Bangkok, Thailand – At the end of January, Cambodia’s Khmer HIV/AIDS NGO Alliance was unexpectedly informed by the United States Agency for International Development (USAID) that all funding for its tuberculosis programme had been put on hold for 90 days.
KHANA, as the NGO is more commonly known, detects about 10,000 tuberculosis (TB) cases each year, providing preventive treatment to some 10,000 close contacts and medical care for some 300 rural patients, according to executive director, Choub Sok Chamreun.
With funding drying up, many rural Cambodians will soon lose care, Chamreun said.
“Within the suspension period, these people will have a service interruption because we have been asked to stop work,” Chamreun told Al Jazeera from Phnom Penh.
“We expect these people will not have services, and they could lose follow-up for their TB treatment.”
“Normally … they receive support for treatment, mental health support, and regular follow-ups because [they] are living in rural communities, so they depend very much on the support from our community health workers,” he added.
KHANA is just one of many charities and nonprofit organisations across Southeast Asia that are fearful for their work as US President Donald Trump moves to effectively abolish USAID under a radical cost-cutting drive spearheaded by tech billionaire Elon Musk.
As the world’s largest single provider of humanitarian aid, USAID last year allocated $860m to the region alone. The agency operates in six out of Southeast Asia’s 11 countries – Cambodia, Laos, Myanmar, the Philippines, Thailand and Vietnam.
The level of economic development varies considerably across the region, which is home to nearly 700 million people.
While Singapore is one of the world’s richest countries with a gross domestic product (GDP) per capita of about $85,000, nations such as Cambodia, Laos and Myanmar lie in or around the bottom quartile of economies and rely heavily on foreign aid.
USAID projects support healthcare, economic development, humanitarian assistance, education, and support for “democracy, human rights, and governance”, according to an archived page from the agency’s now-defunct website.
Many of these projects are administered through small NGOs that work with local communities, such as KHANA.
Much, if not all, of that assistance is now on the chopping block as Trump and Musk, who has called USAID a “criminal organisation”, work to dismantle the agency at lightning speed.
As of Friday, all direct hire or permanent USAID staff are to be placed on administrative leave and have 30 days to return to the US if they are stationed overseas.
Multiple media outlets have reported that Trump plans to keep fewer than 300 of the agency’s some 10,000 workers to run a skeleton version of the agency, which is currently being led by Secretary of State Marco Rubio in an acting capacity.
Critics have slammed the gutting of the agency via executive action as unconstitutional since the status of USAID as an independent body was enshrined in law by the US Congress.
A staffer at an NGO in Thailand that works with Myanmar refugees said the organisation had already shuttered most of its healthcare centres.
The staffer, who asked not to be named, said the nonprofit had consolidated its work to just two centres, discharging patients in stable condition and using its limited non-US funds to transfer critical patients to Thai hospitals.
While the organisation will continue to treat tuberculosis, HIV and malaria, and a small number of patients in-house, many of its operations will need to be taken over by the Thai government, the staff member said.
Refugee camps along the Thai-Myanmar are heavily dependent on US government funding, and some such as the Mae Lae Refugee Camp told Al Jazeera they have only weeks of food left.
Emilie Palamy Pradichit, the director of the Bangkok-based Manushya Foundation, which describes its mission as advancing human rights and social justice, painted a grim picture of the situation in Thailand.
“We have 35 activists and their families facing transnational repression relying on our rapid response fund since January,” Pradichit told Al Jazeera.
“We have until the end of the month, and if we don’t receive those funds, we won’t be able to keep them at those safe houses … We are putting them at risk.”
“This is the end of development aid as we know it,” Pradichit said.
Pradichit’s pessimism was shared by a USAID employee who previously worked in Southeast Asia.
“All of the implementing partners [contractors and NGOs] are clueless because there is no information. All that’s been received is a stop work order, and there’s been no follow-up. The smaller contractors or NGOs are going under,” the USAID employee told Al Jazeera, asking not to be named due to fears of professional repercussions.
“The assumption right now is this 90-day [suspension] is not real. They’re bleeding the programmes dry because, per USAID regulation, for an NGO, you’re not allowed to have more than a 30-day reserve of funding,” the employee said, explaining a stipulation that organisations must follow to receive USAID support.
Some members of the NGO community, and even some supporters of USAID, have acknowledged the agency does need reform to improve its operations and efficiency, but say shutting the agency is not the answer.
“Some of the things Musk and Rubio have said are correct. They’ve [USAID] been getting so much money … But the local organisations are getting crumbs,” an employee with a Thailand-based NGO, who asked not to be named, told Al Jazeera.
“A lot is not making it to the front line. They [USAID] are powerful instruments to development but need reform. But the way they are shutting down is clumsy and hurtful because the ones that need [funding] the most are the small NGOs.”
“The impacts are going to be felt for some time, and some will be irreparable,” the employee added.
Phin Savey, the secretary-general of the Cambodian Human Rights and Development Association, Cambodia’s oldest human rights organisation, said many of its programmes may have to be suspended until he can find alternative sources of funding.
“Without USAID, we want to keep working, but for most activities, we need the budget,” Savey told Al Jazeera.
“The activities that we can do without money is just monitoring the situation of human rights violations, land grabbing or political rights [violations].”
