In January of this year, Kajol unfortunately contracted tuberculosis (TB), and assistance from the United States Agency for International Development (USAID) helped her overcome the crisis. However, after the Trump administration ordered the termination of most U.S. aid spending, she and her family faced hardship once again. Tuberculosis can be fatal if not treated promptly. This highly contagious bacterial disease primarily attacks the lungs, and is uncommon in developed countries due to relatively low treatment costs.
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03-14, 2025But in Bangladesh, tuberculosis is a serious public health problem, especially in communities like the Mohammadpur slum in the capital city of Dhaka, where 17-year-old Kajol lives. "We are poor," Kajol said. She is the sole breadwinner for herself, her mother, and her younger brother. Her job at a garment factory sustains the entire family. When she fell ill in January, the situation could have become very dire.
Fortunately, Deepa Halder provided timely assistance. For the past three years, she has been promoting TB prevention and control knowledge among residents of Mohammadpur and providing free treatment to those in urgent need. This initiative is implemented by the local aid organization Nari Maitree, and funding had been provided by USAID until February of this year, when the organization received a letter from the U.S. government informing them that funding had been terminated.
This led to the interruption of Kajol's treatment; she only received partial treatment. "Now I have to get the medicine myself," she said, "I feel very strained." Interrupting treatment greatly increases the risk of tuberculosis developing drug resistance, making the disease more difficult to treat and exposing patients to more serious illness and death. Deepa said, "The people here are very vulnerable. I can tell them which doctor to see, which can help them save some money. Or I try to provide them with some financial assistance from our organization so that they can continue to receive treatment."
According to a U.S. government performance report seen by the BBC, in 2023, USAID support directly contributed to the discovery and reporting of more than 250,000 new cases of tuberculosis in Bangladesh. In the same year, 296,487 new or relapsed TB cases were cured or successfully completed treatment due to USAID assistance. The agency is considered an indispensable part of the country's fight against tuberculosis.
A USAID program director in Bangladesh, who asked not to be named, said, "You ask people on the street, and they will say, yes, it is the United States, they are the ones who have controlled tuberculosis." Asif Saleh, Executive Director of the non-profit organization BRAC, said, "Bangladesh is USAID's largest program in Asia. In terms of its impact, especially in the healthcare sector, the impact is enormous. Especially in vaccination, reducing child mortality and maternal mortality, USAID has played a huge role in this country."
In 2024, Bangladesh received $500 million in foreign aid. This year, that number plummeted to $71 million. To illustrate this figure, during the three-year period from 2021-2023, USAID invested an average of $83 million per year in healthcare projects in Bangladesh, including the fight against tuberculosis. Cutting funding to USAID means that Nari Maitree can no longer provide its "Stop TB Program," and it also means that Deepa is unemployed. She needs to support her elderly parents and younger sister.
Deepa told the BBC, "I lost my job and am now completely devastated. I bear the burden of my family. Unemployment is a devastating situation." A document seen by the BBC shows that 113 projects directly funded by USAID's Bangladesh office have been halted. This list does not include the countless projects directly funded by agencies in Washington, D.C. Saleh said, "The NGO sector (in Bangladesh) employs at least 500,000 people. That's huge. Thousands and thousands of jobs will be eliminated."
It is not just the United States that is reducing foreign aid. The United Kingdom has announced cuts to its foreign aid programs, as has Switzerland. Other countries may follow suit. For Bangladesh, this is a sobering reality. The country's government was overthrown last year, the economic situation is unstable, the inflation rate is close to 10%, and it faces a job crisis, especially among young people.
Interim leader Mohammad Yunus said that Bangladesh will develop a new strategy to cope with survival after aid cuts, but he did not specify how. In an interview with the BBC, when asked how the country would make up for the funding gap left by USAID, Yunus said, "This is just a small part, it's no big deal. It doesn't mean Bangladesh will disappear from the map." Asif Saleh said that the way the funding was cut was sudden and chaotic. The impact on countries like Bangladesh is immeasurable.
This is especially evident in Cox's Bazar, a city on the southeastern coast of Bangladesh, home to the world's largest refugee camp. More than one million Rohingya, a persecuted Muslim minority group, whom the United Nations calls victims of ethnic cleansing, have fled violent purges in their homeland of Myanmar. The Rohingya cannot return home and cannot work outside the refugee camps; their survival depends on international aid.
The United States provides almost half of the aid to Rohingya refugees. Rana Flowers, the UNICEF representative in the country, said, "We've run out of soap. We now have to truck water into the camps. This is an absolutely critical moment. There is a cholera outbreak, with over 580 cases, and there is also a scabies outbreak." Water and sanitation projects in the refugee camps were previously funded by USAID.
Since the order to stop work took effect at the end of January, hospitals such as the International Red Cross Hospital in Cox's Bazar have only been able to provide emergency assistance. This week, the Trump administration canceled more than 80% of USAID's programs, and hopes that the money could be restored have faded. Patients like Hamida Begum, who regularly receive treatment for high blood pressure, have few other options.
She said, "I am old, and no one can help me." Her husband passed away last year, leaving her alone to care for four children, including her 12-year-old daughter who cannot walk. "I can't go to another hospital far from home because of my daughter." At a nearby UN food distribution center, Rehana Begum stood next to two large sacks.
She said that they contained six liters of cooking oil and 13 kilograms of rice, as well as basic foods such as onions, garlic, and dried chilies. These rations, provided to her by the World Food Programme (WFP), need to sustain her and her family for a month. I asked her how she would cope when her rations were cut in half starting next month.
She looked shocked. Then she started to cry. Rehana, 47, who lives in one room with her husband and five children, said, "How can we possibly survive on such a small amount? Even now, it is difficult to make ends meet." The World Food Programme said that it was forced to make this drastic cut due to "severe funding shortages for emergency response operations."
The rations now allocated to the Rohingya community only meet their basic daily dietary needs, raising concerns that they will only have enough to survive, with no room for anything more. UNICEF's Rana Flowers said, "This is an absolute disaster. Desperate and frustrated people in the camps will lead to security problems. If this escalates to a certain point, we will not be able to enter the camps to provide assistance."
