The Trump administration exempted lifesaving assistance from its foreign aid freeze, but providers say it’s still not getting through.

*This article originally appeared in Politico.

Critical U.S. food and medical assistance to the world’s poorest countries isn’t getting through, despite Secretary of State Marco Rubio’s move to exempt it from the Trump administration’s foreign aid freeze, representatives from nonprofit organizations, a United Nations agency and USAID employees told POLITICO.

Organizations that deliver the aid say they aren’t getting paid. They are laying off workers and they can’t get information from the U.S. Agency for International Development. “What we’re seeing still is not only disruption, but devastation of services,” said Angeli Achrekar, the deputy executive director for programs at the United Nations HIV program, UNAIDS.

On the ground, aid providers say they’re confused about what assistance can resume and when. Some 5,000 public health workers were laid off in Ethiopia and hundreds of them lost their jobs in Kenya after President Donald Trump imposed the freeze last month, Achrekar said.

Rubio issued a waiver soon thereafter, exempting drugs to treat life-threatening diseases, but in some cases there are few or no health workers to dispense them, according to Achrekar.

“The waiver is only the first step in a multi-step process to get programs back up and running, and the infrastructure to do that no longer exists in any real way,” said Elisha Dunn-Georgiou, the president and CEO of the Global Health Council, a Washington-based coalition of organizations working to implement or advocate for global health programs.

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