The U.S. Agency for International Development (USAID) quietly cancelled a critical contract to supply emergency kits for rape survivors in eastern Congo earlier this year, just as violence escalated and the number of sexual assault cases soared, according to the United Nations and multiple humanitarian organizations.

The cancellation left thousands of women without access to life-saving medical care, including HIV prevention and emergency contraception. The kits, funded by the U.S. government, were intended to supply more than 2,000 health centers in Congo’s conflict-ravaged provinces for the year.

Women returnees prepare doughnuts and pancakes as part of their empowerment program after the visit by United Nations Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Tom Fletcher, to assess the humanitarian situation of populations returning from recent conflicts between the M23 rebels and the Armed Forces of the Democratic Republic of the Congo (FARDC), in Buhumba, Nyiragongo territory, Democratic Republic of Congo June 26, 2025. REUTERS/Arlette Bashizi

The decision, not previously reported, followed a broader freeze on foreign aid imposed by President Donald Trump after taking office in January. USAID halted the contract in its final stages, leaving health providers scrambling to respond to a worsening crisis.

“When you look into the eyes of a rape victim, you get the impression that her gaze is dead,” said one healthcare worker in Congo to Reuters, who spoke anonymously due to fear of reprisals. “You never forget telling her you don’t have any medicine, that you don’t know how to help her, and asking her to leave.”

Aid Disrupted, Lives at Risk

The kits, typically distributed in the critical 72-hour window following an assault, include antiretroviral drugs, antibiotics, and emergency contraceptives. They are designed to prevent the transmission of HIV and other sexually transmitted infections, and to avoid unwanted pregnancies.

FILE PHOTO: Burundian volunteers prepare food for Congolese families at Rugombo Stadium, after Congolese fled from renewed clashes between M23 rebels and the Armed Forces of the Democratic Republic of the Congo (FARDC), in Rugombo commune of Cibitoke Province, Burundi February 18, 2025. REUTERS/Evrard Ngendakumana/File Photo

The contract was cancelled just as Rwanda-backed M23 rebels advanced across eastern Congo in January, seizing major cities and displacing thousands. The United Nations estimates at least 67,000 incidents of rape have occurred during the recent surge in conflict, with many more believed to be unreported.

According to the United Nations Population Fund (UNFPA), only seven of 34 health zones in North Kivu still have even a minimal supply of kits. Less than one in four survivors are receiving treatment, and only 13% receive HIV prevention within the recommended timeframe.

Funding Vacuum

The decision traces back to Trump’s directive to pause foreign aid and reduce U.S. contributions to global assistance programs. The administration has argued that America shoulders a disproportionate share of global aid spending and is pushing for other countries to step up. The U.S. distributed $65 billion in foreign aid last year, with nearly half administered by USAID.

Internally displaced Congolese women prepare vegetables outside their houses after they fled, following clashes between fighters linked Allied Democratic Forces (ADF), a Congo-based rebel group and the Armed Forces of the Democratic Republic of the Congo (FARDC), in Oicha, North Kivu Province of Democratic Republic of Congo June 21, 2025. REUTERS/Gradel Muyisa Mumbere

While the U.S. State Department has said it remains committed to life-saving programs, the post-rape kit contract remains cancelled. Aid organizations are now racing to fill the gap.

UNFPA is appealing for $35 million from donors including the Gates Foundation and other Western nations to restore post-rape care services. Without funding, the consequences could be dire: the UN warns of increased HIV transmission, unsafe abortions, unwanted pregnancies, and deaths among survivors unable to access medical care.

“This isn’t just about money,” said Dalmonte to Reuters. “It’s about whether survivors of one of the world’s most brutal conflicts will receive the basic care they deserve.”