In January 2024, while en route to the Zimbabwe-Mozambique border to establish the Emergency Project's first relief effort in the region, our team witnessed a disastrous head-on collision between a bus and tractor trailer. Amid the mangled wreckage, local villagers surrounded the scene—desperate to help but unequipped to do so. Civilian passersby took it upon themselves to transport the injured and dead over long distances to reach hospitals—or morgues.
One surviving victim seemed beyond help as his legs lay pinned beneath the engine of his truck. Our team of medical volunteers lifted the engine with a car jack, fashioned a field tourniquet and splint on scene, and used a portable ultrasound to assess for internal injuries. Thanks to our emergency medical training, the man had a fighting chance. Days later, we learned he had made it to the hospital alive. Sadly, the care he needed did not exist.
Now, almost a year later, a nearly identical catastrophe has occurred in rural Zimbabwe, again a bus crash involving a tractor trailer. This time, 25 died and dozens more were injured. The scope of devastation spurred President Emmerson Mnangagwa to declare the accident a national disaster.
Zimbabwe's disaster is not an isolated tragedy—it reflects a global failure. The World Health Organization (WHO) reports that more than half of all deaths worldwide result from inadequate emergency care. Unsurprisingly, countries like Zimbabwe—under-resourced and suffering from decades or centuries of marginalization—feel the brunt of this shortfall. Trauma alone kills millions each year globally, yet in low-income, rural locales, survival often comes down to luck.
Zimbabwe's disaster is not an isolated tragedy—it reflects a global failure
At a time when global cooperation could dramatically reduce these disparities, the United States is retreating from the very institutions designed to prevent such disasters from becoming death sentences. The WHO—responsible for delivering health care to nearly 2 billion of the world's poorest—is at risk of losing its largest funder. Given the growing availability of diagnostic technologies akin to what we utilized at the accident scene, satellite internet, and telehealth assistance, global cooperation has more power than ever to make a tangible difference on these sobering disparities.
The Donald Trump administration is actively dismantling the U.S. Agency for International Development (USAID), which has provided emergency response and health initiatives to some of the most vulnerable regions on earth. The week before Zimbabwe's national disaster, the unofficial Department of Government Efficiency announced cuts to disease prevention programs in Zimbabwe—amounting to $360 million—despite the country's many ongoing health crises.
One of the responsibilities of the USAID's Humanitarian Assistance Bureau (HBA) is to help bolster emergency rooms and emergency response systems. Now, with more than 95% of USAID staff reportedly cut and 83% of programs canceled—leaving only dozens at the HBA and the Global Health Bureau that leads the U.S. global security efforts against infectious diseases—emergency rooms in the Global South have drastically limited access to resources.
Yes, the WHO has earned some scrutiny, but defunding global health isn't reform—it's abandonment. The consequences won't immediately be felt in Washington but instead on roadsides in rural Zimbabwe, in maternity wards in Somalia, in bombed-out hospitals in Sudan and Gaza. It will be measured not in dollars saved but in lives lost. Poised to combat human disasters such as these, the Emergency Project, along with scores of other organizations, must now forgo global missions years in the making because of diminished or eliminated resources on the ground.
The Emergency Project received a USAID-funded grant through Peace Corps in Guinea to support a long-term initiative aimed at improving maternal and infant mortality through access to diagnostic imaging technology. In preparation for our planned 2025 trip, we delivered portable ultrasound devices to the region and trained local providers. However, with the project's abrupt shutdown, only some of the equipment remains, while the rest has been rerouted to Haiti.
In a 2023 report, the vilified WHO took accountability for its pandemic missteps and urged, "It is vital that the world now seizes the chance to do things differently." COVID-19's devastation, it argued, should fuel urgent efforts to strengthen global preparedness, prevention, and response to health emergencies. Yet currently, colleagues in the field report dwindling or absent supplies of life-saving medicines for tuberculosis and HIV—an invitation for diseases greatly diminished by global cooperation, to regain ground against humankind. Health partners in Kenya and Madagascar will have no time to grieve children lost because of the abrupt cessation of successful programs against famine as countless more deaths and widespread illness loom. One indisputable takeaway from the postpandemic period is that diseases care little about borders and nation-states.
Global health initiatives are investments, not charities. For every dollar spent on global health through the WHO , $35 is returned in public value. In its seven years, USAID's INVEST program mobilized more than $1.6 billion in private capital. The domino effect is one that the private sector understands and that global health initiatives exemplify: Saving lives is good for growth. As key administration figures bemoan the economic costs of declining global birth rates, the Trump administration is slashing programs that accomplish the same ends by upholding health and disease-free lives.
For every dollar spent on global health through the WHO, $35 is returned in public value
As Zimbabwe's latest bus disaster unfolded, ensuing and anticipated details emerged about lives lost en route to faraway hospitals due to a lack of critical medical devices and expertise. Emergency Project's impassioned physicians, nurses, and volunteers are determined to improve outcomes like these, yet the ability to do so has been crippled in the span of weeks.
This crisis extends far beyond a single bus crash—it's about a world in which survival should be a right, not a privilege. Days after encountering that first wreck, our team came upon another: no ambulance, no medics, just a pickup truck and an aluminum coffin, arriving faster than help ever could.
Moments like these convey how for much of the world, surviving what should be nonfatal trauma is often a rarity. As emergency care remains out of reach for most, the United States is retreating from lifelines that stand between a fighting chance and a waiting grave for tens of millions.
The next time disaster strikes in a faraway country, reframe your gaze, and you will likely see the shortsighted cost of neglect.
EDITOR'S NOTE: Sahil Bhatia contributed to this article.
