The U.S. has played a leading role in global maternal and child health (MCH) efforts for over five decades, helping slash maternal and child mortality rates worldwide. But in 2025, that long-standing commitment faces serious threats. Funding freezes, canceled programs, and agency reorganization have already disrupted services—and could unravel years of global health progress.
History
Since the 1960s, the U.S. government has backed MCH programs through USAID and CDC, reaching more than 40 countries. These efforts contributed to a major decline in maternal and child deaths. Under-five child mortality rates have dropped by more than 50% since 1990. From 2000 to 2023, maternal deaths fell by 40%. USAID reports that it helped save over 9.3 million children and 340,000 women in the last decade alone.
Despite these gains, the need remains dire. In 2023, 8 million children under 5 died—13,000 every day. Another 260,000 women died from pregnancy-related causes, nearly all in low- and middle-income countries. Most of these deaths were preventable.
Funding
The FY 2025 budget included $845 million for bilateral MCH programs, keeping funding steady for now. But the administration’s FY 2026 budget proposal doesn’t allocate any money for bilateral MCH efforts. The final amount will be up to Congress.
What’s more alarming is that the administration’s rescission proposal asked Congress to cancel over $1 billion in FY 2025 global health funding. Though Congress trimmed that to $500 million and exempted MCH, the message was clear: global health isn’t safe from the chopping block.
Disruptions
A cascade of policy decisions has severely disrupted U.S.-supported MCH programs:
- Funding freeze: A stop-work order halted all MCH programming, including lifesaving maternal and newborn care. Payments stopped, staff were laid off, and many services ended.
- Limited waiver: A February 4 waiver allowed only “life-saving” services like immunizations, antenatal care, and treatment of child illnesses. But even those services struggled to resume, with delayed approvals and payments.
- USAID closure: The administration plans to shut down USAID permanently, shifting global health duties to the State Department’s Bureau of Global Health Security and Diplomacy (GHSD). This has caused confusion and cut implementation capacity.
- Award cancellations: Of 770 global health awards, 266 had MCH components. 86% of those have now been canceled, according to KFF analysis.
- Legal battles: Lawsuits forced the government to pay for work done before February 13, 2025, but didn’t stop more cancellations.
Impact
The scale of disruption is massive. An internal USAID memo estimated that losing MCH programs would:
- Cut services for 16.8 million pregnant women each year
- Eliminate postnatal care for 11.3 million newborns
- Prevent 14.8 million kids from getting treatment for pneumonia or diarrhea
A WHO survey of 108 country offices found that nearly half reported moderate or severe MCH disruptions tied to the U.S. aid freeze. These include medicine shortages, closed clinics, and staff layoffs—affecting care for bleeding, malaria, and pre-eclampsia, all top causes of maternal death.
A modeling study warns that if the cuts continue, by 2040 we could see:
| Metric | Projected Increase |
|---|---|
| Maternal Mortality Ratio | +29% |
| Under-5 Mortality Rate | +23% |
| Stillbirth Rate | +13% |
| Additional Child Deaths | 7.9 million |
| Additional Maternal Deaths | 510,000 |
| Additional Stillbirths | 1.8 million |
Outlook
As the administration finishes its foreign aid review—already extended 30 days—questions loom. Will more cuts come? Will the restructured State Department have the skills and resources to manage MCH efforts? Congress may have the final say, but the uncertainty alone has already shaken the system.
With services disrupted and millions of lives at risk, the world is watching what happens next. Whether the U.S. continues its leadership in maternal and child health—or steps away from it—will shape global health outcomes for decades to come.
FAQs
How long has the U.S. supported MCH?
Over 50 years through USAID and CDC programs.
What caused recent MCH disruptions?
Funding freezes, canceled awards, and agency closures.
Is USAID still managing MCH programs?
No, it’s being dissolved and folded into the State Dept.
What services are most affected?
Prenatal care, newborn care, and treatment of illness.
Will Congress fund MCH in 2026?
Congress will decide; the admin’s request excluded it.
