Hours after his return to the Oval Office, Donald Trump began implementing his ‘America First’ foreign policy agenda, signing a flurry of odious executive orders that included freezing all U.S. foreign aid and assistance. U.S. Secretary of State Marco Rubio eventually attempted to backtrack through a vague memo that allowed some programs to continue temporarily, but the damage has already been done. Life-saving medications, vaccinations, educational programs, and critical care will be stopped, while aid organizations and federal employees worldwide are left confused about the future of the U.S. foreign service. A complete end to U.S. foreign assistance would be the most significant disruption to U.S. foreign policy in decades and grant adversaries, particularly China, an opportunity to supplant the U.S. as a trusted trading and development partner.

Now, the administration appears to be deferring all foreign aid oversight decisions to Elon Musk, who called USAID– the government agency in charge of managing and dispersing billions in humanitarian aid and developmental assistance- a “criminal organization.” The administration has already removed two officials for trying to prevent Musk and his DOGE staff from accessing classified USAID materials. Never before has an unelected official flagrantly interfered with a federal agency and pushed an administration to end decades of congressional appropriations for foreign assistance.

Since the end of World War II, presidents of both parties have understood the benefit of strategically investing outside the United States to promote global health, security, and democracy. The Trump administration has the right to assess the costs and efficiencies of overseas assistance, and there are legitimate critiques of its management and oversight of certain programs. However, the abrupt freeze and potential shuttering of USAID and all diplomatic, humanitarian, and developmental programs will cost lives, end careers, and have long-term consequences on the effectiveness of U.S. foreign policy.

Health programs combating infectious diseases could be impacted the most by the freeze, including the President’s Emergency Plan For AIDS Relief (PEPFAR). Launched by President George W. Bush in 2003, PEPFAR has been the largest and most impactful foreign aid program of the last 20 years. Through testing and treatment, the program has saved over 26 million lives and prevented millions more HIV infections around the world. International AIDS Society President Beatriz Brinsztejn said the freeze made “no sense” and would threaten the treatment and lives of millions living with the disease.

PEPFAR was issued a temporary waiver as part of Rubio’s reversal, allowing programs to restart services. Still, the future of the program and thousands of others hangs in the balance with the threat posed to USAID, the organization that implements the majority of global health programs. Humanitarian programs providing clean water and cholera treatment were also stopped in Sudan, Syria, and Tanzania.

While the U.S. ranks first in total dollars contributed to global aid efforts, it ranks near the bottom when contributions are presented as a percent of gross national income. In terms of aid contributions as a share of GDP, the U.S. is last in the G7, contributing less than Japan and Italy. From combating human trafficking and the fentanyl epidemic to providing life-saving medications and support for economic development around the world, American foreign aid amounts to 1% of the federal budget, a few dollars per individual taxpayer. If the current administration’s deficit concerns are in good faith, the Pentagon’s $813 billion-approved 2023 spending could be a good starting point after the Department of Defense failed its annual audit for the seventh consecutive year.

American foreign aid is not only a resource for millions around the world but a tool for U.S. policymakers. Handing over humanitarian assistance to Musk and DOGE will have disastrous consequences for millions while directly undercutting American influence in an increasingly tense power competition with China. Careers will be ended, expertise will be foregone, and lives will no doubt be lost by this decision. Failing to support these programs and foster the next generation of foreign service officials at home will have long-term consequences on the effectiveness of U.S. diplomacy and foreign policy while aiding adversaries. Former Russian President Dmitry Medvedev was quick to support Musk during his public tirade against USAID.

Foreign aid is not a charity but a strategic investment into programs that reflect American interests and our values. They should be nourished, not neglected. Blanket freezes are shortsighted, disincentive developing nations into working with American diplomats, push allies away, and would be inconsequential to the administration’s goal of reducing the federal deficit.

U.S. foreign policy is unique in the asymmetric impact decisions made in Washington have on the rest of the world. The U.S. has historically underinvested at home, with a history of costly and unsuccessful interventions abroad. Although there is increasing evidence that nations can transition away from aid dependence, that will take time. Knee-jerk cuts to the programs that are a force for good will make bad problems worse. These decisions reflect campaign promises fueled by populist rhetoric that has distorted perceptions of what U.S. foreign aid is and how it is spent. While the administration abandons the carrot in favor of the stick—threatening alliances and neighbors in North America—it has spent little time articulating how shrinking foreign aid commitments would translate to improving the country’s infrastructure, healthcare, or education.

In less than a month, President Trump has targeted nearly every policy area and bureaucratic domain for widespread reform, cuts, or elimination. The cost of immediate disengagement and cutting investments in foreign assistance amounts will seriously affect health outcomes and global stability. The move amounts to a historic strategic retreat at a time when the U.S. can not afford to fall further behind in an increasingly competitive and chaotic political playing field.