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    Trump Budget Eliminates Funding for Crucial Global Vaccination Programs

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    The spending proposal terminates support of health programs that, according to the proposal, “do not make Americans safer.”The Trump administration’s proposed budget for the coming fiscal year eliminates funding for programs that provide lifesaving vaccines around the world, including immunizations for polio.The budget, submitted to Congress last week, proposes to eliminate the Centers for Disease Control and Prevention’s global health unit, effectively shutting down its $230 million immunization program: $180 million for polio eradication and the rest for measles and other vaccine-preventable diseases. The budget plan also withdraws financial support for Gavi, the international vaccine alliance that purchases vaccines for children in developing countries.Overall, the budget request explicitly follows President Trump’s America First policy, slashing funds for global health programs that fight H.I.V. and malaria, and cutting support altogether to fight diseases that affect only poorer countries.“The request eliminates funding for programs that do not make Americans safer, such as family planning and reproductive health, neglected tropical diseases, and nonemergency nutrition,” the proposal said.Many public health experts said that such thinking is flawed because infectious diseases routinely breach borders. The United States is battling multiple measles outbreaks, prompting the C.D.C. last week to warn travelers about the risks of contracting measles. Each of those outbreaks began with a case of measles contracted by an international traveler.“Every single measles case this year is related to actual importations of the virus into the United States,” said Dr. Walter Orenstein, associate director of the Emory Vaccine Center and a former director of the United States’ Immunization Program.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Millions of Women Will Lose Access to Contraception as a Result of Trump Aid Cuts

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      The United States is ending its financial support for family planning programs in developing countries, cutting nearly 50 million women off from access to contraception.This policy change has attracted little attention amid the wholesale dismantling of American foreign aid, but it stands to have enormous implications, including more maternal deaths and an overall increase in poverty. It derails an effort that had brought long-acting contraceptives to women in some of the poorest and most isolated parts of the world in recent years.The United States provided about 40 percent of the funding governments contributed to family planning programs in 31 developing countries, some $600 million, in 2023, the last year for which data is available, according to KFF, a health research organization.That American funding provided contraceptive devices and the medical services to deliver them to more than 47 million women and couples, which is estimated to have averted 17.1 million unintended pregnancies and 5.2 million unsafe abortions, according to an analysis by the Guttmacher Institute, a sexual health research organization. Without this annual contribution, 34,000 women could die from preventable maternal deaths each year, the Guttmacher calculation concluded.“The magnitude of the impact is mind-boggling,” said Marie Ba, who leads the coordination team for the Ouagadougou Partnership, an initiative to accelerate investments and access to family planning in nine West African countries.The funding has been terminated as part of the Trump administration’s disassembling of the United States Agency for International Development. The State Department, into which the skeletal remains of U.S.A.I.D. was absorbed on Friday, did not reply to a request for comment on the decision to stop funding family planning. Secretary of State Marco Rubio has described the terminated aid projects as wasteful and not aligned with American strategic interest.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      U.S. to End Vaccine Funds for Poor Countries

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      A 281-page spreadsheet obtained by The Times lists the Trump administration’s plans for thousands of foreign aid programs.The Trump administration intends to terminate the United States’ financial support for Gavi, the organization that has helped purchase critical vaccines for children in developing countries, saving millions of lives over the past quarter century, and to significantly scale back support for efforts to combat malaria, one of the biggest killers globally.The administration has decided to continue some key grants for medications to treat H.I.V. and tuberculosis, and food aid to countries facing civil wars and natural disasters.Those decisions are included in a 281-page spreadsheet that the United States Agency for International Development sent to Congress Monday night, listing the foreign aid projects it plans to continue and to terminate. The New York Times obtained a copy of the spreadsheet and other documents describing the plans.The documents provide a sweeping overview of the extraordinary scale of the administration’s retreat from a half-century-long effort to present the United States to the developing world as a compassionate ally and to lead the fight against infectious diseases that kill millions of people annually.The cover letter details the skeletal remains of U.S.A.I.D. after the cuts, with most of its funding eliminated, and only 869 of more than 6,000 employees still on active duty.In all, the administration has decided to continue 898 U.S.A.I.D. awards and to end 5,341, the letter says. It says the remaining programs are worth up to $78 billion. But only $8.3 billion of that is unobligated funds — money still available to disburse. Because that amount covers awards that run several years into the future, the figure suggests a massive reduction in the $40 billion that U.S.A.I.D. used to spend annually.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Roy L. Prosterman, 89, Dies; Worked to Secure Land for the Rural Poor

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      Seeing land rights as the key to lifting up the impoverished, he pushed authoritarian governments as well as emerging democratic ones to distribute farmland.Roy L. Prosterman, a lawyer who left a lucrative corporate law practice to champion land reform in the underdeveloped world, died on Feb. 27 at his home in Seattle. He was 89.His death was announced by the Seattle land-rights institute Landesa, of which he was a founder. The organization did not specify a cause.Mr. Prosterman worked with governments in some 60 countries in Asia, Africa and Latin America over nearly six decades, crafting plans to give a degree of ownership to peasant families. Sometimes the governments he worked with obtained land by expropriating large tracts, with compensation to the owners. At other times, the government simply gave away land it owned.Seeing land rights as the key to lifting up the world’s millions of rural poor people, he pushed authoritarian governments in places like Vietnam and El Salvador, as well as emerging democratic ones in countries like India, to distribute farmland to impoverished farmers.Mr. Prosterman, center, conducting interviews in China in an undated photo. Beside him is Tim Hanstad, his longtime colleague and a co-founder of Landesa.via LandesaIn an obituary, Landesa said that millions of people had benefited from the programs created by Mr. Prosterman and his group. Landesa, which was founded in 1981 as the Rural Development Institute at the University of Washington and became an independent organization in 1992, was “an early, and often lonely, voice recognizing the importance that access to land and security of land has in uplifting the lives of the poor in agrarian economies,” the Nobel-winning economist Joseph Stiglitz wrote in the preface to “One Billion Rising: Law, Land and the Alleviation of Global Poverty” (2009), a book edited and partly written by Mr. Prosterman.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Climate Change Made South Sudan Heat Wave More Likely, Study Finds

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      Years of war and food insecurity in the region made the extreme heat especially dangerous.After a blistering February heat wave in South Sudan’s capital city caused dozens of students to collapse from heat stroke, officials closed schools for two weeks. It was the second time in less than a year that the country’s schools closed to protect young people from the deadly effects of extreme heat.Climate change, largely caused by the burning of fossil fuels in rich nations, made at least one week of that heat wave 10 times as likely, and 2 degrees Celsius hotter, according to a new study by World Weather Attribution. Temperatures in some parts of the region soared above 42 degrees Celsius, or 107 degrees Fahrenheit, in the last week of February.The analysis used weather data, observations and climate models to get the results, which have not been peer reviewed but are based on standardized methods.South Sudan, in the tropical band of East Africa, was torn apart by a civil war that led to independence from Sudan in 2011. It’s also one of the countries least responsible for the greenhouse gas emissions that are heating up the globe. “The continent has contributed a tiny fraction of global emissions, but is bearing the brunt of climate change,” said Joyce Kimutai, a researcher at the Center for Environmental Policy at Imperial College London.Heat waves are one of the deadliest extreme weather events and have become more frequent and more severe on a warming planet. But analysis methods connecting heat to mortality vary between and within countries, and death tolls can be underreported and are often unknown for months after an event.Prolonged heat is particularly dangerous for children, older adults and pregnant women. For the last three weeks, extreme heat has settled over a large region of continental Eastern Africa, including parts of Kenya and Uganda. Residents have been told to stay indoors and drink water, a difficult directive for countries where many people work outdoors, electricity is sporadic, access to clean water is difficult and modest housing means there are few cooling systems.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Chief Justice Allows U.S. to Continue Freeze on Foreign Aid Payments

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      Chief Justice John G. Roberts Jr. on Wednesday night handed the Trump administration a victory for now in saying that the U.S. Agency for International Development and the State Department did not need to immediately pay for more than $1.5 billion in already completed aid work.A federal judge had set a midnight deadline for the agencies to release funds for the foreign aid work. The Trump administration, in an emergency appeal to the Supreme Court just hours before the deadline, said the judge had overstepped his authority and interfered with the president’s obligations to “make appropriate judgments about foreign aid.”Chief Justice Roberts, acting on his own, issued an “administrative stay,” an interim measure meant to preserve the status quo while the justices consider the matter in a more deliberate fashion. The chief justice ordered the challengers to file a response to the application on Friday, and the court is likely to act not long after.In another aggressive move on Wednesday to carry out President Trump’s Day 1 directive to gut U.S. spending overseas, lawyers for the Trump administration said that it was ending nearly 10,000 U.S. Agency for International Development and State Department contracts and grants.The administration actions stunned diplomats and aid workers already reeling from mass firings at U.S.A.I.D., which funds food, health, development and democracy programs abroad, and which the Trump administration has systematically dismantled. A former senior U.S.A.I.D. official said the cuts account for about 90 percent of the agency’s work and tens of billions of dollars in spending.The signage for U.S.A.I.D. in Washington, which has been covered up with tape, seen on Tuesday.Jason Andrew for The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      The World Bank Pivoted to Climate. That Now May Be a Problem.

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      The Trump administration’s deep cuts to clean-energy programs are raising concerns about U.S. commitments to the lender.As the Trump administration imposes deep cuts on foreign aid and renewable energy programs, the World Bank, one of the most important financiers of energy projects in developing countries, is facing doubts over whether its biggest shareholder, the United States, will stay on board.While the Trump administration has voiced neither support nor antipathy for the bank, it has issued an executive order promising a review of U.S. involvement in all international organizations. And Project 2025, the right-wing blueprint for overhauling the federal government, has pressed for withdrawal from the World Bank.If the United States were to withdraw, the bank would lose its triple-A credit rating, two credit-rating companies warned in recent weeks. That could significantly reduce its ability to borrow money. Roughly 18 percent of the bank’s funding comes from the United States.In an interview, Ajay Banga, the bank’s president, said his institution was fundamentally different from the aid agencies, such as U.S.A.I.D., that the Trump administration has been cutting. And he used some of the administration’s own talking points to argue the case: Investment in natural gas and nuclear power is good, he said, and the development projects funded by the bank can help prevent migration.He also said that the bank makes money and shouldn’t be seen as charity from U.S. taxpayers.“The World Bank is profitable,” he said, noting that it more than covers its own administrative costs even if most of its projects are designed to yield slim returns. “It’s not as though we take money every year from taxpayers to subsidize us and our salaries.”The concern about the bank’s future is heightened as the second Trump administration doubles down on its repudiation of climate projects and promotes an accelerated expansion of U.S. oil and gas projects.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      The Unnecessary Suffering of Women With Obstetric Fistulas

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      One of the most dangerous things a woman can do in much of the world is become pregnant, and the risks caught up with a Kenyan named Alice Wanjiru a decade ago.Then 20 years old and pregnant for the first time, she suffered a childbirth injury called an obstetric fistula, caused by prolonged labor without access to a C-section to end it. This left her with a hole in the tissue between her rectum and her vagina, and for 10 years she endured the humiliation of continually leaking stool through her genital tract.“I could never get fully clean, for there was always some stool left,” she told me. “The other women would say, ‘She is the woman who stinks.’ I would ask God, ‘Why me? Why can’t I be like other women?’”Wanjiru bathed herself several times a day, fasted from morning until evening so there wouldn’t be much in her digestive tract during the day, and always wore a sanitary pad. Doctors misdiagnosed her, sex was a nightmare and her husband abandoned her after harshly accusing her of having poor hygiene.Shamed by the continuous odor, she withdrew from friends and stayed home from church and other gatherings. She endured her shame in solitude, year after year.Perhaps one million or two million women worldwide are enduring fistulas and leak stool or, more commonly, urine through their vaginas. These are typically impoverished women in poor countries where home births are the norm, who couldn’t get to a doctor in time for a needed C-section.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      World Bank Warns of Record Debt Costs for Developing Countries

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      The World Bank warned in a new report that poor countries will be stuck in economic “purgatory” without debt relief.Soaring inflation saddled developing countries with a record $1.4 trillion in debt servicing costs last year, the World Bank said in a report published on Tuesday, detailing the precarious state faced by the world’s most vulnerable economies since the pandemic.As central banks around the world raised interest rates to slow rising prices, poor countries with already high debt burdens saw the interest payments on the money that they owed to creditors balloon. While principal balances held steady at around $951 billion, interest payments jumped by a third, to $406 billion. That has left more countries facing fiscal crises and struggling to avoid default.“These facts imply a metastasizing solvency crisis that continues to be misdiagnosed as a liquidity problem in many of the poorest countries,” Indermit Gill, the World Bank’s chief economist, wrote in the report. “It is easy to kick the can down the road, to provide these countries just enough financing to help them meet their immediate repayment obligations. But that simply extends their purgatory.”More than a dozen sovereign nations defaulted on their debt in the last three years, and more than 30 of the world’s poorest countries have experienced “debt distress,” according to the United Nations. In 2023, Belarus, Ghana, Lebanon, Sri Lanka and Zambia were all in default, according to Fitch Ratings.Global financial institutions such as the World Bank and the International Monetary Fund have been working with international lenders to help developing countries restructure their debt, but the process has been slow and painstaking. China, the world’s largest creditor, has been particularly reluctant to alter the terms of its loans as it grapples with its own economic challenges.The Biden administration has been critical of China’s lending practices. Treasury Secretary Janet L. Yellen described them as “opaque” in an interview with The New York Times in October in which she called for accelerating debt relief. She also raised the idea of helping nations find new sources of borrowing by creating coordinated aid packages for “high-ambition countries” that want to invest in clean energy projects.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More