My connection with GAIA Global Health began in Rwanda in 2009.  That’s where I first met Todd Schafer.  His wife, Molly, worked for me in the U.S. Agency for International Development (USAID) field office in Kigali.  Our boys were the same age and, for a couple of years, best buds.  Todd and Molly left Rwanda when Todd was invited to serve as GAIA’s Executive Director.  That’s when I first became a supporter – because I knew any organization Todd ran would do amazing work.

USAID then sent me to Malawi, where I got to see GAIA’s programs up close.  USAID was partnering with GAIA to train nurses and midwives for Malawi’s chronically under-resourced health system.  Virtually all of their trainees remained in Malawi instead of emigrating, a common challenge with these types of programs due to the shortage of nurses and higher pay in rich countries.  As impressive as GAIA’s trainee retention record was, I was even more impressed with their mobile health clinic program, which delivered “last mile” services to hard-to-reach communities in some of the most vulnerable regions of the country.  GAIA seemed to be providing critical services, literally “at the end of the road” (and occasionally beyond), extremely cheaply; in fact, a recent cost-effectiveness analysis suggests GAIA’s mobile clinic program provides the equivalent of an extra year of healthy life for slightly more than $50, the impact benchmark used by renowned philanthropic organization, Coefficient Giving.

It was therefore absolutely gut-wrenching, as the newly appointed head of USAID’s Africa Bureau, responsible for 33 field offices and about $10 billion of annual programming, to watch the Trump administration lay waste to programs like GAIA’s when it cancelled 85 percent of USAID-managed programs in 2025.  As it became clear that the administration intended to shut down USAID, I established two main objectives for my small (remaining) team: take care of our roughly 3,500 staff on the continent and in Washington, DC, and preserve as much of our programming as possible regardless of which U.S. government agency might eventually end up managing it.  I remain extremely proud of how we managed to take care of our people in the face of the outright cruel circumstances foisted upon USAID’s dedicated public servants and their families.  But we completely failed when it came to preserving critical programming, the consequences of which are becoming increasingly clear.  

I am still embarrassed by my government for both what it did and how it did it.  My government did not even have the decency to inform supposed “partner” governments, implementing organizations, communities, and program beneficiaries, all of whom were counting on USAID and the word of the U.S. government to fulfill its commitments, of the actions it intended to take.  The unilateral cancellation of agreements, which gave them no warning and no time to pivot to alternative sources of support, was inexcusable and shameful.  Even more disgraceful is the fact that, to this day – over a year and a half since the administration initiated its “pause” on foreign assistance – GAIA and hundreds of organizations like it have not been paid for legitimate work completed on behalf of the U.S. government.  The U.S. government should pay its bills, full stop.

That sense of shame is why I donated the retention incentive that USAID gave me to GAIA.  USAID offered a “retention incentive” to a small number of laid-off career staff to continue working to manage closeout operations until September 2, 2025, the date USAID was supposed to cease to exist.  I did not require a retention incentive to do whatever I could for as long as I could to take care of our staff and continue to advocate for the preservation of critical lifesaving programs across Africa.  For the sake of my colleagues, I would have remained in my role until September 2 regardless. 

In stark contrast to the U.S. government, GAIA chose to maintain the financial commitment to every single nurse and midwife scholar whose education was supposed to have been covered by USAID.  That it did so makes me proud to be a supporter of GAIA – first as a private donor, then as a USAID Officer, and now as a Board Trustee.  Working with GAIA to support the delivery of “last mile” health services to remote communities in a country and to a people that have meant so much to me and my family has been an encouraging reminder that the same values that powered USAID – belief in human dignity and freedom, generosity of spirit, i.e., the very best of America – remain present even as our government seems to have abandoned them.  

‍Brian Frantz is a Professor of Practice in International Studies at Indiana University, GAIA Board Trustee, and retired USAID Senior Foreign Service Officer.  During his USAID career, he served in East Timor, Rwanda, Malawi, Kenya (covering Somalia), and Washington, DC.  From late January 2025 until his separation in September, he was USAID’s Acting Assistant Administrator for Africa.