How badly will US aid cuts impact Afghanistan?

LONDON - U.S. President Donald Trump's decision to slash aid will cost lives in Afghanistan where millions depend on assistance to survive, humanitarian experts say.

They warned of "massive impacts" on everything from healthcare to demining programmes, along with huge staff layoffs. 

The United States, which pulled out of Afghanistan in 2021 as the Taliban seized power, has remained the country's largest single donor, accounting for more than 43% of the $1.72 billion contributed last year, according to U.N. data.

Trump has gutted the U.S. Agency for International Development (USAID), declaring it out of step with his "America First" agenda.

Washington says it has provided waivers for life-saving aid, but there is ambiguity over their scope.

Almost half of Afghanistan's population - about 23 million people - are predicted to need assistance this year.

The funding crisis also comes as hundreds of thousands of Afghans continue to return from neighbouring Pakistan and Iran, further straining resources. 

Here are some key impacts of the cuts.

Health and maternal mortality

The World Health Organization has warned that 80% of its health services could close following the cuts. It says 167 facilities have already shut and more than 220 more could follow.

Afghanistan's health service is already on the verge of collapse and it remains one of the world's deadliest places to give birth with a woman dying from preventable complications every two hours.

Aid workers say there will be more deaths as children miss vaccinations, diseases spread and pregnant women struggle to access life-saving care. 

The U.N. reproductive health agency (UNFPA) says about 550 of its clinics will close this year.

Food security

Even before the USAID cuts, the World Food Programme (WFP) warned that many Afghans were just living on "bread and tea".

It says one in three people do not know where their next meal will come from.

While funding for some emergency food aid continues, the cuts will likely reduce agricultural assistance to help farmers grow their own food. 

Aid workers also fear that cutbacks to nutrition services will endanger lives.

About 3.5 million babies and young children, and 1.2 million pregnant or breastfeeding women, are already acutely malnourished or likely to become so.

The cuts have also hit legal services run by aid agencies that help returning Afghans obtain identity documents without which they will struggle to access aid.

Demining

The funding crisis could have a big impact on demining programmes in Afghanistan, one of the world's most contaminated countries.

Some national organisations that depended on U.S. funding have halted clearance operations and face closure. International NGOs, which partially relied on U.S. funding, will have to scale back.

Clearance operations not only save lives, but allow people to farm land and increase communities' access to clinics, schools and clean water.

Eight in 10 victims are children who pick up explosive remnants of war while playing or collecting scrap metal for income.

Programmes to educate people about the risks have already been cut, as have surveys to identify and mark contaminated areas.

Education

U.S. money would have supported education programmes for children in villages without schools, internally displaced children and those returning to the country.

One large axed project would have reached 300,000 children by setting up community classes and rehabilitating schools. It would also have supported education for adolescent girls who have been banned from school by the Taliban.

Jobs

Thousands of Afghans employed by international and national aid agencies have lost or could lose their jobs. Some have been with these organisations most of their lives and support large families on their salaries.

One agency is cutting between 70% and 80% of its staff. Others expect to shed about a quarter of their workforce. Aid experts predicted some small national NGOs would shut.

There are few other job opportunities in Afghanistan, particularly for women who are barred from most work by the Taliban. 

One aid agency has received many requests from highly educated Afghan staff offering to take hefty pay cuts. Some had also pleaded for the agency to spare drivers' and guards' jobs because they were more vulnerable.

"This sense of solidarity among Afghans is quite remarkable. I've never seen anything like it," one humanitarian worker said.

Other impacts

Programmes to improve water safety and sanitation could be impacted, exacerbating the spread of waterborne diseases like cholera, which is prevalent in Afghanistan.

Some one-stop shops helping new returnees access assistance have shut, and protection services for children and victims of domestic violence have been suspended.

Prepositioning and stockpiling of supplies will also be affected, slowing the response to natural disasters.

(Reporting by Emma Batha; Editing by Jon Hemming)