Asanda Zondi received a surprising phone call last Thursday, with orders to a health clinic in Vulindlela, South Africa, where she participated in a research study that tested a new device for pregnancy and H.IV. infection.
The process was closed, a nurse told her. The device, a silicone ring inserted into its vagina, had to be removed immediately.
When Mrs Zondi, 22, arrived in the clinic, she learned why: the American Bureau for International Development, which financed the study, had withdrawn financial support and issued a stop-work order to all organizations around the world who receive his money . The abrupt move followed an executive order by President Trump who froze all foreign help for at least 90 days. Since then, the Trump government has taken steps to completely dismantle the agency.
Mrs Zondi's test is one of the dozens that are abruptly frozen, so that people around the world stay behind with experimental drugs and medical products in their bodies, cut off the researchers they keep an eye on and waves of suspicion and fear.
The Ministry of Foreign Affairs, which now supervises USAID, responded to a request for commenting by a reporter to USAID.GOV in Leiden, which no longer contains information, except that all permanent employees are placed on administrative leave. State Secretary Marco Rubio has said that the Agency is wasting and promotes a liberal agenda that is contrary to President Trump's foreign policy.
In interviews, scientists described are prohibited by the conditions of the Stop-Work Order to speak with the news media choices: the stop-work orders are violating and keep taking care of volunteers from the test, or leaving them alone To take on the potential side securities and damage.
The United States are signing for the explanation of Helsinki that contains ethical principles, including medical research, whereby researchers ensure participants during a study and report the results of their findings to the communities where tests were conducted.
Mrs Zondi said she was stunned and scared. She spoke with other women who had registered for the study. “Some people are afraid because we don't know exactly what the reason was,” she said. “We don't really know the real reason to pause the study.”
The stop-work order was so immediately and sweeps that the research staff would violate it if they help the women remove the rings. But Dr. Leila Mansoor, a scientist at the Center for the AIDS research program of research in South Africa (known as Caprisa) and a researcher in the process, decided that she and her team would do this anyway.
“My first thought when I saw this order was that there are rings in people's bodies and you can't leave them,” said Dr. Mansor. “For me, ethics and participants come first. There is a line. “
In the communities where its organization works, people have offered themselves for more than 25 years to test HIV treatments, prevention products and vaccines, which contributes to many of the most important breakthroughs in the field and benefits people worldwide.
That work trusted a carefully built web of trust that has now been destroyed, Dr. Mansor. Building that trust lasted years in South Africa, where the apartheid regime carried out medical experiments with black people in the years of white domination. These fears are reflected in a long history of experiments by researchers and pharmaceutical companies in developing countries and in marginalized population in the United States.
The times identified more than 30 frozen studies that volunteers already had in the care of researchers, including tests from:
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Malaria treatment in children under the age of 5 in Mozambique
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Treatment for Cholera in Bangladesh
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A screen and treatment method for cervical cancer in Malawi
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Tuberculosis treatment for children and teenagers in Peru and South Africa
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Food support for children in Ethiopia
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Interventions for developing early children in Cambodia
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ways to support pregnant and breastfeeding to reduce malnutrition in Jordan
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An MRNA vaccination technology for HIV in South Africa
It is difficult to know that the total number of closed tests, or how many people are affected, because the rapid demolition of USAID has erased the public record in recent days. In addition to the disabled website, the agency no longer has a communication department. And the Stop-Work order forbids every implementation agency to publicly speak of what happened.
Around 100 people are inoculated in England with an experimental malaria vaccine in two clinical studies. Now they no longer have access to the clinical test staff if vaccine would cause a negative reaction in their bodies. The test is an attempt to find a vaccine of the next generation better than it is now used in Africa; That shot protects children against about a third of the malaria cases, but researchers hoped to find a vaccine that offered much more protection. Malaria remains a global worldwide murderer of children; 600,000 people died of the disease in 2023, the newest figure available.
If the test was not frozen, the participants would come to a clinic routinely to be checked for adverse physical effects and to have blood and cell samples taken to see if the vaccine worked. The participants are intended to be followed for two years to assess the safety of the vaccine.
A scientist who worked on the process said that she hoped that partners from the University of Oxford, where it was performed, shuffled staff to respond if a participant fell ill. But she was fired last week and no longer has access to information about the test. She spoke on condition of anonymity because she was afraid of jeopardizing her ability to work on malaria research that the US could perform in the future.
“It is unethical to test something in people without bringing it to the complete completion of studies,” she said. “You put them in danger for no good reason.”
If the Stop-Work order were to come later this year, the newly vaccinated volunteers might have been in a still precarious position. They were planned to be deliberately infected with malaria to see if the experimental vaccine protected them against the disease.
Dr. Sharon Hillier, a professor in reproductive infectious diseases at the University of Pittsburgh, was director of a five-year-old, $ 125 million test that was financed by USAID to test the safety and efficacy of six new HIV prevention products. They include bi -monthly injections, quickly solved vaginal inserts and vaginal rings.
With the study of the study, she and her colleagues cannot process biological samples, analyze the data they have already collected or communicate findings to participants or the cooperation of government agencies in countries where the tests were carried out. These are requirements under the Helsinki agreement.
“We have betrayed the confidence of Ministries of Health and the regulatory authorities in the countries where we were at work and of the women who agreed to be in our studies who were told that they would be cared for,” Dr. . Hillier. “I have never seen anything like this in my 40 years of international research. It is unethical, it is dangerous and it is reckless. “
Even tests that were not fully or partially financed by USAID were turmManized because they used medical or development infrastructure that was supported by the agency and is no longer operational. Millions of dollars from American taxpayers who have already been issued to start those tests are not recovered.
The shutdowns also have business consequences. Many of those tests were partnerships with American pharmaceutical companies that tested products that they hoped to sell abroad.
“This made it impossible for pharmaceutical companies to do research in these countries,” said Dr. Hillier.
Another HIV study, called Catalyst, has thousands of volunteers in five countries who test an injectable medicine that long-acting Cabotegravir is called. Participants received bi -monthly injections to maintain a sufficient level of the drug in their bodies to prevent HIV infection. Without regular injections, or a carefully managed end to the use of the medicine, the participants will not have enough cabotegravir to stop a new infection, but there will be enough in their systems that, if they contract the virus, the It could easily be Mutate to become drug resistant, said Dr. Kenneth Ngure, president-elect of the International AIDS Society.
This is an important threat to the volunteers of the trial and also for millions of people who live with HIV, because Cabotegravir is closely related to a medicine that is already used worldwide in the standard treatment of the virus. The development of resistance can be catastrophic, said Dr. Ngure: “It's wrong on so many levels – you can't just stop.”
A clinical study of the development organization FHI 360, which implemented a lot of health programs and studies funded by USAID, tested a biodegradable hormonal implant to prevent pregnancy. Now there are women in the Dominican Republic with the devices in their bodies without constant care.
Another study, in Uganda, tested a new regime of tuberculosis treatment for children. The Stop-Work order cuts that children from possible life-saving medication.
“You can't walk away from them, you just can't,” said a researcher in that test.
