A dramatic purge and counter-purge at USAID played out in emails obtained by The Washington Post, as Trump’s pause on foreign aid upends humanitarian work around the world.

USAID is in charge of ordering the drugs used by the President's Emergency Plan for AIDS Relief (PEPFAR) in its programs that keep 20 million people with HIV alive, Gawande said. This work stoppage means that pharmacy stocking in more than 25 countries suddenly stops, as do payments to partner organizations, which are mostly locally run.

On Monday, top officials at U.S. Agency for International Development (USAID) were put on leave for allegedly not abiding by President Trump's executive order to freeze much of U.S. foreign aid.