The Trump administration’s efforts to dismantle the United States Agency for International Development (USAID) has led to the elimination of necessary tools for tracking health indicators in other countries. Trump’s cuts include the Demographic and Health Surveys program, also regarded as the DHS program, which collected data in 90 low- and middle-income countries, including Afghanistan, Burkina Faso, and Cambodia.
The DHS program provided survey data on health indicators such as maternal and child health, morality, nutrition, and HIV/AIDS. While many countries rely solely on markers provided by census data to evaluate public health issues, the DHS program recorded critical aspects of household health, including mortality data, height and weight, and nutrition status of children and adults, among others. The data was then used to track the progress of interventions and establish benchmarks for local scientists, public health officials, and government agencies. Many countries relied on DHS data for guidance on resource allocation and policy adjustments, now facing an uncertain future and having to mobilize due to USAID’s sudden departure.
The program started in 1984 as a project funded through USAID. In 2001, the DHS program’s work in understanding HIV prevalence resulted in an “international reassessment” of the AIDS epidemic. The organization also boasts free access to data for healthcare providers, policymakers, researchers, and other stakeholders. In April 2024, the ICF, a consulting group that helps to implement the DHS program, was awarded a contract of $236 million for a five-year term.
At the time of publication, the DHS program website remains online, reading, “[due] to the on-going review of US foreign assistance programs, The DHS Program is currently on pause. We are unable to respond to any data or other requests at this time. We ask for your patience.” Registrations for new users to access existing data have also been put on hold at this time.
The New York Times reports that program administrators were told to “stop all work, terminate subcontracts, and place no further orders,” effective immediately. The Times also says that only 11 members of the previously 80-strong staff remain. Relationships with contractors were also terminated.
In the meantime, several public health officials and experts have called for the restoration of the website. A call to action written by around 30 researchers urges for the continuation of ongoing projects in over 25 countries, which had been collecting decades worth of data. The letter also offers commentary on the future of global public health, as current students would lack the necessary data to build upon classroom exercises and lessons.
The fate of the DHS program underscores a larger trend in the Trump administration’s approach to foreign aid. The dismantling of USAID, with thousands of expected layoffs, signals a retreat from global health initiatives that the U.S. government has long supported. The absence of DHS data will hinder efforts to evaluate the effects of foreign aid cuts, leaving the international community in the dark about the real impact of reduced funding on vulnerable populations.
Despite calls from researchers and health advocates to restore DHS, the program remains in limbo. The future of America’s role in global health remains uncertain, and its immediate consequences are now reverberating around the world.
By Lois Angelo