Trump’s Foreign Aid Overhaul Sent Millions More Dollars to Big U.S.-Based Contractors

When the Trump administration began its overhaul of foreign aid in January 2025, officials made no secret of their disdain for giant aid organizations and private businesses who received multimillion dollar contracts to deliver health services to poor nations. They characterized them as “beltway bandits” who charged bloated amounts of overhead.

“They did the exact opposite of what they said they were going to do,” said Dr. KJ Seung, a physician in the Division of Global Health Equity at Mass General Brigham, and a member of the team that conducted the funding analysis for the academy, a policy think tank affiliated with the medical center.

The analysis found:

• The for-profit contractor Chemonics received $173 million more during the 2025 financial year than it did in 2024, a 16 percent increase. Chemonics generated annual revenue of about $1.6 billion before this surge in funding.
• Global Solutions Ventures, a for-profit joint venture between two development consultancies, saw an $82 million rise in its funds, a 727 percent increase. The company took over the operation of many of the remaining H.I.V. programs.
• The nonprofit FHI 360, based in North Carolina, received $444 million more than in 2024, a 110 percent increase.
• Jhpiego, a nonprofit health organization affiliated with Johns Hopkins University, received $194 million more, a 133 percent increase.

Nonprofit agencies typically had a negotiated indirect cost rate that accounted for 15 to 25 percent of the value of the award, while the rate for businesses could be as high as 35 percent.

In the last year of the Biden administration, the top 25 recipients of U.S. global health funding received 67 percent of the total amount awarded, the analysis found. After the Trump administration’s restructuring began, they received 91 percent of the funds through the rest of the 2025 fiscal year, the report shows. From 2024 to 2025, there was a 40 percent decline in the number of recipients in the global south, from 613 groups to 384.

Dr. Seung said the huge spike in funds to a small number of big organizations was the inevitable outcome when State Department officials had only a few mechanisms left to keep operating the programs deemed lifesaving.

“They painted themselves into a corner. They had to get out of it and move this money somehow,” he said. Only the largest organizations had the financial cushion to weather the months of stop-and-start funding disruptions, and retain the personnel and systems to receive funds and run programs.

The State Department has made no significant new awards since the aid review began, but recently established a new funding platform. Rather than inviting competition for individual grants, it establishes a standing mechanism to release targeted funding.