The work of two Baltimore organizations charged with improving the health of millions of people around the world screeched to a halt this week when they lost their main funding source, the U.S. Agency for International Development.

Johns Hopkins University-affiliated Jhpiego and Center for Communication Programs have received stop-work orders, affecting at least 4,400 employees worldwide and programs that treat people with cancer and HIV, train local doctors and ensure the health of newborn babies in poor nations.

Seeming to cement the pause, virtually the entire staff of USAID was told Tuesday night by the Trump administration’s main cost-cutter, Elon Musk’s Department of Government Efficiency, or DOGE, that they would be off the job by Friday and workers abroad would be brought home.

“It’s frightening,” said a worker at Jhpiego, who did not want to be named. The worker said staff was still reporting to work and were told they’d be paid at least until the end of February.

Jhpiego was founded more than a half-century ago and has a focus on improving health for women and children. From its office in Fells Point, it manages hundreds of millions of dollars in grants from USAID and other federal agencies and philanthropic organizations, reaching more than 40 countries at any one time.

Humanitarian groups are in turmoil, the worker and a Washington-based USAID employee told The Banner. They did not want to be named because they didn’t have permission to comment and feared retribution by President Donald Trump’s administration.

Both said they worried about their careers — and have deeper concerns about the future of the work they have been doing in some of the most unstable and poorest parts of the world. The programs save countless lives, they said, but also aim to protect the health and security of Americans.

“The level of experience that could be lost is massive,” the staffer said, “and the effects enormous.”

Alice Payne Merritt, a former deputy director of the Center for Communication Programs, said the organization could have thousands of staff globally at any one time. There are about 150 employees at the Baltimore headquarters and nearby offices who oversee some $100 million in programs in 40 to 50 countries.

The group works with local partners to ensure that people learn about and receive HIV/AIDS medications, as well as nets to protect children from malaria, a leading cause of death among children in Africa. It trains local officials to continue that work.

Other countries benefit, and so do Americans, she said.

“COVID, malaria, mpox, Ebola, all those things came here from other places. If we can contain them in one place, it stops them from spreading here,” she said. “If humanitarian aid is gutted, we can’t do anything.”

USAID’s budget of about $40 billion is less than 1% of the federal budget, and international development experts say that’s a relatively small investment for the return.

Allyson Bear, a Baltimore-based international development expert and former USAID foreign service officer, said USAID is one of the three legs in the national security stool, along with State Department diplomacy and Defense Department military power.

“USAID changes hearts and minds; it’s a soft power that helps us gain allies,” she said. “We go to these countries and ask them to accept this aid for them, but it’s really for us.”

She said U.S. workers, for example, have largely prevented Ebola cases here despite multiple outbreaks in other parts of the world over the years.

Days ago, Ebola broke out in Uganda, “and we’re not there,” she said.

Leaving so abruptly can make the governments, public health workers and the public in those countries feel betrayed, she and others said. They could welcome adversaries such as China, which could gain a foothold in enough places and replace the United States as the biggest superpower.

That can play out in many ways, including when there is another pandemic, like COVID-19, and Americans can’t put themselves first in line for supplies and therapies.

“What happens when China moves into the top spot and bosses us around?” Bear said.

The moves to gut USAID was called “puzzling” by Maryland Rep. Kweisi Mfume, adding the approach to governing had “seemingly no regard for deliberate or thought-out reform.”

It was called “illegal” by Sen. Chris Van Hollen after he and other Maryland Democratic lawmakers, including Reps. Jamie Raskin and Johnny Olszewski Jr., were denied entry into USAID’s headquarters in Washington.

Lawmakers say funding is a constitutionally designated duty of Congress and there already are several lawsuits to stop the dismantling of federal agencies.

The blunt cuts also extend to other organizations in Baltimore, including academic institutions that rely on billions in funding from the National Institutes of Health for biomedical research and humanitarian nonprofits that focus on aiding refugees and those seeking asylum.

Baltimore is home to several organizations that assist refugees and asylum seekers, and officials also fear massive cuts, further threatening jobs, the area economy, and risking harms to international relationships.

One of those organizations, Global Refuge, a nonprofit formerly known as Lutheran Immigration and Refugee Services that helps immigrants, refugees and asylum seekers, defended its work after Trump’s former National Security Advisor Michael Flynn called it a “money laundering operation.”

A reply from Elon Musk said DOGE was “shutting down these illegal payments.”

Global Refuge condemned the “false accusations lodged against our humanitarian work.”

Executive orders and memos issued by the Trump administration have canceled travel for thousands of approved refugees and ordered resettlement agencies receiving federal funds to stop providing services to refugees already here.

There is a lot of anxiety about what is coming, said Tim Young, spokesman for Global Refuge.

“It’s good to know that we are not alone in this,” he said.