Taipei, Taiwan – Until recently, the Mekong region of Southeast Asia seemed to be on track to achieve its goal of eliminating malaria by 2030.
Named after a 4,900-kilometer (3,000-mile) river that runs from southwestern China to Myanmar, Thailand, Cambodia, Laos and Vietnam, the area has long suffered from mosquito-borne diseases.
Between 2010 and 2023, the number of cases caused by the most common malaria parasites fell from about 500,000 to less than 248,000, according to the Global Fund, a US government-funded organization that is the world’s largest funder for programs that prevent, treat and care for HIV/AIDS, tuberculosis and malaria.
Of these cases, 229,000 were reported in a single country in Myanmar. There, the outbreak of the civil war in 2021 and the movement of millions of people exploded there.
As US President Donald Trump’s administration has cited large numbers of foreign aid in the effective dismantling of the US Agency for International Development (USAID), medical campaigners fear that progress made in Mekong will be lost after targeting Myanmar’s anti-malaria initiative.
“We were throwing all the resources [Myanmar]But by stopping this, malaria will return to the Southeast Asia and the Mekong subregions,” Alexandra Wharton Smith, who worked on USAID’s Myanmar program until fired by the Trump administration, told Al Jazeera from Thailand.
The Myanmar government estimates that incidents have risen 300% since the start of the Civil War, but Wharton Smith said independent studies show that the actual figures are more than doubled.
Wharton Smith said refugees and migrants from Myanmar had not seen malaria for years, and new cases have emerged and new cases have not seen malaria for many years, and they have not seen malaria for many years, Wharton Smith said it is likely to rise even further.
The rollback of funding for anti-malaria efforts in Mekong is just one of many examples of cuts in which the collapse of USAID is erroneously warning among humanitarian workers in the world, where decades of progress against health crises such as tuberculosis, HIV/AIDS, Ebola and malnutrition.
On Wednesday, the top UN official of the Humane Society said the Trump administration has brought “earthquake shocks” to the global aid sector.
“Many people will die because of the drained aid,” Tom Fletcher, director of the UN Humanitarian Agreement (OCHA), said at a press conference Monday.
According to US Secretary of State Marco Rubio, if it becomes the top source of international aid in the world, USAID plans to cut 5,200 programs out of around 6,200 programs (about 83% of the total).
“The 5,200 contracts currently being cancelled have spent hundreds of billions of dollars in ways that are (and often unharmed) in the US’s core national interest,” Rubio said on X on Monday.
The remaining contracts will be overseen by the US State Department, he said.
The announcement curtailed six weeks of disruption at the agency that began on January 20th when Trump issued a 90-day “suspension” to support the US development.
Thousands of USAID employees, contractors and support staff have been on leave, taken or taken leave or taken leave for projects around the world to receive and suspend “stop work orders.”
Confusion continued as NGOs filled the budget gap and scrambled to understand programs eligible for exemptions announced for their partners.
Last week, the Supreme Court ordered the Trump administration to comply with an order that ordered the government to release $2 billion in backpay, which was paid to USAID partners and contractors before the suspension.
On Monday, a federal judge once again called on the Trump administration to release funds that were “illegally” hired, claiming they had already been allocated by the US Congress for specific purposes.
US development aid has become a major target for the Department of Government Efficiency (DOGE), led by Elon Musk, the world’s wealthiest person and close-up adviser to Trump.
Katherine Kyobtungi, executive director of the African Population and Health Research Center in Nairobi, Kenya, agreed that the USAID should be reformed, but said that Trump administration’s agency Gatting showed “a lack of a complete understanding of how the world works.”
“We argued that the USAID funding mechanism was very, very inefficient. It was not a perfect system because there was not much attention paid to impact, long-term sustainability, such as that. The problem is that you won’t overturn an incomplete system overnight,” Kyoto told Al Jazeera.
“There’s not just about people coming out and distributing pills for medical resistance, there’s a whole structure,” Kyoto said.
“It completely ignores the way things work, how the world works, how projects are run, that’s exactly what’s amazing.”
Politicized aid
While the full impact of the USAID cut has not yet been seen, humanitarian workers from major nonprofit organizations tackling malnutrition in multiple regions, including Africa and the Middle East, said delays in funding could be fatal.
Among the most at-risk people are being treated in intensive care units at emergency feeding stations for complications such as organ failure and hypoglycemia, according to humanitarian workers who spoke on condition of anonymity.
“The global humanitarian community has thousands of stabilization centers around the world, supported by US government funding,” the person told Al Jazeera, asking him not to be named because of fear of impact.
“This is important because all of the people waiting for the exemption request to resume the program are waiting for cash flow issues, so these centres cannot be closed for a day because if the lights go out at these centres, they will see their children dead.”
“Until now, this has never been a political issue. Feeding hungry children was a bipartisan issue, and humanitarian aid was a non-political. Now they have politicized it,” the workers added.
It is also unclear how major US projects will take fares in the future, such as the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative.
The project was founded 20 years ago by Republican President George W. Bush and is believed to have saved more than 32 million lives, according to HIV/AIDS (UNAIDS) Joint United Nations Program and archived USAID data.
Both are funded by Congress but are implemented through government agencies such as USAID and the Centers for Disease Control and Prevention in the United States.
Pepfar’s key partner, Unaids, said last month that it was notified that the US government had immediately terminated its relationship. The agency said HIV programs in at least 55 countries have reported funding cuts.
The UNICEF program grants targeting polio have also ended, according to the United Nations. It is funding the United Nations Population Fund, which oversees reproductive and sexual health programs.
USAID explicitly refused exemptions from programs related to family planning or so-called “gender ideology.”
Asia, Africa and other ground NGOs are currently struggling to close the funding gap and have faced a major disruption in service since the “suspension work order” was issued during the 90-day USAID “suspension”.
According to two sources from NGOs, Rubio’s latest declaration on USAID did little to clear up the confusion, but USAID-funded food and essential items remain locked in the warehouse.
Back in Mekong, Wharton Smith, a former advisor to USAID’s Myanmar program, said he was concerned that the trickle of the Malaria incident that crossed the Myanmar border over the past two years could turn into floods with USAID’s withdrawal.
“There’s more malaria that didn’t exist before. Many people are losing their immunity, so that could mean death,” she said.
“What happens when we stop treating tens of thousands of people because of malaria? In a few weeks, the rainy season will come, summer will come. It will be a disaster.”
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