The United States Department issued a “stop-work” order on all current foreign assistance and paused new aid on Friday, following President Donald Trump’s directive to review whether aid distribution aligns with his foreign policy, according to cable obtained by Reuters.

The cable, prepared by the Department’s foreign assistance office and approved by Secretary of State Marco Rubio, noted that waivers had been granted for military financing to Israel and Egypt, with no other countries mentioned.

The move risks halting billions of dollars in life-saving assistance, as the United States is the largest single donor of aid worldwide. In fiscal year 2023, the U.S. disbursed $72 billion in assistance.

Just hours after taking office on Monday, President Trump ordered a 90-day pause in foreign development aid to review its efficiency and alignment with his foreign policy, though the full scope of the order was not immediately clear.

The State Department cable stated that, effective immediately, senior officials must ensure that, “to the maximum extent permitted by law,” no new obligations for foreign assistance will be made until Secretary Rubio completes his review.

It also mentioned that stop-work orders would be issued for existing foreign assistance awards until they have been reviewed by Rubio.

“This is lunacy,” Jeremy Konyndyk, a former USAID official who is now president of Refugees International, said. “This will kill people. I mean, if implemented as written in that cable … a lot of people will die.”

“There’s no way to consider this as a good-faith attempt to sincerely review the effectiveness of foreign assistance programming. This is just simply a wrecking ball to break as much stuff as possible,” Konyndyk said.