The "Broken Chair" sculpture in front of the UN’s European headquarters in Geneva. The US makes up over a quarter of public donations to major international organisations headquartered in the city, including UN agencies. (Keystone/Martial Trezzini)

The Trump administration’s decision to bring US foreign assistance to an abrupt halt, and a further waiver that appeared to backtrack on a full freeze, has caused havoc and confusion among international aid organisations and NGOs in Geneva, disrupting life-saving work in countries worldwide as they scramble to understand what measures to take next.

The unprecedented order, signed by Trump after his inauguration on 20 January and published Friday, froze virtually all foreign aid flows for 90 days pending a review of all programmes.

“This stop-work order is really appalling,” said Nicoletta Dentico, director of the Society for International Development’s global health justice programme and co-chair of the Geneva Global Health Hub, after attending an online crisis meeting of 300 public officials, charities and other civil society groups involved in fighting HIV and Aids on Tuesday.

Pepfar, the US President’s Emergency Plan for AIDS Relief, which provides antiretrovirals to 20 million people as well as other treatments vital to preventing the spread of the virus, was also included in the order, leaving clinics and other grantees and frontline programmes in developing countries that rely heavily on US funding rushing to find new sources for drugs. “People with HIV/Aids need antiretrovirals, without which they are being killed,” Dentico told Geneva Solutions.

On Tuesday, secretary of state Marco Rubio backpedalled on the near-total freeze of aid and issued a further waiver exempting “life-saving humanitarian assistance” programmes, like the World Food Programme, which was welcomed with relief but also sowed further confusion among grantees that only hours before had been grappling with how they adjusted to the sudden shortfall.

Read the full story on Geneva Solutions.

Aissata Soumah, a technician at Guinea’s National Program for the Control of Neglected Tropical Diseases, runs a blood test for sleeping sickness in the Poste de Sante de Yindi in Guinea, 14 January 2025. (Keystone/EPA/Diego Menjibar Reynes)

Guinea wipes out sleeping sickness. The World Health Organization has declared that human African trypanosomiasis is no longer a health threat in Guinea after only 12 cases were recorded in three endemic hotspots last year.

Why it matters. The infection is caused by protozoan parasites transmitted by tsetse flies, it affects the nervous system and is fatal without treatment. About 1.5 million people in Subsaharan Africa are at significant risk of contracting the disease, though less than 600 people were diagnosed with it in 2023.

According to the Geneva-based Drugs for Neglected Diseases Initiative, which helped develop an effective treatment, the victory in Guinea can be attributed to “improved tsetse fly control, large-scale screening and awareness campaigns, and the development of new, safe and effective medicines”.

The organisation’s director, Luis Pizarro, celebrated the news while cautioning: “We should not be complacent. The disease can return if we lower our guard.”

💡In numbers we trust: How 'prioritisation' makes humanitarian numbers murky. For the second year in a row, the UN has tightened its humanitarian response plan, reducing the number of people it intends to help and the amount of money it is asking to do so, all while indicators point to a rise in needs. This "calculated pitch" meant to convince donors to foot the bill may have some positive effects but also some significant unintended consequences, The New Humanitarian explains in this in-depth analysis.