For more than 50 years, Jhpiego—a nonprofit global health affiliate of Johns Hopkins University—has worked to advance U.S. interests while improving health outcomes and saving lives around the globe. Backed in part by funding from the United States Agency for International Development—better known as USAID—Jhpiego and its partners help protect the lives of mothers and families; prevent and contain the spread of deadly diseases such as HIV, malaria, and tuberculosis; and build resilient health care solutions in low-resource communities.
But recent federal cuts curtailing USAID—the State Department announced Monday that more than 80% of USAID's programs had been cancelled—mark an unexpected turn for an organization with a long and proud tradition of building relationships abroad and delivering lifesaving interventions. The impact of the USAID cuts is also being felt at the university's Bloomberg School of Public Health—particularly at the Johns Hopkins Center for Communication Programs and in the Department of International Health—as well as at the School of Medicine.
With the termination of more than $800 million in USAID grants at the university, Johns Hopkins has had to wind down much of its USAID grant-related activities in Baltimore and internationally. This has resulted in the loss of more than 2,200 jobs—1,975 positions in 44 countries and another 247 positions in the U.S., most of them in Baltimore. An additional 29 international and 78 domestic employees will be furloughed with a reduced schedule.
USAID was the largest funding agency for both Jhpiego and CCP, and the significant cuts at the agency led directly to Thursday's job losses at Johns Hopkins. The university will continue its lifesaving work around the world, including via Jhpiego, CCP, and the Department of International Health, working with existing partners while actively seeking new partnerships.
"Today is a profoundly difficult day for our colleagues and for our university, marking a significant loss of exceptional people across the Bloomberg School of Public Health, the School of Medicine, and Jhpiego whose work has advanced the mission of our university," said Ron Daniels, president of Johns Hopkins University.
"Over more than five decades, our colleagues have brought the benefits of research, discovery, and clinical care to mothers, children, and families at home and around the world, from Nepal to Nigeria, from the Western highlands of Guatemala to our hometown of Baltimore. We remain immensely grateful for all they have done for the communities in which they have worked. They made our world better."
The programs terminated by USAID include efforts to accelerate research to eliminate tuberculosis, the world's deadliest infectious disease, which killed an estimated 1.25 million people worldwide in 2023; a project in Tanzania that helps reduce the spread of malaria; services and supports for pregnant mothers in Nigeria and Afghanistan; diarrhea prevention in Bangladesh; HIV/AIDS treatment and prevention in India and Africa; and work in partnership with governments and media in multiple countries to reduce vaccine hesitancy and integrate the malaria vaccine into broader childhood immunization efforts.
"The landscape of global health is shifting, and we are confronting challenges that test our resilience," said Leslie Mancuso, president and CEO of Jhpiego. "Yet the unwavering commitment of our exceptional and talented team to mothers, children, and families remains steadfast. Now more than ever, we must adapt, innovate, and work alongside our partners to ensure access to essential, high-quality care. While obstacles exist, so do opportunities to strengthen our impact and forge new solutions where they are needed most.
"In partnership with national governments, Jhpiego will continue our critical work in the countries we serve, focusing on so many important areas including maternal and newborn health, combating infectious diseases like HIV, malaria, and TB, responding to the increasing burden of women's cancers, and strengthening global health security. With our diverse network of partners and an extensive team of Jhpiego experts around the world, we remain committed to reimagining health systems—harnessing the power of technology, artificial intelligence, private sector innovation, and human-centered design—to bring quality, lifesaving care closer to every woman and her family, no matter where they are."
USAID was established by the Kennedy administration in 1961, at the height of the Cold War, to lead the nation's efforts to alleviate poverty, disease, and humanitarian need in developing nations around the world. In fiscal year 2023, the most recent year for which complete data is available, USAID managed more than $43 billion in combined appropriations and provided assistance to approximately 130 countries.
Jhpiego has been supported by USAID since its founding in 1973 as the Johns Hopkins Program for International Education in Gynecology and Obstetrics. The organization was founded by Theodore M. King, an early innovator in women's health who understood the importance of sharing health breakthroughs with physicians, nurses, and administrators in low- and middle-income countries. Early on, the organization established itself as a leader in women's health training, policy, and guidelines. But as its geographic reach grew, so, too, did the health challenges it encountered. This spurred a broadening of expertise and activities to other health areas, including infection prevention and control, HIV/AIDS, and infectious diseases, in addition to its founding focus on maternal and child health. In 2008, the organization embraced its acronym and became simply Jhpiego.
For more than five decades, Jhpiego has delivered critical care and health care training around the world, supporting populations in Africa, Asia, and the Americas. Each year, Jhpiego reaches more than one billion people in more than 45 countries through programs spanning maternal, newborn, and child health; infectious diseases; strengthening health systems; primary health care; global health security; immunizations; family planning; humanitarian assistance; cancer prevention and detection, particularly breast and cervical cancer; and other essential services for families.
The Center for Communication Programs addresses similar global health issues based on the principle that establishing healthier populations can be achieved through informative communications that change attitudes and reduce health stigmas.
CCP began with founder Phyllis Tilson Piotrow, a professor in the Bloomberg School's Department of Health, Behavior, and Society, who set out to prove communication's effectiveness as a public health tool. The groundwork for CCP was laid in 1978 with a grant from USAID to distribute up-to-date scientific literature in low- and middle-income countries globally, and the project was established as a Bloomberg School center in 1988.
In an interview celebrating CCP's 35th anniversary in 2023, Piotrow spoke of the challenges of convincing other public health experts of the necessity of communications: "At that point, communication was considered a very soft science, and not comparable with epidemiology and other advanced sciences, which was the kind of research that others were doing. We had to work hard to make that case and prove to our donors—chiefly USAID—how we could make communication work. We not only had to prove it ourselves, but also we had to train our counterparts around the world to do the same kind of things we were doing here."
In recent years, CCP has worked in more than 40 countries to promote healthy behaviors that save and improve lives, addressing malaria, infectious diseases, HIV/AIDS, family planning, sanitation and hygiene, and maternal and child health.
"For more than three decades, CCP has empowered people in the U.S. and around the world to make healthier decisions, deeply improving their lives and those of their families," Bloomberg School Dean Ellen MacKenzie said. "From preventing malaria to training thousands of health workers to helping pass laws against child marriage, the work of CCP has made a deep and lasting impact on millions of people across more than 40 countries. I am forever grateful to the faculty and staff for their commitment to partner with and help communities in need."
Not all USAID-funded work at CCP will cease; the center was recently granted a waiver to restart activities to limit the spread of mpox—a viral disease formerly known as monkeypox—in the Democratic Republic of Congo (DRC). CCP and its partners in DRC have returned hundreds of community health workers to their posts as of March 5. These workers constitute the backbone of the DRC's community health care system, going door to door in selected health zones of the capital city Kinshasa to help people take proper precautions against mpox and refer them for care should they present any signs of the disease.
In 2022, an outbreak of mpox that began in Africa made headlines when it reached the shores of Europe and the United States. Over 18 months, the outbreak infected more than 32,000 people and killed 58 people in the United States alone.
"Diseases do not know borders, and in our increasingly interconnected world we must do everything we can to stop diseases like mpox wherever they start," said Debora B. Freitas López, CCP's executive director.
"I am so proud of what we at CCP have accomplished across our history, including reaching more than two billion people with lifesaving messages designed to inspire healthy behaviors," she added. "Our work may look different in the coming months, but our commitment remains the same. We will continue working with key actors around the world, including in the U.S., to improve the lives of many. We know that stronger communities mean healthier communities, and we are committed to those values."
USAID cuts have affected dozens of programs in the Bloomberg School's Department of International Health. The department began in 1961 as the Division of International Health, the first academic program in international health, with a grant from USAID's predecessor, the International Cooperation Agency. Its mandate was to help improve the agency's programs and to train domestic and foreign personnel.
The division became a department in 1967 and has grown to work in more than 90 countries around the world, with thousands of its alumni working on a wide range of global health issues.
"There's still a lot of uncertainty about additional cuts and future global health investments," said Judd Walson, professor and chair of the department. "But I am certain that the cuts will contribute to more vaccine preventable illnesses and deaths and a decrease in women's access to health care, particularly reproductive health services. I also know that we will find a way to carry on our work partnering with communities and institutions, both in the U.S. and globally, to save lives."
