NEW YORK: Days after cutting billions of dollars in foreign aid programs, the United States began reversing some decisions, but humanitarian groups say funds have not yet arrived and the United Nations has started evaluating "choices we are making on which lives not to save" due to cuts.

U.S. President Donald Trump returned to office on January 20 and immediately ordered a 90-day pause on foreign aid pending a review of whether the programs align with his "America First" foreign policy.

The review, which had granted waivers for life-saving and emergency food aid, has been marked by what aid officials describe as chaos and confusion.

"Severe funding cuts have been a body blow to our work to save lives," U.N. aid chief Tom Fletcher said on Thursday. "It is the pace at which so much vital work has been shut down that adds to the perfect storm that we face."

Fletcher said he has asked U.N. humanitarian coordinators around the world to report by the end of next week "on where we will need to cut back most dramatically, and the implications of the tough choices we are making on which lives not to save."

The U.S. has been the world's biggest aid donor, but - less than halfway through the 90-day review - the State Department said last week that it had completed its assessment and terminated 92% of USAID foreign aid contracts, worth some $54 billion.

Some of the terminations were quickly reversed. Then, despite the State Department having said the review was complete, aid groups this week were asked to fill out a U.S. government survey asking whether projects "conform to the Trump Administration's goal of aligning foreign assistance with American interests and values."

State Department spokesperson Tammy Bruce said on Thursday that if programs had been cut it was because "they did not serve either American interests or make us safer, more secure, or more prosperous," adding: "Those decisions are going to be made – clearly, some have been – in the process of the review."

'PARALYZED'

Last week the U.N. Population Fund said the U.S. had cut 48 grants worth about $377 million for critical maternal health care, protection from violence, rape treatment and other life-saving care in more than 25 countries. On Tuesday, Washington reversed its decision on seven of those programs.

The Norwegian Refugee Council said it has 29 U.S.-funded projects and received 24 termination notices, many for programs that had been operating under waivers during the review. This week, the U.S. reinstated 10 of the terminated projects.

"Our many lifesaving U.S.-funded projects that have gone from suspension to waivers to termination to revision and now green light will still be paralyzed as there still has been no reimbursement of costs incurred and no clarity on when we will be reimbursed," NRC Secretary General Jan Egeland told Reuters.

"So we have no liquidity to resume lifesaving aid and war victims, most of them women and children, are left with no relief," said Egeland, a former U.N. aid chief, adding NRC was owed tens of millions of dollars for work done.

On March 5, the U.S. Supreme Court said the Trump administration could not withhold payments to foreign aid groups for already completed work.

The International Rescue Committee said it is also owed tens of millions of dollars for completed work.

Last week IRC received termination notices for 42 of its 77 programs. Among those terminated were 17 programs that had received life-saving aid waivers. Just a few days later the U.S. reversed its decision and reinstated 12 programs - 11 of which were among those considered life-saving according to the waiver.

"We still have five grants that had life-saving activities that had previously been waived, that are counted in the termination notices," said Ciaran Donnelly, head of IRC's crisis response, recovery and development. "These aren't things where you can't just turn them on and off at the drop of a hat."

He said some of the terminated projects covered activities in countries such as South Sudan, Yemen and Bangladesh on malnutrition, safe water and essential health care projects, including specialized services for women and girls.

"We're determined to do everything we can, to deliver every last ounce of humanitarian assistance that we can. So getting clarity on expectations and confidence on funding guarantees to be able to do that is critical," he said.

"The bigger question is what kind of humanitarian partner will the U.S. government be in the future?"