Global SRHR

The consequences of these actions extend far beyond the immediate harm to women’s and girls’ health and rights.  When women and girls are denied access to reproductive health care, entire communities suffer.

By retreating from congressionally mandated agencies, terminating funding that has bipartisan approval, and reneging on multilateralism and bilateral commitments, the United States has ceded leadership on human rights and democratic values and removed a core tool from our soft power arsenal.

Rising maternal mortality, unintended pregnancies, and loss of access to education and employment fuel cycles of poverty and instability — conditions that breed conflict and humanitarian crises.  Global health security depends on strong international systems. Withdrawing from WHO, slashing aid, and politicizing global health initiatives make it harder to detect disease outbreaks, respond to crises, and build goodwill that underpins global alliances.

The world watches as the United States abandons individuals’ rights and dignity. Refusing evidence-based health programs and human rights commitments erodes our standing as a trusted partner and moral leader.

At PAI, we are steadfast in our commitment to championing the rights of every individual to access the health care they need, advocating for U.S. leadership that upholds dignity and rights, and pushing back against policies that threaten progress.

The first 100 days have been damaging, but we know that when civil society rises, advocates persist, and truth is on our side, we can and will chart a different course.