As Congress begins drafting legislation to fold the duties of the U.S. Agency for International Development (USAID) into the Department of State, it is important to re-emphasize what a grave mistake it is to eliminate USAID as an independent agency.
The Administration’s freeze on foreign assistance earlier this year and the subsequent dismantling of USAID have increased suffering and death among children in low-income countries and diminished U.S. global status as a trusted world leader.
Lawmakers now are tasked with combining USAID’s humanitarian role and, to a far lesser extent, its development role, with the diplomacy role of the State Department. But fewer than 20% of USAID programs will be folded into the State Department. Key steps must be taken to ensure that children are not left behind in this process. For instance:
- The State Department’s Function 150 Account for Fiscal Year 2026 must be maintained, at a minimum, at the FY 2025 level of roughly $60 billion, and the Administration must obligate and disburse this funding as directed by Congress
- USAID programs supporting children must be saved
- Development programs must be preserved along with humanitarian assistance
- U.S. humanitarian programs must continue to align with humanitarian principles
- Senior, empowered leadership reporting directly to the Secretary of State must oversee and lead these development and humanitarian programs
USAID Programs Supporting Children Must Be Saved
Worrying signs suggest that the Administration is forgetting children. According to plans shared with Congress, the Administration has terminated a vast swath of child-focused programming, including basic education, Vulnerable Children, and Orphans and Vulnerable Children programs. The Administration passed over these programs because they were not deemed “lifesaving” by the Secretary of State (and therefore given a theoretical waiver) or did not align with the Administration’s goal of using foreign assistance to make America “safer, stronger, and more prosperous.” Before the dismantling of foreign assistance, children were receiving roughly 10% of U.S. foreign assistance resources. Although that amount was far too small given that kids make up 30-50% of the population of many low-income countries, it was far better than the barren landscape that is emerging.
The State Department Must Retain Orphans & Vulnerable Children Programs
The Administration has already ended 23 programs for orphans and vulnerable children (OVC) under the President’s Emergency Plan for AIDS Relief (PEPFAR) and has no plans to carry them over to the State Department. Unlike the rest of PEPFAR, which the Administration plans to retain, the OVC program will disappear, leaving vulnerable children and orphans without protection and nurturing care and at dangerous risk of sexual abuse, trafficking, and violence.
The Administration is operating under the misconception that PEPFAR’s non-clinical support for children, such as Orphans and Vulnerable Children (OVC) programs, is not “lifesaving” and therefore does not need to be preserved. But decades of community-level HIV implementation have shown that barriers to testing, treatment, and adherence to treatment for children living with and orphaned by HIV cannot all be addressed through clinical interventions. Instead, PEPFAR’s OVC programming has been the key to tackling barriers to adherence, such as inadequate nutrition, parenting education for caregivers of children living with HIV, home visits to support testing and adherence to treatment, and lack of financial assets for families to ensure their children reach the clinic and remain on treatment.
OVC Programs Enjoy Broad Support
Since Congress passed the first AIDS, TB, and Malaria bill that authorized PEPFAR in 2003, and in every subsequent reauthorization, lawmakers have required that 10% of bilateral HIV resources go to orphans and vulnerable children to keep them fed and protected. The State, Foreign Operations Subcommittee of Appropriations has also included the 10% directive for OVC in recent foreign aid funding bills because Congress felt so strongly that these world-class programs must continue. But now, the United States has turned its back on these children — at last count, 6.6 million children and their caregivers were under the care of these programs.
PEPFAR’s OVC work historically has enjoyed strong bipartisan support in Congress. The faith community also backs the program. But absent an immediate reversal by the Administration, history tells us that many of the millions of children who were dropped from OVC support will soon be found in hazardous labor, sex trafficking or the grave, instead of in school where they belong.
Modeling of PEPFAR’s OVC programs in Kenya showed a return on investment (ROI) of 4:1 because of reductions in HIV infections, child marriages, cases of child sex trafficking, and cases of physical violence against children while simultaneously boosting the number of girls in school. Long-term, these programs reduced costs to society and increased labor market productivity by keeping girls safe. In fact, PEPFAR’s adolescent girls’ programs, the majority of which are funded by the OVC set aside, reduced their experiences of sexual violence by 65% in Malawi and 68% in Kenya.
Development Programs Are an Essential Part of U.S. Strategic Policy
The Administration plans to slash most development programming and to retain a smaller version of USAID’s humanitarian work at the State Department. But investing in humanitarian assistance without development programs would be inefficient, simply placing the smallest of proverbial Band-Aids on open wounds while ignoring what caused the gashes in the first place.
Humanitarian assistance focuses on the short-term — the immediate response to crises —by providing food, water, shelter, medical care, and protection to people affected by emergencies. Development assistance, on the other hand, seeks to create lasting change by addressing long-term issues such as the root causes of poverty and food insecurity, and promoting resilience to shocks such as extreme weather. The goal is to make humanitarian assistance less necessary over time. Appropriate international responses require both humanitarian and development assistance, and a smooth transition from humanitarian aid to development is crucial for long-term recovery and sustainability.
Examples of highly effective development assistance include basic education (especially for girls), caregiver training in positive parenting of toddlers, breastfeeding support that enables moms to exclusively breastfeed babies for the first six months, and improved child nutrition achieved by helping families provide children with protein and vitamins and minerals, often from kitchen gardens. Other examples include training farmers in pest control techniques and water resource management to allow their crops to flourish. Peacebuilding among warring groups also allows families to safely plant and harvest crops or travel to markets.
In South Sudan, for instance, a project funded by USAID and implemented by a faith-based organization helped warring tribes build and maintain community water points together. The communal water sources provided families with clean water and reduced the spread of water-borne disease, and also promoted peace between the tribes. With peace came regular planting and harvesting of crops, allowing communities to feed themselves and avoid the need for humanitarian intervention. Simply reacting to emergencies as they break out without a long-term plan to stabilize the area (as seems to be the current plan) will keep the U.S. lurching from one humanitarian situation to another without reducing insecurity or poverty long-term.
Empowered, senior leaders must head these programs
The Administration must establish a new position at the State Department, such as Deputy Secretary for Development and Humanitarian Affairs, to oversee all development and humanitarian programs. This position must report directly to the Secretary of State. This position is necessary because the goals and expertise needed to lead, implement, and monitor development and humanitarian assistance are vastly different than the skills needed for diplomacy. The goals of aid and diplomacy must be aligned, but distinct.
For example, diplomacy seeks to advance American interests abroad. But the core ethical accepted guidelines for humanitarian assistance include humanity, neutrality, impartiality, and independence. Humanitarian aid is given regardless of race, creed, or nationality of the recipients, and without adverse distinction of any kind. It is absolutely critical that the Administration adhere to these global humanitarian principles not only because it is the right thing to do, but also because to do otherwise will endanger the lives of American humanitarian workers. To insist upon “America First” policies in humanitarian work would compromise trust and acceptance within affected communities and would undermine the safety and security of humanitarians. This is no small matter. Last year was the deadliest year on record for aid workers, with 377 humanitarian workers killed and hundreds of others attacked and kidnapped.
Ideally, Congress would insist that USAID remain an independent, fully staffed, and fully funded agency. Barring that unlikely possibility, lawmakers must mandate the appointment of a Deputy Secretary for Development and Humanitarian Affairs at the State Department who reports directly to the Secretary of State. This person must demonstrate a strong development and humanitarian background and prove capable of leading the following offices and programs:
- Humanitarian Assistance, including migration, refugees, and emergency relief
- Development Assistance, including food security and nutrition, water and sanitation, basic education, and economic development
- Global Health, including Maternal, Newborn & Child Health and Nutrition, Vulnerable Children, Malaria, Tuberculosis, Neglected Tropical Diseases, the President’s Emergency Plan for AIDS Relief (including a strong Orphans & Vulnerable Children component), and the Office for Global Health Security
- Democracy, Human Rights and Labor (DRL) and Good Governance
- Office of Foreign Assistance, integrating policy and budget
- Office to Monitor and Combat Trafficking in Persons (including a strong focus on child protection/anti-trafficking).