A Qualitative Assessment of the Impact of and Response to Disruptions of Global Health Assistance in Peru, Cameroon, Tanzania, and South Africa

Abstract

On January 20, 2025, President Trump signed an executive order to freeze all USAID funding for 90-days effective immediately. The abrupt loss of a major funding source resulted in chaos, confusion, extensive loss of jobs, and elimination of services. The aim of this study is to provide perspectives of individuals working in the healthcare sectors of impacted countries and compare the impacts of and response to these disruptions across countries. A multi-case study design was utilized to understand the impacts of the global health finance disruptions in Peru, Cameroon, Tanzania, and South Africa. Elite interviews were conducted with 12 participants from NGOs, research institutions, universities, and the government in target countries. Reflexive thematic analysis was used to develop four themes: the disruptions caused pervasive losses and shared feelings of uncertainty, the biggest threat to health of communities is the loss of jobs, responses varied across countries, and disadvantages heavily outweighed opportunities. This study highlighted the human cost that came with the abrupt removal of funding, and our hope is that partnerships can be reimagined in ways that are less transactional.