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Bangladesh’s fight against tuberculosis (TB) and its broader healthcare system have been thrown into crisis following an abrupt $48 million aid withdrawal by the United States, under the administration of former President Donald Trump. The decision, part of a broader scale-back in US foreign assistance, has jeopardized life-saving programs that had made significant strides in curbing disease and improving health outcomes for millions.
TB Eradication Dreams Derailed
Until recently, Bangladesh had made major progress toward eradicating TB, one of the world’s deadliest infectious diseases. The country saw annual TB deaths fall from 81,000 in 2010 to 44,000 in 2023, thanks in large part to programs funded by the US Agency for International Development (USAID).
But that progress is now at risk.
Health workers fear that the gains achieved over more than a decade could unravel in a matter of months due to the sudden termination of US funding, especially in critical TB screening and treatment initiatives.
Frontline Voices: The Patients and Providers
Laborer Mohammed Parvej, 35, is one of many whose life was saved thanks to early TB detection by USAID-funded medics in Dhaka.
“Doctors told me I was infected with a serious kind of tuberculosis,” Parvej said from his hospital bed. “I am alive because they found it early.”
Parvej is being treated for multidrug-resistant TB, a form that requires prolonged care lasting over a year — care that now faces a deeply uncertain future.
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Ayesha Akhter, deputy director of Dhaka’s specialized TB hospital, explained the gravity of the situation:
“We were running a robust program, then one fine morning, USAID pulled out their assistance. It’s devastating.”
A National Health Network at Risk
The scope of the cuts goes beyond TB. According to Tariful Islam Khan of the International Centre for Diarrhoeal Disease Research Bangladesh, the USAID-backed TB screening initiative had reached over 52 million people between 2020 and 2024, diagnosing more than 148,000 TB cases, including 18,000 children.
“This work is critical not only for Bangladesh’s health but for global TB control,” Khan said. “The loss of support could reverse everything.”
Devastating Domino Effect on Child Health and Nutrition
USAID’s presence extended to the immunization of 2.3 million children against diseases like diphtheria, measles, polio, and tetanus. According to Nurjahan Begum, a senior health adviser to the country’s interim government, the future of those programs is now in jeopardy.
“I am particularly worried about the immunization programme,” she said. “If there is a disruption, the success we have achieved will be jeopardised.”
Programs designed to treat malnourished children have also been shelved. “We had just launched a feeding formula initiative,” Begum added. “Many such vital efforts have now halted.”
Rohingya Refugees Left Vulnerable
The cuts have had an especially severe impact on Rohingya refugees in Cox’s Bazar, where hundreds of thousands have lived in overcrowded camps since fleeing persecution in Myanmar.
Health services in these camps were largely funded by USAID via WHO and UNICEF. Now, reduced access to care has heightened the risk of cholera, hepatitis C, and maternal mortality, according to humanitarian officials.
Salma Sultana, a WHO representative, warned of the possibility of “uncontrolled outbreaks” if health interventions stop. Faria Selim from UNICEF echoed the concerns, particularly for the 160,000 children under five in the camps.
Maternal and Reproductive Health in Peril
Masaki Watabe, head of the UN Population Fund (UNFPA) in Bangladesh, described the situation as a public health emergency.
“Reduced donor funding has led to clinic closures and unpaid midwives,” he said. “The risk of preventable maternal and newborn deaths has increased dramatically.”
Jobs Lost, Hope Fading
The economic toll of the aid withdrawal is equally grim. Bangladesh’s Daily Star estimates that 30,000 to 40,000 aid workers have lost their jobs. Zinat Ara Afroze, recently laid off from Save the Children, said she is deeply worried for those she served.
“I have seen how these projects change lives,” she said. “Now, many of these people will be in immediate crisis.”
Bangladesh Looks Elsewhere for Support
As the country reels from the financial vacuum, Bangladesh is seeking new donors, with officials mentioning possible support from Arab nations, China, and Turkey. Yet shifting alliances won’t come quickly or easily, especially as the country’s economy braces for the expiration of a 90-day suspension of harsh US tariffs on garments.
A US State Department official, Audrey M. Happ, stated that aid decisions were made to ensure funds “align with the interests of the United States,” and are used “as effectively as possible.”
