menu_open Columnists
We use cookies to provide some features and experiences in QOSHE

More information  .  Close

The world just lost its health report card. Now what?

2 1
05.08.2025
A census enumerator, right, talks with a Maasai woman during the population and housing census, the first time being conducted digitally, at a village in Engikaret on August 23, 2022.

When President Donald Trump and Elon Musk fed the US Agency for International Development into the wood chipper earlier this year, one of the lesser-known casualties was the shutdown of an obscure but crucial program that tracked public health information on about half of the world’s nations.

For nearly 40 years, the Demographic and Health Surveys (DHS) Program has served as the world’s health report card. In that time, it has carried out over 400 nationally representative surveys in more than 90 countries, capturing a wide range of vital signs such as maternal and child health, nutrition, education levels, access to water and sanitation, and the prevalence of diseases like HIV and malaria.

Taken together, it offered perhaps the clearest picture ever compiled of global health.

!function(){"use strict";window.addEventListener("message",function(a){if(void 0!==a.data["datawrapper-height"]){var e=document.querySelectorAll("iframe");for(var t in a.data["datawrapper-height"])for(var r,i=0;r=e[i];i )if(r.contentWindow===a.source){var d=a.data["datawrapper-height"][t] "px";r.style.height=d}}})}();

And that clarity came from how rigorous these surveys were. Each one started with a globally vetted blueprint of questions, used by hundreds of trained local surveyors who went door-to-door, conducting face-to-face interviews in people’s homes. The final, anonymized data was then processed by a single contractor ICF International, a private consulting firm based in Reston, Virginia, which made the results standardized and comparable across countries and over time. Its data powered global estimates from institutions like the Institute for Health Metrics and Evaluation, which in turn shaped public health policy, research, and funding decisions around the world. “If DHS didn’t exist, comparing anemia across countries would be a PhD thesis,” said Doug Johnson, a senior statistician at the nonprofit IDinsight.

Crucially, DHS also tracked things few other systems touched, like gender-based violence, women’s autonomy, and attitudes toward domestic abuse. Doctor’s offices aren’t representative and only capture folks who can access a formal health care system. Also, since DHS data is anonymized, unlike a police report, responders don’t have to fear intervention if they don’t want it. “You can’t get answers from other sources to sensitive questions like the ones DHS posed,” said Haoyi Chen from the UN Statistics Division, pointing to one example: Is a husband justified in beating his wife if she burns the food?

Then, earlier this year, DHS was shut down.

The decision came as part of the Rescissions Act of 2025, a bill passed in June that clawed back $9.4 billion from foreign aid and other programs. Eliminating DHS saved the government some $47 million a year — only about 0.1 percent of the total US aid budget, or half the cost of a single F-35 fighter jet.

That tiny budget cut has had immediate consequences. The move halted around 24 in-progress country surveys – 10 of which were just short of final publication, and three in Ethiopia, Guinea, and Uganda that were........

© Vox