Catholic agencies that provide relief services around the globe are grappling with how to respond to plans to gut the U.S. Agency for International Development, which in 2023 managed more than $40 billion in appropriations, or about 40% of the global aid budget.

A sweeping freeze of funding by the Trump administration has shut down most USAID programs around the globe.

Hospital Sisters Mission Outreach, a mission of the Hospital Sisters Health System based in Springfield, Illinois, published a four-part blog series on USAID, explaining the purpose of foreign aid, why USAID matters to global health, and why readers should care.

"Make no mistake. Because of these actions, and if humanitarian aid isn't completely and immediately restored, vulnerable people will die," wrote Erica Smith, executive director of the outreach group. "They will starve to death. They will die because they didn't receive medicine they need. They will die because they have no access to hospitals or clinics."

In a statement to Catholic Health World, Smith said: "For over two decades, Hospital Sisters Mission Outreach has partnered to advance health care access in low-resource settings. We are in solidarity with organizations delivering humanitarian global health care and the hundreds of thousands of vulnerable people whose access to food, medicine, and shelter has been halted."

Global health leaders who gathered for a networking call Feb. 5 organized by CHA lamented the implications of the cuts, said Bruce Compton, senior director of global health for CHA.

He has spoken to colleagues in agencies across the globe about their uncertainties and fears. He said workers with a relief group in Africa told him they don't know what to do. "They're scared," he said. "They're worried about their patients. They've worried about their employees. They're having to cut staff. And they don't know about the reality of replacing some of these funds."

The United States Conference of Catholic Bishops and its international charitable arm, Catholic Relief Services, released an action alert urging people to contact members of Congress and request that USAID funding be restored. They acknowledged that Secretary of State Marco Rubio issued an exception for lifesaving humanitarian help, but said organizations were not able to access the money to implement those programs.

"While we are always there with lifesaving relief in times of crisis, our goal is to help the people we serve become self-reliant and live with dignity," the alert says. "When societies thrive, they contribute to greater global stability, reduce the risk of conflict, and create safer, more prosperous environments that benefit everyone, including us."

Cardinal Michael Czerny, who heads the Vatican office responsible for migrants, the environment, the church's Caritas Internationalis charity and development, told the Associated Press that governments have the right to review their budgets but that dismantling an agency after it has made funding commitments is another issue.

"There are programs underway and expectations and we might even say commitments, and to break commitments is a serious thing," said Cardinal Czerny.

He noted that the USAID budget is less than 1% of the U.S. gross domestic product and a fraction of the biblical call to tithe 10% of a person's income.

Compton, with CHA, said that even if USAID funds suddenly get reinstated, trust already has eroded. He recalled a conversation he had with a consultant on a global health research report he was involved in writing.

"She was talking about in-kind donations and said the best and most successful partnerships happened because of good communication and building of trust," he said.

"And we have just eroded much of that in one month."