LONDON/JOHANNESBURG/GENEVA -- U.S.-funded projects worldwide, including those providing lifesaving care for millions of people in countries such as Sudan and South Africa, received termination notices on Thursday sending shockwaves across the global aid community.

The latest cancelations come as U.S. President Donald Trump's administration nears completion of a review to ensure that grants are aligned with his "America First" agenda after ordering a 90-day pause on all foreign aid in January to assess whether projects were consistent with his policy aims.

U.S. Secretary of State Marco Rubio had dismissed concerns that Washington was ending foreign aid, saying waivers had been provided to life-saving services.

Only weeks later, the Trump administration decided to terminate more than 90 percent of the U.S. Agency for International Development programs, according to a February 25 court document. Those included many that were initially covered by waivers such as work addressing HIV as well as wider health programmes. It is unclear whether the projects can be reinstated.

Major United Nations health programs were among those to get termination notices, including UNAIDS, the Stop TB Partnership and Scaling Up Nutrition as well as projects helping millions of forcibly displaced people.

"We are hit, but we will continue to be there," Lucica Ditiu, Stop TB's executive director, said.

Ditiu said that the group has different sources of funding it would use for procuring TB tests and treatments, but that it would have to terminate contracts with 140 partners around the world, many of which provide services including helping TB patients get diagnosed and stay on treatment.

'Egregious breaches'

Charlotte Slente, secretary general of the Danish Refugee Council, said she was appalled after receiving more than 20 termination notices for projects across a range of countries including Sudan, Yemen and Colombia.

"Not only are these terminations egregious breaches of contracts, but they endanger the lives of millions of the world's most vulnerable people," Slente said, adding that the decision would hit forcibly displaced people in conflict zones.

"While it is understood that incoming governments want to review their overseas development assistance, the decisions from the U.S. government over the last month are abrupt and unilateral, and the rationale for these are unfathomable," Slente added.

A global non-profit with projects on malaria and newborn health, among other areas, said the majority of its contracts had been canceled. Smaller organizations were also hit, such as Khana in Cambodia, a TB and HIV organization, and many organizations working on HIV and AIDS in South Africa.

UNAIDS on its website called the termination of its relationship with USAID a "serious development" that would affect lifesaving services, and said it had asked the U.S. government for more information.

Reuters was not immediately able to determine how many organizations worldwide were affected. Trump's administration also eliminated nearly 30 percent of State Department foreign assistance grants, worth $4.4 billion.

The State Department did not respond to a question on why life-saving aid programs were terminated.

"Secretary Rubio and (USAID) Deputy Administrator (Peter) Marocco have determined your award is not aligned with Agency priorities and made a determination that continuing this program is not in the national interest," said the notice received by organizations, which was seen by Reuters.

For some groups, USAID represents the majority of their funding, and they will struggle to survive, while for others it is only one of many donors.

'Devastating blow'

International AIDS Society President Beatriz Grinsztejn, referring to cuts worldwide, said: "The U.S. funding cuts are dismantling the system. HIV treatment is crumbling. TB services are collapsing."

In South Africa, which has the world's largest number of people living with HIV at around eight million, health experts said the cuts could roll back years of progress on the epidemic.

"We will see lives lost. We are going to see this epidemic walk back as a result of this," said Linda-Gail Bekker, chief operating officer of the Desmond Tutu HIV Foundation, which works with many organizations that were affected.

Bekker said she expected a funding cut for programs targeting specific groups such as LGBT+ people and sex workers, but in fact the cuts are far-reaching and include HIV/AIDS prevention and treatment programs for women and children.

The United States provides about 17 percent of South Africa's HIV/AIDS budget, and health experts said this funding was crucial for providing testing and getting new patients on treatment.

"The programs who received their termination letters this morning were among the most efficient, effective health delivery programs in the country," said Francois Venter, executive director of the Ezintsha Research Center in Johannesburg, which is not funded by USAID, calling it a "devastating blow" for South Africa's HIV response.

Nonprofit Humanity & Inclusion had more than 30 contracts with the U.S. government to provide services to hundreds of thousands of people with disabilities in multiple countries. Over the past 36 hours, the organization received notice that about half of those contracts had been canceled, said its U.S. executive director Hannah Guedenet.

"If you want to cut funding," Guedenet said "... there's a way to responsibly do that. And that is not what's being done. This is complete disregard for human life."