You know that the terror of famine is hanging over a place when you begin to see plastic bracelets to measure the thickness of the arms of affected children; Those same bracelets also make hope visible, because they mean that there are doctors caring for the weak among the weak. These bracelets are already part of the health landscape in the town of Baidoa (Somalia)which is suffering from a serious humanitarian crisis caused by war, forced displacement and a recurring drought with four failed rainy seasons.
At least four million people face food insecurity. Nearly two million children under five years of age may suffer from acute malnutrition by mid-2026. On November 10, the Federal Government of Somalia formally declared a drought emergency and requested urgent international help as conditions deteriorated. “The cuts have led to less supply and distribution of therapeutic milk, which prevents many Somali children from falling into severe malnutrition. In addition, also because of the cuts, there are fewer basic health and nutrition services in rural areas,” he explains to THE NEWSPAPER Rachel Gonzalezcoordinator of Doctors Without Borders (MSF) Spain.
“So the number of children who have to receive care has increased. In the nutrition service we have in the Mudug region, the number of hospitalized children has gone from 700 between January and November 2024 to 1,700 hospitalized in the same period this year. At the Baidoa City Regional Hospital, we have spent from 8,700 to 12,600 cases this year. We fear that everything will get worse soon, because in March the United Kingdom should renew its key aid to Somali health.” The withdrawal of funds has taken into account Somalia a chain effect. The United Nations World Food Programme, for example, has limited food aid to 350,000 people, even though there are 3.9 million in need.
Doctors Without Borders Cooperator in Sudan / Doctors without Borders
Closure of USAID programs
“It has been a very traumatic year for cooperation and humanitarian aid, in shock since the closure of USAID (the US humanitarian aid agency) and the cuts in countries like France and Germany and, to a lesser extent, the United Kingdom were announced,” he said in conversation with EL PERIÓDICO. Paco ReyCo-Director of the Institute for Conflict Studies and Humanitarian Action. The organization has just presented, together with Doctors Without Borders, its balance of humanitarian action for 2024.
Last year had already been a year of cuts. About 5,000 million less in humanitarian aid alone, one of the two legs next to the Official Development Assistance (ODA)a 10% reduction. The reduction for 2025 is estimated to be 34% less compared to the record of 2023. Everything is getting worse very quickly.
There have been thousands of layoffs in the main international agencies: UNHCR, UNICEF, FAO, etc. The United Nations tries to hold on by applying what has been called ““humanitarian reset”. “Many agencies have cut more than 25% of their staff, and they continue to lay off. Until now, they had committed funds from previous years, but they are running out, especially at headquarters,” says the expert. “All of this has had an impact in certain areas more than others: sexual and reproductive health, gender violence and protection, refugees.” Everything that the new policy disapproves. “It is regressive: Everything that has to do with sexual and reproductive rights is threatened, after decades of progress. The United States was the largest donor in these programs, with 40% of the total,” emphasizes Raquel González.
“Hyperprioritization” in humanitarian action
To move forward, NGOs are applying the paradigm of “hyperprioritization”: focus on those programs that serve the population with the greatest need, and abandon those that seek substantive and lasting solutions to the problems. “Everything focuses only on saving lives, in a very outdated vision of cooperation that ignores how to help them in the long term,” says Rey.
On the ground, the impact is deadly. Following the US cuts, health staff at South Sudan’s Renk County Hospital stopped getting paid. The maternity and pediatric wards were left empty. That same country has recently suffered a cholera outbreak with more infections than expected. The health system is very fragile, and funding cuts have forced the closure of health centers and essential services, such as water distribution, key to preventing the spread of cholera, explains Raquel González. The result: 93,000 cases and 1,500 deaths from the disease. Now, the country is facing a hepatitis C outbreak.
Spain maintains the rate
Is there anyone else filling the void left by the big contributors? The short answer is no one. China is increasing its contribution, but the data it provides is very opaque and mixes trade issues with ODA: “It is known that it is growing especially because we see more Chinese presence on the ground,” says Rey.
Spain has not yet given updated figures for this year, but in 2024 it maintained the rate in global Official Development Assistance (ODA) figures, with a 11.8% more than the previous year. The humanitarian component, however, has been reduced, partly because of the initial effect of increased aid to Ukraine in the early years of the war.
This year Seville hosted the IV International Conference on Financing for Development of the United Nations. It was lackluster because practically no head of state or government of the great powers attended the meeting, with the exception of the French president. Emmanuel Macron. Governments are now more concerned about defense spending and rearmament in an increasingly violent and ruleless world.
The debt of rich nations to poor ones continues to eat up development aid, in a vicious circle. At the Seville summit, progress was made, for example, so that when accounting for aid this debt would not be counted.
Humanitarian organizations warn: aid is not cut in numbers, but in lives. And 2025 has made it clear that the weakest pay the bill.
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