A dramatic purge and counter-purge at USAID played out in emails obtained by The Washington Post, as Trump’s pause on foreign aid upends humanitarian work around the world.

At least 56 senior officials in the top U.S. aid and development agency were placed on leave amid an investigation into an alleged effort to thwart President Donald Trump’s agenda.

USAID is in charge of ordering the drugs used by the President's Emergency Plan for AIDS Relief (PEPFAR) in its programs that keep 20 million people with HIV alive, Gawande said. This work stoppage means that pharmacy stocking in more than 25 countries suddenly stops, as do payments to partner organizations, which are mostly locally run.