SYRIA – Mustafa Abdelqader lives with his family in Karameh, an internally displaced persons (IDP) camp in Atmeh, in northwest Syria. This region is home to hundreds of IDP camps, a consequence of the 14-year-long war that has ravaged the country. Forcibly displaced from Hama in 2013 due to the fighting, like millions of other Syrians, Abdelqader’s only source of livelihood has been humanitarian aid, which has steadily declined. “We’re left with no aid, just a little food trickling in,” he told The American Prospect with a sense of abandonment.
On February 27 of this year, hundreds of aid organizations in Syria, including GOAL and Relief International, received an unexpected email announcing the abrupt suspension of U.S. funding. Activities were halted for months, leaving millions of people on the brink of disaster. While some operations resumed after months of uncertainty, there was a significant reduction in funds, leading to sweeping strategic shifts.
President Donald Trump lifted sanctions on Syria in June, and has tried to portray himself as a friend to the country’s new government. But his decisions to dismantle the U.S. Agency for International Development and stopping the flow of foreign aid have caused ripple effects here and across a tumultuous world. The fragile balance established by humanitarian organizations that already struggle to provide aid to millions in conflict zones or areas facing environmental emergencies is being destabilized by USAID funding cuts.
A Long War, Heavy Consequences
This month, Syria marks one year since the fall of Bashar al-Assad, the leader of a regime that drenched the country in blood for over a decade. The violent crackdown on the 2011 popular uprising, with thousands of deaths and disappearances, spiraled into a sectarian war whose wounds are still far from healed. Now, the transitional government led by Ahmad al-Shara, once head of the dissolved Hayat Tahrir al-Sham, is tasked with rebuilding Syria from its ruins. The humanitarian toll is enormous: over 600,000 deaths, more than 100,000 people missing, and 14 million displaced. Half of the displaced are outside the country, and the rest live in internal camps across Syria.
The war effort, international sanctions, and internal corruption have left 16 million people dependent on humanitarian aid, according to the U.N. Office for the Coordination of Humanitarian Affairs. That’s about 70 percent of the population. The United States was the largest donor to U.N.-coordinated aid previously, contributing 25 percent in 2024, but the coordination structure and funding flows are so complex that it is difficult to know how many beneficiaries are affected, both directly and indirectly.
But the aid cuts, which Trump officials celebrated with sheet cake in February, have had clear and devastating consequences throughout the country.
The USAID funds were suspended at precisely the moment when they could have had more reach.
In Idlib, a network of refugee camps houses 3.5 million displaced people. Hospitals and clinics that once relied on USAID funding have felt the impact. “The funding cuts were brutal,” said Mohamed Fadel, director of the Sarmin Health Center, speaking to the Prospect. Sarmin, a village in Idlib devastated by war, saw its health care staff go nine months without any supplies. “Workers stopped receiving their salaries, but they continued as volunteers to avoid cutting off services to patients,” Fadel said. “This area is very poor, most buildings are in ruins, and the uncertainty is huge because contracts are renewed on a monthly basis.”
A few kilometers away in the town of Saraqib, where Relief International funds a local clinic, Abu Omar, the center’s director, explained: “The impact of USAID cuts has been huge. This clinic is still standing, but two others have closed.” These clinics offered a range of medical services, including pediatrics, surgery, and gynecology. “We came from Harem, Darkoush, and Salqin, near the border, where there were cholera outbreaks in recent years. Now, there are no clinics in the area,” he added. “This increases the chances of new outbreaks.”
“Over the past three years, we’ve received less and less help, but this year, it was zero,” said Abu Muhammad, 55, surrounded by his neighbors in Hamze, one of the more than 50 camps in Atmeh. Three of his six children, who were born in the camp, suffer from an undiagnosed eye condition due to the lack of medical resources.
“Almost all the organizations have left,” he said. “There’s no water, no garbage collection. We barely get food items, but we’ve reduced our meals to just one plate a day. Before, they pumped water for an hour a day, now we get just ten minutes, and we can’t drink it; it’s contaminated,” said Muhammad, adjusting his red keffiyeh. Winter is approaching, but his heater is still empty of fuel. “They don’t give us fuel anymore. The children collect garbage during the day to light it at night to heat homes, the smoke from the plastic doesn’t even let us breathe.”
Abu Ali, a former GOAL humanitarian worker, explains that “80 percent of WASH [water, sanitation, and hygiene] services have stopped.” This includes water trucking, garbage collection, maintenance of water stations, and water pumping. As a result, the streets of Atmeh are filled with garbage, which Ali said increased the spread of diseases, although he conceded, “There are no data because the funding cuts led to the dismissal of 300 to 400 workers from GOAL alone in Syria. From 761 water stations, 389 have been nonoperational since the USAID cuts.”
A New Syria, a New Strategy
The fall of Assad dismantled the front lines that once divided Syria. In the areas around Atmeh, many shops have been abandoned, as people returned to their homes after the end of Assad’s reign last December 8. According to the U.N. High Commissioner for Refugees, at least 1.9 million IDPs have returned from various parts of the country. This allowed many USAID-funded NGOs to access territories that were previously controlled by the old regime, which had banned any organization linked to the U.S. The USAID funds were suspended, then, at precisely the moment when they could have had more reach.
“The needs are enormous and increasing, but the money is dwindling,” said Youssef Khoury, coordinator of an NGO in Atmeh, whose name was changed to maintain anonymity. The aid funding shortfall is estimated at $237 million, according to reports.
“Most cities are destroyed. We can’t stop people from returning to their homes, but it also demands changes in humanitarian intervention,” the NGO coordinator added. Many buildings are on the verge of collapse, and infrastructure is inefficient. “At least 600 people have died due to mines left in former conflict zones, not to mention the need for psychological and physiotherapy assistance.”
“The needs are scattered across the country, and this creates a lot of confusion because everything is in transition, but donors haven’t taken this into account,” said Youssef.
In Damascus, the capital, humanitarian organizations are barely able to carry out their operations. In neighborhoods like Yarmouk, Tadamon, Jobar, and Ghouta, more than 60 percent of the buildings are ruins, with no access to essential services like electricity, education, health, or water. Moreover, 90 percent of the population lives in poverty under a subsistence economy. “All WASH-related work is disappearing,” said Nour, 35, a supervisor for a humanitarian organization. “The money allocated for water extraction infrastructure has run out or hasn’t arrived, and the active boreholes are extracting contaminated water.” Hundreds of thousands of Syrians rely on privately funded wells to access water, as the pipelines have been destroyed. Since the fall of Assad, the humanitarian organizations that have arrived in the capital have only been able to conduct soil studies. While Damascus suffers one of the worst droughts in history, Syrians have had to reorganize locally to create their own water supplies in the absence of funding.
“The environmental crisis is a legacy of the war; all infrastructure is destroyed, and people are returning to their homes in areas contaminated with chemicals that are leaking into the Fijah Spring, our main water source,” explained Nour. “Organizations are focusing only on immediate food aid, not infrastructure … In rural areas, it’s a disaster; people only get water once every ten days.”
An Unstable Scenario
With the arrival of Ahmad al-Shara as the head of the transitional government, Western countries rushed to establish the necessary diplomatic relations to stop considering Syria an ongoing humanitarian emergency. One goal is to lower public spending, but it also aims to push refugees back into Syria. This threatens the gains the government is attempting to make.
“We’re at a critical moment where international aid is key to the success of this transition,” said Mahmoud, a humanitarian consultant. “The government is establishing itself after years of dictatorship, but changes in the United States have pushed European donors, through ECHO, to follow the same pattern [of aid reduction]. This has created confusion when what’s needed is money, lots of money.”
In the same vein, Sara Stachelhaus, Syria program coordinator at the Heinrich Böll Foundation in Beirut, told the Prospect: “This lack of reliability from the United States at such a critical moment undermines the stabilization efforts diplomatically supported by the Trump administration, affecting … civil society efforts to promote justice, social cohesion, and a democratic political transition.” The collapse of humanitarian aid is pushing “more Syrians to consider leaving, and the distributive conflicts will fuel more crime and violence, further destabilizing the situation,” added Stachelhaus.
“The U.S. funding cuts in Syria are motivated by domestic political agendas, aiming to show foreign aid reductions to voters, but they are counterproductive to the stabilization agenda in Syria,” explained the expert, referring to how the civil society in Syria, particularly women’s organizations and political participation, has been undermined in a climate of sectarian tensions and gender-based violence.
While Assad may be in exile in Moscow, not everyone believes it’s time to put down arms. The war has left deep wounds at multiple levels, opening new conflicts, something Trump fails to account for when making aid cuts. Sectarian massacres against Alawites in the Latakia and Tartus coasts in March, clashes in the Druze-majority province of Suweida, and Israel’s occupation of the Golan Heights are all generating scores of new refugees.
Extreme poverty is also a factor in instability, further exacerbated by devastating sanctions imposed for years by the U.S. and Europe, with reconstruction estimated by the World Bank to cost $345 billion. While Congress recently approved the removal of the Caesar Act (which imposed sanctions on Assad and Syria during Trump’s first term in 2019), the situation remains unpredictable. If Trump continues with his humanitarian cuts, it will only spread fire in a world of dry grass.
Mouyad Al-Ekhwan contributed to this report.