American-funded aid efforts to tackle diseases such as malaria, as well as preventing newborn baby deaths and treating severe malnutrition, should resume, according to a memo from the United States government reviewed by Reuters.

President Trump moved to freeze international aid while undertaking a 90-day review hours after taking office last month. Secretary of State Marco Rubio issued a waiver a week later clarifying that "lifesaving" efforts were exempt during this period, but organizations on the ground remained confused over what was included.

"These lifesaving activities must resume or continue in the next 30 days of the 90-day pause on foreign assistance to prevent imminent mortality among USAID beneficiaries," the memo states.

It lists activities tackling tuberculosis, malaria, acute risks of maternal and child mortality, including severe acute malnutrition, and other life-threatening diseases and health conditions.

It also said efforts to combat disease outbreaks, including mpox, avian flu and Ebola, should restart, and global health supply chain activities.

USAID did not immediately respond to a request for comment.

The memo is dated February 4, cleared by email on February 6. One aid group said they had received it on Friday.

However, two sources said it was still unclear what could restart, and with what funding, especially given the hollowing out of USAID both in Washington and globally.

Martin Edlund, CEO of Washington-based global non-profit Malaria No More, said the memo was an important step towards resuming programmes.

"Even short-term interruptions of malaria prevention and treatment lead to outbreaks and deaths," he said. But he added that "start-work" orders would also need to be issued to all programmes to begin indoor spraying, net distribution, testing and treatment for malaria.

A separate clarifying memo, dated February 6, also attempted to give more detail on a waiver issued last week for the United States President's Emergency Plan for AIDS Relief (PEPFAR). In red at the top, it outlines that the care, treatment and prevention of mother-to-child HIV transmission "should be resumed as soon as possible". (Reuters)

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