Almost eight million people have lost access to health care and food support and hundreds of thousands have already died because of the collapse of the global humanitarian aid system, a new report reveals.

The report by the NGO Refugees International points out that between 2024 and 2025, more than 30 percent of global humanitarian funding disappeared – driven largely due to an implosion of US support, which fell from about $US14 billion to $US3.7 billion.

The report – which draws on publicly reported humanitarian impact data, Refugees International’s own field reporting, and reporting from refugee-led organizations and community-based NGOs in multiple crisis-affected countries – says that in 2025, humanitarian funding was about 40 per cent below 2022 levels.

“The consequences have been deadly and devastating and are now beginning to come into focus,” it says.

Following the US freeze on global aid in early 2025, the UN led a ‘hyper-prioritisation’ exercise to reallocate limited funding toward the highest-risk needs across major crises.

This meant the cutting of services and narrowing the number of people targeted for humanitarian assistance to just 88.2 million – a reduction of more than half of the population it planned to target in its initial 2025 Global Humanitarian Overview.

“These reductions also substantially reduced the capacity of aid organisations themselves. Major UN agencies abruptly cut thousands of staff, closed field offices in crisis zones, and shuttered programs,” the report says.

UNHCR cut 5,000 positions and scaled back 185 field offices; The World Health Organisation (WHO) slashed more than 2,300 positions; the World Food Program (WFP) cut 6,000 positions, and thousands of other staff lost their jobs across other agencies.

Major international NGOs, which deliver aid on the ground, also suffered with one analysis putting the number of lost humanitarian worker positions at a quarter of a million.

The net effect has been a historic implosion of global humanitarian response leading to “clear” evidence that aid cuts are driving a rising number of deaths, the report says.

It says the collapse in international humanitarian funding also reflects an apparent erosion of global political support for humanitarian action.

“The Trump administration’s closure of USAID is the most prominent manifestation of this, but the trend is broader. Aid budgets in many countries have declined as rising nationalism is turning governments inward, reducing political support for global solidarity. These trends raise daunting questions: Will humanitarian funding ever rebound? If not, how many will die as a result?” the report says.

The report analyses the aid cuts across six areas.

Health care

The WHO estimates that foreign aid for global health shrunk by 30 per cent from 2023 to 2025. It reports that the funding cuts in 2025 disrupted services at 5,687 health facilities across 20 humanitarian crisis settings.

This includes 2,038 clinics that suspended operations or closed, reducing access to essential health services for an estimated 53.3 million people.

“They have weakened emergency response and health surveillance as well as immunisation, malaria, HIV, TB, and maternal and child health programs. In addition, health facilities in humanitarian crises and refugee settings are shifting to emergency-only care and stopping routine treatment,” the report says.

In Bangladesh, the loss of non-emergency services has impacted more than 300,000 Rohingya refugees, including the suspension of Hepatitis C treatments for 7,000 people.

In Afghanistan, more than 420 health facilities have closed or suspended operations, eliminating basic health care for three million people.

One major health facility has recorded a 3-4 per cent increase in infant mortality, the report says.

In Mozambique, 81 per cent of HIV prevention funding came from USAID. Disruptions have been linked to a 44 per cent drop in viral tests on children and could lead to a 10 per cent increase in HIV-related deaths in the next four years.

In northern Ethiopia, aid cuts have reduced the population’s access to medical services, particularly harming internally displaced people and cutting them off from treatment for HIV and other conditions. Women in Tigray are now unable to access critically needed health services for sexual violence.

Food aid 

The Refugees International report says food aid cuts are increasing the risk of severe hunger. 

“Reductions in rations and cash support quickly increase the likelihood that food insecurity will rise – especially for populations already dependent on humanitarian assistance,” the report says.

Funding shortfalls have pushed many humanitarian actors to reduce the amount of food assistance they provide or suspend operations entirely. In refugee settings, the impact is immediate and quantifiable, it says. 

In Uganda, funding shortfalls linked to donor cuts meant the UN to suspended food assistance for a million refugees and reduce general food rations by up to 80 per cent.

“These cuts may be contributing to the increased rate of acute malnutrition among refugees in Uganda as UNHCR reports that the Global Acute Malnutrition (GAM) rate increased from 5.5 per cent at the end of 2024 to 7.7 per cent in late 2025,” the report says. 

In Bangladesh, WFP’s planned to Rohingya rations would have been devastating for more than a million refugees and would have left people trying to survive on roughly $US6 per month.

“Following intensive advocacy, US funding allowed WFP to avoid the extreme ration cuts, but, without further funding, cuts are again on the horizon,” the report says. 

In Kenya, the UN reduced the minimum food basket by 40 per cent for nearly 800,000 refugees, sparking protests and unrest in refugee camps, and leading to deaths.

Women and girls 

“Aid cuts have acutely hurt women and girls because the services they rely on are often treated as ‘non-emergency’ and the first programs cut as humanitarian organisations re-prioritize funding,’ the report says.

Programs have dramatically contracted, including those supporting gender-based violence (GBV) prevention and response, safe shelter, psychosocial support, and sexual and reproductive health care, as well as the outreach and case management that connect survivors to protection pathways.

The report notes that gender-related programs were deemed inconsistent with the Trump administration’s political priorities, making them especially vulnerable to elimination.

“The impact has not just resulted in fewer services but also weakened referral networks and reduced the number of safe points of contact, increasing household stress and pushing women toward negative coping mechanisms,” the report says.

In the Tigray region of Ethiopia, aid cuts have significantly reduced the capacity of safe houses for women.

In Chad, UNHCR is struggling to respond to the health needs of Sudanese women refugees, including new arrivals from El Fasher who have suffered appalling sexual violence, the report says.

According to a November 2025 UNHCR assessment cited in the report, the agency faces a $US7.2 million shortfall for GBV prevention, life-saving services, and safehouses, and is unable to provide dignity kits for the more than 190,000 women, girls, and at-risk individuals in camps along the Sudanese border. 

In Afghanistan, aid cuts led to the closure of family health houses and mobile clinics and caused at least 1,700 female health workers to lose their jobs.

This took away for many Afghan women, their primary – and often only – access to maternal, reproductive, and emergency care and have forced women and girls into dangerous travel that has resulted in preventable deaths.

Refugee hosting countries

“The aid cuts are degrading migration, asylum, and refugee-protection systems in refugee hosting countries,” the report says. 

The aid cuts are actually eroding orderly migration management within in transit and refugee-hosting countries, it says.

“Many states rely on international support for funding, technical expertise, and staff to manage their asylum systems. The curtailment of aid has degraded the operational capacity of national asylum systems – fewer staff, fewer secondments, fewer protection partners, and fewer ‘front door’ services that help people register, access information, and navigate procedures.

“…when humanitarian support and protection casework contracts are cut, people are more likely to be stranded without services, pushed into legal limbo, or forced into irregular onward movement, which can put them in greater danger and force them to operate outside the law,” the report says.

Dangerous survival strategies 

The report says that when families and individuals come under increasing strain, they turn to negative coping mechanisms.

Parents skip meals or trade rations to cover medical costs. As options for livelihoods and food decrease, individuals also become more vulnerable to exploitation, it says.

“Displaced individuals seek dangerous work or take dangerous journeys, often at the hands of smugglers or traffickers. Women and children are particularly at risk. Women and girls are more likely to face GBV or rely on negative coping strategies such as early marriage, transactional sex, or unsafe migration,” the report says.

In the Rohingya camps in Bangladesh, verified cases of child marriage and child labour rose by 21 per cent and 17 per cent in 2025, respectively, compared to the same time period in 2024. 

Local leadership

The report says that across all crises; local leaders have been negatively affected by foreign aid cuts but are stepping up to meet the challenge.

“The aid cuts are hitting local and national responders in the most direct way: they lose the small, flexible funding that supports basic operating costs: staff time, local transportation, communications equipment, and rent,” it says.

“Unlike international actors, local organisations do not have an ‘exit’ option. They are rooted in place, accountable to neighbours, and expected to keep showing up, whether or not the formal system is functioning. This is shifting responsibility downward as higher-level capacity shrinks. 

“In Sudan, in the immediate wake of the aid cuts, some 70 per cent of the more than 1,400 community kitchens across Sudan were forced to shut down.

“Similarly, in Afghanistan, women-led organisations have been decimated by US aid cuts. In an environment severely restricted by the Taliban, these organisations were often the sole provider of services for women and girls. As a result of the aid cuts and Taliban prohibitions, most of these organisations are ceasing operations or are being forced entirely underground, making it harder for women in need to access critical support,” the report says.

The report concludes that the dire impact of humanitarian aid cuts is likely to get worse.

“As systems break down further and negative coping strategies run out, levels of unmet need will rise even further. The negative coping patterns playing out across many crises mirror how communities often adapt in the period preceding a famine,” it says.

“Widespread mortality is the endpoint of a famine, but it follows a period in which deprivation spreads, support systems break down, and dangerous survival strategies eventually run out of steam. 

“The United States and other donors have it within their power to prevent those outcomes – but only if they take swift action to reverse the draconian cuts of the last year,” the report says.

Read the full report: A Generational Collapse: Tracking the Toll of Trump’s Humanitarian Aid Cuts – Refugees International