Pakistan TB Deaths will Increase as USAID Funding Ends

WASHINGTON (03-10) – On Friday, March 7 all tuberculosis (TB) related health activities were terminated in Pakistan and elsewhere as a result of President Trump’s January 20 executive order ending the $44 billion funding of United States Agency for International Development (USAID) and State Department projects for 90 days. The proclamation also called for all foreign service officers (FSO) in Pakistan to be placed on administrative leave.

According to the order, the administration will review each of the funded programs to decide how to move forward in considering whether to make changes, cancel or better “align” them with “Trump’s priorities.” The operative term being “priorities” that in Trump world change frequently and often.

Worldwide, the highest rates of new TB cases occur in India, Indonesia, China, the Philippines, Pakistan, Bangladesh, Nigeria, and South Africa. TB is considered to be the top cause of death worldwide by the World Health Organization (WHO).

The necessity of maintaining vital medical programs such as the USAID Tuberculosis Local Organization Network (TB-LON) are unlike a faucet that can simply be turned on or off. Patients who depend on and are unable to get their daily prescribed medications in order to fight the easily transmittable bacterial disease will, in turn, infect others around them resulting in further spread of the deadly contagion in the country of 241 million. Combined with terminated TB-LON programs in other countries, controlling the spread of TB, this will now contribute to its spread around the world.

The urgent medical necessity of continuing to diagnose, treat and cure TB infections by keeping it contained and managed was simply wiped away with by the simple use of a Sharpie. While the act of signing the order may make for a dramatic TV moment without aforethought of the repercussions of doing so, it will in the end result in the unnecessary and tragic consequences of further deaths.

Even if a pause of 90 days is a viable reality considering the thousands of such projects that have been terminated and would be subject to review, it will take many months before any will be restarted, preventing early diagnosis through chest x-rays and in restarting medication for those whose treatment had been disrupted in an all-out effort to contain and control the disease.

One ongoing challenge for physicians and staff in treating TB patients is monitoring the taking of their daily medications which is so critical to their recovery. Continuity of taking medication is a crucial factor in the control and cure of the disease. There is also the concern in the spreading of several thousand cases of drug-resistant TB that will go unmonitored and untreated.

According to the World Health Organization, in 2021 there were 611,000 TB cases in Pakistan and 50,000 deaths anually. Treatment through the use of daily prescribed medications of those patients under the pre-DOGE program realized a cure rate of around 94 percent.

Along with TB, the incident of HIV/AIDS is another area of concern in the country where it is estimated that in 2023 there were around 290,000 adults and children living with HIV according to the United Nation AIDS (UNAIDS) Project, accounting for 11,000 deaths annually. Medication for patients distributed by USAID to treat the disease have also been discontinued and like TB, will result in additional new cases and an increase in preventable deaths.

Defunded overall health programs in Pakistan will affect millions of people and, according to Global Voices, a Dutch human rights activist group, “In Pakistan, suspending US-funded health programs endanger 1.7 million people, including 1.2 million Afghan refugees who have been stuck in limbo in Pakistan since the US pulled out of Afghanistan in August 2021.” Many patients will lose considerable momentum in their recovery and die as a result, but not before spreading diseases further.

These are just some of the health programs terminated by the Musk/Doge “Government Efficiency” program that has and will affect additional programs and services. And Pakistan is just one country out of many that receive critical lifesaving assistance through health-related programs whose cessation will impact global health and endanger the national security of the US and other nations.

Pakistan is also grievously afflicted by childhood malnourishment. In 2023, The Guardian newspaper reported that Pakistan has “recorded its highest-ever rates of malnutrition. According to the National Nutrition Survey, 33% of children are underweight, nearly 44% are stunted, 15% are wasted, and 50% suffer from anemia, with 33% specifically experiencing iron deficiency.” The salvation for babies and children who suffer from severe acute malnutrition is the USAID distributed Plumpy’Nut™ a peanut butter-based nutritional paste fortified with powdered milk and enriched with vitamins and minerals. The ready-to-use therapeutic food (RTUF) can revive a malnourished child in just three weeks at home without medical supervision or refrigeration and be administered easily in aiding a child’s recovery.

After initially canceling the USAID contract for the product in early March, the government changed direction the following day by reinstating its contract with Rhode Island manufacturer, Edsia (named for the goddess of food, associated with child development) but required that the company change all packaging to remove any USAID identification. The net effect in the disruption of the life-saving product is uncertainty, and moving forward no one can determine how long the contract may stay in force to maintain a steady supply of the life-saving product.

This fiasco echoes the sentiment of a sign held by a protester here in Washington that read “Why is the World’s richest man starving the World’s poorest children?”

Report and photos by Phil Pasquini

© 2025 nuzeink all rights reserved worldwide