By the time the earthquake struck, flattening mud-brick homes across Afghanistan’s eastern mountains last week, many nearby health clinics had already been shuttered for months.

Mushtaq Khan, a senior advisor for the International Rescue Committee, felt his building jolt from all the way in the capital, Kabul, on Sunday night. He woke the next morning to a horrifying death toll slowly trickling in. First, 200 lives lost; then 500; 800; 1,000; and finally, by Thursday, there were over 2,200 confirmed deaths, with some rural villages still unreachable by rescuers.

As his team searched for survivors, he wondered what could have happened if the gutting of the US Agency for International Development hadn’t forced four of their clinics in the country’s hardest-hit province to close earlier this year, cutting off 60,000 rural Afghans from care.

How many lives could be saved if the emergency aid came rushing in like it did before? If the roads had been built in time, or if the food assistance was at the ready like it used to be, they could have surely reached more people more quickly in the disaster’s wake.

“The way we are responding now would’ve been way different,” he said.

At the beginning of this year, the US cut almost $1.8 billion worth of aid to Afghanistan. Because of those cuts alone, the country’s GDP will likely shrink by a full 5 percent this year, cutting off food, shelter, and medical care for millions of Afghans. In 2022, after a magnitude 6.1 quake hit southeastern Afghanistan the US gave $55 million for food, health, and sanitation supplies. The next year, it gave $12 million in the wake of yet another earthquake. But this time, the US offered nothing.

Globally, we are at risk of unraveling decades of progress in making disasters less deadly, driven by investments in infrastructure, early warning systems, and better coordination between the patchwork of actors and agencies that kicks into gear when crisis strikes. Foreign aid has always been a critical part of that puzzle in low-income countries like Afghanistan. A steady flow of foreign aid helps facilitate the kind of development — the roads and resources — needed to make emergency response truly effective when disaster strikes.

The US isn’t alone in slashing aid. As a result of the worldwide retreat in funding lifesaving development programs, every disaster is now deadlier than it needs to be — and every aid worker is left navigating an increasingly dysfunctional system.

“The resources are really, really scarce right now,” said Khan. If the money was there like it used to be, he told Vox that he “would be on the ground working side-by-side with my team right now. We are really feeling the difference.”

How disaster relief works

When an earthquake or a cyclone strikes a poor village, what normally happens first is that the country’s government puts out a call for international relief.

Then, a hodgepodge of NGOs, United Nations agencies, and foreign governments would spring into action. USAID would typically........

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