One of President Donald Trump’s first actions after taking office last month was to sign an executive order freezing foreign aid, much of which flows through the United States Agency for International Development (USAID), an independent agency that represents less than 1 percent of the overall federal budget. The administration later said that “lifesaving” work was exempt and could continue. But USAID employees and officials from nonprofit organizations say they are still being blocked from doing vital work on ending the global HIV/AIDS epidemic.

The consequences may be dire: “At a minimum, 300 babies that wouldn’t have had HIV, now do,” one current USAID worker estimates.

WIRED interviewed eight current and former USAID employees and contractors for this story, several of whom directly work on the agency’s HIV and AIDS programs. They were granted anonymity due to fears of retaliation and because they were not authorized to speak publicly about the agency. USAID did not respond to requests for comment.

Elon Musk’s Department of Government Efficiency (DOGE) Service has plowed through several government agencies since President Donald Trump took office last month, proposing sweeping changes to federal infrastructure. But no agency has been gutted as thoroughly as USAID. A cadre of young DOGE agents have been stationed in USAID’s headquarters since last week; after reportedly wresting control of USAID’s secure systems and placing key personnel on administrative leave, the DOGE team began cutting off staff email accounts on a rolling, seemingly random basis, with no guidance or explanation, employees claim. “It’s been absolutely hellish,” says a current USAID employee who lost access to their email on Monday morning.

“We spent the weekend feeding USAID into the wood chipper,” Musk said on social media Sunday. “Could [sic] gone to some great parties. Did that instead.”

One popular program implemented by USAID, however, has already been granted an “emergency humanitarian waiver” to keep operating: the President's Emergency Plan for AIDS Relief, or PEPFAR.

The global health program, which was founded by former US president George W. Bush and is overseen by the State Department, has saved an estimated 26 million lives since its launch in 2003. It’s implemented by a handful of government agencies, including USAID. While in theory the Trump administration’s waiver allows the program to resume some of its activities while the foreign aid freeze is still in effect, in reality, sources tell WIRED that much of its lifesaving work remains paused.

"Your money is being unfrozen but you can’t contact the people who actually froze it," a senior official at an HIV/AIDS organization told WIRED. "There’s a bigger communication blockage that is frustrating even the efforts put in place to free up the lifesaving work."

Large numbers of USAID employees have been placed on administrative leave or locked out of their emails and work servers in recent days, including those working on a variety of what they say are critical public health missions. USAID staffers say this demonstrates that the emergency waiver application process is ineffective and isn’t ensuring that aid workers can continue serving vulnerable populations.

USAID staff who still have access to their email accounts received a notice on Monday evening from Ken Jackson, the agency’s assistant to the administrator for management and resources, saying that the agency “would likely undergo a reorganization” and be integrated into the State Department. “As we evaluate USAID and ensure it is in alignment with an America First agenda, the President Trump Administration, and the efforts of the State Department, we will focus on ensuring every agency dollar is delivering targeted and results-driven aid,” the email read.

In countries like Zambia, Nigeria, Haiti, and Mozambique, medical equipment ranging from antiretroviral drugs for treating HIV to pre-exposure prophylaxis and condoms that can prevent transmission of the disease are currently sitting in limbo, according to the same USAID worker who warned of a drastic uptick in the number of children living with HIV. The aid is unable to reach its destinations because the USAID workers tasked with logistics have been placed on administrative leave.

“When a baby is born, you do an early infant diagnostic test, and if it comes back positive, you can blitz them with retrovirals, but you can’t do that if you don’t have retrovirals,” the same USAID worker says. “It’s an absolute disaster.”

In Haiti, an aid worker confirmed that HIV/AIDS medication from USAID remains inaccessible. “We cannot touch the medication,” they say. “Everything is on hold.” The worker added that nobody from USAID had answered their phone calls for days.

“The Trump administration is playing with tens of millions of people's lives, and Haiti is just one consequential example of that in our hemisphere,” says Asia Russell, the executive director of the international HIV advocacy group Health GAP.

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While PEPFAR is the most well-known HIV/AIDS program implemented by USAID, the agency has a number of additional projects devoted to the issue. One current USAID worker whose research focuses on prophylactic devices primarily for women in sub-Saharan Africa says that their work has been interrupted, too. They say members of their team were abruptly cut off from their work emails this afternoon. “We hadn’t yet applied for a humanitarian waiver,” they say. “We don’t even have a way of contacting IT.”

Democratic lawmakers and dozens of USAID employees protested in front of the Ronald Reagan Building in Washington, DC, on Monday after they were denied access to USAID’s offices. “This illegal, unconstitutional interference with congressional power is threatening lives all over the world,” said Maryland representative Jamie Raskin.

A current USAID employee shared an email with WIRED they received from the agency on Monday night, informing them that USAID buildings in Washington will remain closed tomorrow. “We will continue to provide further updates as they become available,” the email reads. “Thank you for your cooperation.”