The months since President Trump’s election have been characterised by jitters in the global health community. These jitters have not been unfounded based on the actions he took in his first term, such as expanding the global gag rule which led to widespread disruption of health programmes.
Nothing though could have prepared the world for the shocking decision to dismantle USAID overnight in what some have termed “geopolitical vandalism”. The impact of this decision will take time to comprehend, partly because data systems that track the impact of various programmes across the world have also been closed.