In a year marked by mounting global health crises and shifting U.S. foreign policy, a storm of controversy has erupted over the Trump administration’s dramatic cuts to international aid—especially funding for reproductive health supplies. As reports of nearly $10 million worth of contraceptives languishing in a Belgian warehouse surfaced, advocates, global health leaders, and philanthropists like Bill Gates sounded the alarm about the far-reaching human toll of these policy changes.
Back in July 2025, news broke that the Trump administration intended to destroy a massive stockpile of contraceptives—birth control pills, IUDs, hormonal implants, and more—purchased by the United States Agency for International Development (USAID) before its downsizing and transfer to Secretary of State Marco Rubio’s oversight earlier that year. By September, rumors swirled that the supplies had already been destroyed. Later confirmation, however, revealed that the products remained intact in storage, though their future was anything but secure.
These contraceptives were never intended for American medicine cabinets. Instead, they were earmarked for low- and middle-income countries, where an estimated 214 million women want to avoid pregnancy but lack reliable access to birth control. The need is urgent: by late 2025, at least three African nations had already exhausted at least one form of contraception, with 13 more at high risk of running out and 21 facing moderate shortages.
Advocacy groups wasted no time mobilizing. Dozens of organizations, including heavyweights like the Bill & Melinda Gates Foundation, signed an open letter to Secretary Rubio urging the administration to reverse course. “It is not too late to do the right thing,” the letter implored. Some even offered to purchase the contraceptives outright and distribute them themselves, hoping to avert what they saw as a looming disaster.
According to the Reproductive Health Supplies Coalition, the stakes could not be higher. Destroying the contraceptives would likely result in 362,000 unintended pregnancies, 161,000 unplanned births, 110,000 unsafe abortions, and a staggering 718 preventable maternal deaths. And those figures, advocates warn, could climb even higher as funding cuts ripple through already-vulnerable health systems.
For many, the issue is not just about public health, but about economic and social opportunity. Caitlin Horrigan, Senior Director of Global Advocacy for Planned Parenthood, told The Borgen Project that without aid, “the increase in unintended pregnancies would mean an increase in girls dropping out of school and women missing out on economic opportunities.” She called the loss of these supplies “a serious loss of critical tools that contribute to a lot of goals that the U.S. government used to believe in; improving health, achieving gender equality, reducing poverty.”
The Trump administration’s decision earlier in 2025 to end financial support for family planning programs in developing countries interrupted nearly six decades of U.S. leadership in global reproductive health. According to a Guttmacher Institute analysis, the U.S. had provided 40% of the funding for family planning in 31 developing countries, supplying contraceptives for more than 47 million women and couples, preventing 17.1 million unplanned pregnancies, and averting 34,000 maternal deaths annually.
The effects have been swift and severe. At a recent convening of global health leaders hosted by Columbia University’s Global Health Action and Evidence Program, aid workers from Kenya described the impact on the ground. As contraceptive stocks dwindled, progress on gender equity, maternal health, and educational opportunities for girls began to unravel. “We’ve tried for years to reduce unplanned pregnancies, keep girls in school, but now contraceptive supplies are limited or nonexistent. That will affect their livelihoods and education,” one Nairobi-based development expert said.
Health experts emphasized that family planning is not just about choice, but about safety. “People may have pregnancies too close together, and that can be bad for the health of both people becoming pregnant, as well as their children and families,” said Kelly Blanchard, president of Ibis Reproductive Health. For those with pre-existing health conditions, Blanchard added, pregnancy itself can be directly dangerous.
As the crisis unfolded, Bill Gates emerged as one of the most vocal critics of the aid cuts. In a December 12, 2025 interview with Politico, Gates did not mince words: “There were sudden and massive cuts—you just can’t deny that’s led to lots of deaths.” He pointed to the Gates Foundation’s 2025 Goalkeepers report, which projected that for the first time this century, the number of children dying before their fifth birthday would rise—from 4.6 million in 2024 to an estimated 4.8 million in 2025, an increase of more than 200,000. “Nobody wants to take responsibility for the tragedy that’s going on here,” Gates lamented.
Gates also acknowledged that the U.S. is not alone in slashing aid; the UK and Germany have also scaled back their commitments. But he warned that philanthropy alone cannot fill the gap left by government cuts. Mark Suzman, CEO of the Gates Foundation, told The Independent, “By far, the largest single cause of death is the cuts in international aid. When you pull back at short notice, that has consequences, and sadly those consequences are measured in human lives.”
Despite his criticism, Gates expressed a willingness to work with President Trump and Secretary Rubio, saying, “In my dialogue with President Trump, he clearly cares about these issues and wants to find a generous level for the spending so that the US won’t be responsible for these big increases [in deaths].” Gates noted that he’d had “great conversations” with Trump about eradicating polio, and that the president “would love to be the leader in charge if the disease is finally eradicated”—even as vaccine skeptics like Robert F. Kennedy Jr. hold sway in the administration.
The White House, for its part, has pushed back strongly against Gates’ claims. Spokesperson Anna Kelly insisted, “This is totally false—America remains the most generous country in the world because President Trump has a humanitarian heart, and partner countries want to be self-reliant in addressing the needs of their people. The Trump administration is ensuring all programs funded by American taxpayers align with American interests, just as this President was elected to do.” A senior administration official added that U.S. aid would continue but would be “much more successful and much more effective,” focusing on direct assistance rather than large-scale NGO projects.
Meanwhile, with some contraceptives in the Belgian stockpile reportedly beginning to expire, advocates are doubling down on efforts to preserve the remaining supplies and push for renewed international support. As Kelly Blanchard put it, “High quality sexual reproductive healthcare, information and services should be easy to access and affordable for everyone, available without unnecessary medical requirements or legal impediments or geographic barriers.”
For now, the fate of millions hangs in the balance, as policymakers, philanthropists, and advocates wrestle over the future of U.S. foreign aid—and the lives that depend on it.
