The United States, the world's biggest donor, froze virtually all foreign aid on Friday, making exceptions only for emergency food, and military funding for Israel and Egypt.
Secretary of State Marco Rubio sent an internal memo days after President Donald Trump took office vowing an "America First" policy of tightly restricting assistance overseas.
"No new funds shall be obligated for new awards or extensions of existing awards until each proposed new award or extension has been reviewed and approved," said the memo to staff seen by AFP.
The sweeping order appears to affect everything from development assistance to military aid -- including to Ukraine, which received billions of dollars in weapons under Trump's predecessor Joe Biden as it tries to repel a Russian invasion.
The directive also means a pause of at least several months of US funding for PEPFAR, the anti-HIV/AIDS initiative that buys anti-retroviral drugs to treat the disease in developing countries, largely in Africa.
Launched under president George W. Bush in 2003, PEPFAR is credited with saving some 26 million lives and until recently enjoyed broad popular support along partisan lines in Washington.
But the memo explicitly made exceptions for military assistance to Israel -- whose longstanding major arms packages from the United States have expanded further since the Gaza war -- and Egypt, which has received generous US defense funding since it signed a peace treaty with Israel in 1979.
Rubio also made an exception for US contributions to emergency food assistance, which the United States has been contributing following crises around the world including in Sudan and Syria.
Lawmakers from the rival Democratic Party said that more than 20 million people relied on medication through PEPFAR and 63 million people on US-funded anti-malaria efforts including nets.
"For years, Republicans in Congress have decried what they see as a lack of US credibility vis-a-vis countries like China, Russia, and Iran," said Representative Gregory Meeks, the top Democrat on the House Foreign Relations Committee, and Representative Lois Frankel.
"Now our credibility is on the line, and it appears we will cut and run from American commitments to our partners around the world," they wrote in a letter.
Washington has long leveraged aid as a tool of its foreign policy, saying it cares about development and drawing a contrast with China, which is primarily concerned about seeking natural resources.
Meeks and Frankel also noted that foreign assistance is appropriated by Congress and said they would seek its implementation.
'Life or death consequences'
The memo allows the State Department to make other case-by-case exceptions and temporarily to fund salaries to staff and other administrative expenses.
The memo called for an internal review of all foreign assistance within 85 days.
In justifying the freeze, Rubio -- who as a senator was a supporter of development assistance -- wrote that it was impossible for the new administration to assess whether existing foreign aid commitments "are not duplicated, are effective and are consistent with President Trump's foreign policy."
The United States has long been the world's top donor in dollar terms, although a number of European nations, especially in Scandinavia, give significantly more as a percent of their economies.
The United States gave more than $64 billion in overseas development assistance in 2023, the last year for which records were available, according to the Organization for Economic Cooperation and Development, which advises industrialized countries.
Trump had already on taking office Monday signed an executive order suspending foreign assistance for 90 days, but it was not immediately clear how it would be implemented.
Anti-poverty group Oxfam said that Trump was abandoning a longstanding consensus in the United States for foreign assistance.
"Humanitarian and development assistance accounts for only around one percent of the federal budget; it saves lives, fights diseases, educates millions of children and reduces poverty," Oxfam America president Abby Maxman said in a statement.
"Suspending and ultimately cutting many of these programs could have life or death consequences for countless children and families who are living through crisis," she said.