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On a Tuesday morning in February, 70 health facilities across three Nigerian states suddenly stopped feeding malnourished children. Not because they ran out of food. Not because of war or natural disaster. Because someone in Washington decided that treating 60,000 children on the brink of starvation was no longer a priority.

This is what policy looks like when it hits the ground. This is what happens when the world's largest humanitarian donor decides to take its ball and go home.

About seven and a half months ago, Donald Trump was inaugurated for his second term, and since then we've been conducting a massive, uncontrolled experiment in human suffering. The experiment goes like this: What happens when you suddenly cut off billions in aid to the world's most desperate people, start trade wars with your biggest partners, and slam the door on refugees fleeing persecution?

We're getting our answer, and it's uglier than even the pessimists predicted.

The question isn't whether global suffering has increased since Trump took office. Walk into any humanitarian organization right now and you'll see the spreadsheets of cancelled programs, the maps with red zones growing larger, the field reports that read like something from a different century. The question is how much of this carnage we can directly trace to specific policy choices versus the background noise of a world that was already falling apart.

This isn't about partisan point-scoring, though I won't pretend false neutrality when children are starving because of decisions made in air-conditioned offices. This is about following the evidence where it leads, even when, especially when, that evidence points to conclusions that make us uncomfortable. Because right now, the world's most vulnerable people are paying the price for an ideological experiment in "America First," and we need to understand exactly what that price is.

Before diving into Trump-specific effects, we need to establish the baseline—and it wasn't pretty to begin with. Global suffering was already trending upward before November 2024. Acute food insecurity and child malnutrition rose for the sixth consecutive year in 2024, pushing millions of people to the brink¹. Around 733 million people faced hunger in 2023, equivalent to one in eleven people globally and one in five in Africa². The number of forcibly displaced people rose to 122.6 million by mid-2024, an increase of 11.5% compared to 2023³.

This context matters enormously. You can't just point at suffering that started after January 20th and blame Trump for all of it. That would be lazy analysis. But dismissing all correlations as coincidence would be equally stupid. When you see the same pattern across multiple domains—humanitarian aid cuts leading to immediate program closures, tariffs causing economic disruption, migration restrictions creating new displacement—you're looking at more than coincidence.

The clearest increases in suffering relate to global conflict. About seven and a half months into his second term, conflicts are raging on multiple fronts around the world. Trump announced in June that he had ordered a U.S. strike on Iran's nuclear facilities⁴. As recently as September 2025, Trump alleged that China, Russia and North Korea are conspiring against the United States, as the leaders of each nation were pictured together at Chinese President Xi Jinping's military parade in Beijing⁵. This year could be the most dangerous in the Council on Foreign Relations' seventeen-year history of tracking global conflicts⁶.

The data on specific conflicts is stark. Sudan's Rapid Support Forces inflicted widespread sexual violence on women and girls, while the number of people internally displaced by Sudan's two-year civil war rose to 11 million – more than anywhere else on earth⁷. Famine was confirmed in Zamzam camp, North Darfur in July 2024⁸. In Palestine's Gaza Strip, while the Famine projected in March 2024 was averted due to humanitarian response, if the large-scale military operation and humanitarian blockade continue, acute food insecurity, malnutrition and mortality will surpass Famine thresholds⁹. Russia carried out some of its deadliest attacks on Ukraine's capital in months, while the conflict shows no signs of abating despite Trump's campaign promises to end it quickly¹⁰.

Now, these conflicts obviously predate Trump's second term. But here's where Trump's fingerprints start showing up: The Trump administration's massive foreign aid cuts have aggravated these situations, causing the closure of hospitals in refugee camps in neighboring Thailand, exposing fleeing human rights defenders to risk of deportation and imperilling programmes helping people survive the conflict¹¹. As one analyst put it, his words and deeds are chaotic and inconsistent, and the notion that he's unpredictable hasn't proven to be helpful in any of these three conflicts¹².

But the smoking gun for Trump-caused suffering comes from his sledgehammer approach to U.S. foreign aid. This isn't about correlation—it's direct causation. Trump signed executive orders, aid was cut, people started dying. By February 26, 2025, the State Department announced that it had terminated 5,800 USAID contract awards and 4,100 State Department grants¹⁴. They took a sledgehammer to the foreign aid budget, dismantling USAID and ending thousands of grants¹³. Congress approved clawing back $7.9 billion in foreign aid pledges¹⁵. As of late August 2025, despite claims that lifesaving humanitarian aid would continue, many aid organizations worldwide were still grounded under stop-work orders and unable to secure waivers¹⁶.

The immediate impacts were catastrophic. A memo from USAID senior official Nicholas Enrich warned that millions of people would be affected by the cuts and hundreds of thousands could die¹⁷. A survey of PEPFAR recipients in the first week of the stop-work order found that more than 60% had laid off staff, 36% had completely closed down¹⁸. A nutrition program in Nigeria was terminated, requiring more than 70 health facilities across three states to completely stop treating children with severe acute malnutrition, putting 60,000 children under 5 at immediate risk of death from preventable causes¹⁹. The International Rescue Committee closed a project providing healthcare and nutrition services to more than 115,000 people in South Sudan²⁰. HIV programs in Lesotho, Tanzania and Eswatini were terminated, cutting off support for more than 350,000 people on HIV treatment, including nearly 10,000 children and more than 10,000 HIV positive pregnant women²¹.

The global health security infrastructure that took decades to build? Gone. Our 50-country network for stronger surveillance of deadly diseases from bird flu to swine fever is gone. Our emergency response system that cut response times to global outbreaks from greater than two weeks to less than 48 hours is gone²². The termination of $133 million toward UNICEF's Global Polio Eradication Initiative threatens vaccination programs for around 400 million children annually²³. Enrich wrote that the discontinuation of aid could lead to an additional 200,000 paralytic polio cases a year, and hundreds of millions of cases over the next decade if eradication efforts cease²⁴.

Then there's the economic carnage from Trump's "Liberation Day" tariffs, implemented starting April 5, 2025. These aren't abstract economic theories—they're creating measurable global economic disruption. Under all the imposed tariffs, the weighted average applied tariff would reduce market income by 1.5 percent in 2026 and amount to an average tax increase per US household of $1,254 in 2025 and $1,588 in 2026²⁵. Multiple studies find the tariffs significantly reduce US and global economic growth and increase inflation²⁶. Global real GDP growth is expected to be 1.4% in the fourth quarter of 2025, down from 2.1% at the start of the year²⁷. China, Canada, and the European Union have imposed retaliatory tariffs affecting $330 billion of US exports²⁸.

These economic headwinds hit the world's most vulnerable populations hardest. Economic shocks including inflation and currency devaluation drove hunger in 15 countries affecting 59.4 million people - still nearly double pre-COVID 19 levels²⁹. A Labor Department report showed only 73,000 jobs were added in July, fewer than the 100,000 economists expected³⁰.

Trump's migration policies add another layer of deliberate cruelty. One executive order proclaims that admitting refugees is "detrimental" to US national interests and suspends entry under the refugee program³¹. An estimated 14,600 Afghans eligible for Temporary Protected Status lost it in May, while nearly 8,000 Cameroonians lost it in June³². The termination of humanitarian parole programs left more than half a million individuals without legal status³³. If Trump succeeds in large-scale expulsions as promised, the rhetoric and action will impact European policy debates in 2025, strengthening calls for stricter enforcement³⁴.

The intersection of Trump's aid cuts with global food insecurity creates a particularly devastating case study. In 2024, more than 295 million people across 53 countries experienced acute levels of hunger– an increase of 13.7 million from 2023³⁵. As of November 2024, 343 million people were identified as acutely food insecure in 74 countries where WFP works³⁶. The Global Network anticipates the most significant reduction in humanitarian funding for food and nutrition crises in its history³⁷. The top three donors contributed 62% of public humanitarian funding in 2023, with the US alone providing 43%³⁸. Trump showed how a single government donor can turn off the tap and leave an entire aid system in disarray³⁹.

Look, I'd love to convert everything to quality-adjusted life years and produce a clean numerical answer. But human suffering resists neat quantification, especially over short timeframes. What we can say with confidence: The affected populations run into hundreds of millions of people across multiple domains. The confidence level for Trump causation varies—very high for humanitarian aid cuts, refugee policy changes, and direct economic impacts of tariffs; medium for acceleration of existing conflicts and global economic spillovers; lower for long-term trend changes.

A rigorous analysis requires considering what would have happened under a Harris administration. Would she have maintained or increased humanitarian aid levels? Avoided the tariff-induced economic disruption? Continued refugee resettlement programs? The available evidence suggests dramatically different approaches that would have reduced global suffering. On conflict management, the counterfactual is murkier, though Trump's unilateral and unpredictable approach appears to have made things worse rather than better.

From a utilitarian perspective focused on minimizing suffering, the evidence points to a clear net increase in global human suffering attributable to Trump's second-term policies. The scale is massive—affecting hundreds of millions of people across multiple domains of human welfare. But what's more troubling than the scale is the deliberateness. Unlike natural disasters or economic cycles, much of this suffering results from explicit policy choices: cutting aid, imposing tariffs, restricting refugee admissions, withdrawing from global health partnerships. As recently as September 5, 2025, Trump signed an executive order to rebrand the Pentagon as the "Department of War," reflecting his administration's increasingly militaristic approach⁴¹. One hundred days into his second term, President Trump showed only utter contempt for universal human rights, deliberately targeting vital institutions designed to make the world safer and fairer⁴⁰.

The trends are deeply concerning. As one humanitarian leader put it, this is more than a failure of systems – it's a failure of humanity. Hunger in the 21st century is indefensible⁴². Existing crises are being accelerated by policy choices. This is the biggest crisis humanitarian experts have seen in their lifetimes⁴³. The global humanitarian system's dependence on U.S. funding has been exposed as a critical vulnerability. European countries won't fill the breach—Germany, France, and the U.K. have announced they'll cut back on foreign aid⁴⁴.

If we were keeping a ledger of global human welfare, the entries since Trump's election would be overwhelmingly negative. As we approach the end of 2025, the Global Humanitarian Overview shows that humanitarian needs continue to reach unprecedented levels, with over 295 million people in 53 countries requiring assistance⁴⁵. Hundreds of millions of people face increased food insecurity, reduced access to healthcare, greater economic hardship, and diminished prospects for safety and asylum. While some of these trends predate Trump, his administration has measurably accelerated and amplified global suffering through deliberate policy choices. The "net gain" in suffering isn't just a number—it represents a moral catastrophe unfolding in real time. These cuts undermine the humanitarian infrastructure that enables displaced people to access protection, placing already marginalized people in acute danger⁴⁶.

The question for those of us observing from positions of relative safety isn't whether this suffering has increased (the data makes that clear). The question is what moral obligations that imposes on us, and how we can work to reverse these trends. In a world of finite resources, every policy choice involves tradeoffs. But the evidence suggests that Trump's approach has systematically prioritized symbolic politics and economic nationalism over human welfare, with devastating consequences for the world's most vulnerable people.

The ledger is clear. The question is whether anyone with power is reading it.

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