When Outside Funding Disappears
The Question USAID’s Retreat Poses

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Federal budget cuts under the Trump administration are hitting Latin American public-health research directly. In 2025, USAID cancelled more than 5,300 grants and contracts. The lost funding reportedly totals some 27 billion dollars. A 2026 commentary in The Lancet Regional Health – Americas warned that these cuts threaten Latin American public-health research and health equity, and took on the root of the problem directly.

The depth of dependence, in numbers

Latin American public-health research has relied on U.S. federal money for years. Much of the work on HIV, tuberculosis, and neglected tropical diseases (NTDs) has run on U.S. funding channeled through the NIH and USAID. The problem does not stop there. The very choice of what to study, and what to put off, has been pulled toward the interests of the funders. These cuts are not a story about a smaller budget. They expose a system that has decided research priorities from the outside.

On the global scale, the figures for USAID's retreat are larger still. One study estimated that if the cuts continue from 2025 through 2030 they would cause more than 14 million additional deaths worldwide, 4.5 million of them children under five. The more fragile a country's health infrastructure, the heavier the toll.

A prescription: stop depending

The Lancet commentary does more than describe how grave the crisis is. If outside money controls research priorities, the authors argue, the region must rebuild its own agenda with its own funding. The first moves are already here. Brazil put forward a Belém Health Action Plan at COP30 in November 2025, on three pillars: surveillance, policymaking, and innovation around adaptation to climate change and health. PAHO issued policy guidance in 2026 on aging and the buildup of care systems. Regional bodies are trying to build a base of their own to replace outside money.

A cutoff of research funding is more than a drop in the number of papers published. Whether in efforts against HIV, tuberculosis, and neglected tropical diseases, or in maternal-and-child health and chronic disease, the people and know-how built up in each country through international projects have quietly underpinned how policy is put into practice. When that ladder is pulled away, the first to pay are always those whose voices carry least. Who falls out of the studies, and whose regional data goes dark from here on—that quiet sorting behind the numbers is the change worth watching.

Once NIH and USAID money is gone, each country is tested on whether it can rebuild its research with questions and a budget of its own.

※ This article is the author’s commentary based on public information. Please confirm the latest figures, dates and procedures with governments and primary sources. Quotations are kept minimal and sources are cited.