‘People Are Going to Die': A Malnutrition Crisis Looms in the Wake of USAID Cuts

WIRED

09-07-2025

Jul 9, 2025 6:00 AM Warehouses in the US are full of foods that fight malnutrition, while kids go hungry in places like South Sudan. Photograph:Few lifesaving tools are as effective as ready-to-use therapeutic foods, known as RUTFs, which are specially designed to treat severe malnutrition and often resemble fortified peanut butter. Despite announcing a $50 million pledged to fund RUTFs earlier this summer, the Trump administration's deep cuts to foreign assistance have wreaked havoc on RUTF distribution globally, and the State Department hasn't placed orders with leading suppliers this year. Experts say the disruptions will result in more children dying from hunger.
'Stock is running critically low,' Clement Nkubizi, the country director for the nonprofit Action Against Hunger in South Sudan, tells WIRED. 'People are going to die.'
The very existence of RUTFs is a secular miracle. Considered one of the greatest innovations in preventing deaths from hunger since they were invented in the 1990s, RUTFs increase success rates treating childhood malnutrition from 25 percent to over 90 percent, according to Action Against Hunger.
Since Donald Trump took office in January, foreign aid in the United States has been gutted beyond the point of recognition. On July 1, the United States Agency for International Development (USAID) officially closed, leaving the State Department to administer some of its initiatives while wholly killing countless others. Throughout the radical dismantling of assistance programs, though, leaders like secretary of state Marco Rubio have insisted that certain lifesaving efforts would not be abandoned. Despite those assertions, critical programs have already been jettisoned, and some experts say the fatality toll from the cuts will be up to 14 million preventable deaths.
USAID directly funded around 50 percent of the world's production of RUTFs. While the Trump administration has reinstated its RUTF contracts from 2024 after initially cutting them in March, US-based providers like MANA Nutrition and Edesia are still waiting for new orders from the US government.
MANA's warehouses are still overflowing with product, up to three times the average amount of back stock the company keeps in case of acute emergencies. 'It's been sold to the US government,' says MANA cofounder David Todd Harmon. 'Nobody's picked it up.'
Rhode Island–based Edesia has been filling 2024 orders for its RUTF product, Plumpy'Nut, at a slowed-down pace. This July it finished fulfilling those contracts, and it has not received word from the State Department about future orders. In the meantime, it is filling orders from nongovernmental organizations that are far smaller than the orders that the US government formerly placed. (USAID made up 85 percent of Edesia's customer base; for MANA, it was over 90 percent.)
According to Edesia founder Navyn Salem, an order of 122,000 boxes of Plumpy'Nut is currently on its way to Sudan, but Edesia still has 185,000 boxes 'sitting there' waiting to be assigned to a country and for government officials to sign off on transportation contracts. 'For six months, we haven't been shipping anything. That means there are millions of children who are not getting what they need, and we can't catch up fast enough to reach them,' Salem says.
Edesia had to lay off 10 percent of its staff in March as USAID was dismantled; Salem says that it took 'many, many, many weeks' for the company to receive partial payment owed by the US government, and that it is still owed money for 2024 orders. 'I believe Marco Rubio when he said, 'We want to continue these programs,'' Salem says. 'Still, we have not had an order in the fiscal year.'
'We are providing $40 million to UNICEF to treat approximately 432,000 children with severe acute malnutrition, and $80 million to the World Food Programme to prevent 1.5 million children from becoming severely wasted,' a State Department spokesperson told WIRED by email when asked about the impacts of the cuts. 'The Administration is working with Edesia and other partners to broaden its partnership network, potentially adding more US-based companies, while also improving shipping efficiency and cost-effective procurement.'
Salem noted that the State Department has not communicated any of this with Edesia, and called its statement to WIRED 'not accurate, as of today.' She says she remains 'extremely hopeful' about the situation.
In the wake of broader, drastic foreign aid cuts in the United States, other nations have pared back assistance. 'People might have expected that other countries would step up and fill in the gap. We've seen the opposite,' says Action Against Hunger associate director Heather Stobaugh. 'And when we look to the philanthropic world and private foundations, there's not enough of them to fill the gap.'
So far in 2025, the UK, Germany, Switzerland, France, and Canada are among the countries further slashing aid, according to an analysis from the anti-poverty nonprofit Center for Global Development. Some private donors are helping; MANA, for example, has received $250 million in donations from a philanthropist over the past several years, which allowed it to move forward with plans to expand its warehouse space even amid the turmoil.
The disruption to the RUTF supply chain, in tandem with other aid funding cuts, is already having a dire impact on the ground. Nkubizi is seeing this unfold firsthand. Since the larger funding withdrawal meant that most of his staff have been laid off and many clinics have shuttered, patients have to travel much farther to get the help they need—often 50 to 100 kilometers. Since most travel by foot, some simply cannot make the journey.
'Now mothers have to travel a long distance with their children,' he says. When these families do reach their destinations, the RUTF supply is dwindling; after traveling all that way, they are no longer guaranteed access to the prescription foods needed to stave off death and further illness.
Nkubizi, who was born in a refugee camp in the Democratic Republic of Congo after his family fled conflict in Burundi, knows what it's like to get a chance because of US-funded RUTFs. 'I grew up as a child who needed nutritional support,' he says, noting that assistance from the United States has been viewed as a major force for good in the region. 'Catastrophe—that's the feeling going on here in Africa. People are still hoping they'll wake up and the orders will be reversed.'
Stobaugh says that the broader funding cuts have made this crisis even more acute.
'Additional cuts to the health programs are creating a perfect storm, because malnourished children' s bodies have a weakened immune system. They're not strong enough to fight off common childhood illnesses,' she says. 'We have no malnutrition treatment. We also don't have funding for treatment for TB, malaria, HIV immunization programs. With the combination of no nutrition response and no health response, these children don't stand a chance.'