The well-known phrase “Let them eat cake” symbolizes the indifference of the very rich toward the poor. I like billionaire Bill Gates’ expression better, as he is a wealthy person discussing in a timely and appropriate way, the Trump administration’s regard for the poor.
Gates described the act of Elon Musk and his wrecking ball DOGE operation abolishing USAID as the “world’s richest man killing the world’s poorest children.”
An independent, peer-reviewed analysis in The Lancet estimated that USAID assistance had saved 92 million lives over the 20 years from 2001 to 2021. The impact was particularly significant for children under five, with an estimated 30 million lives saved in that age group over the same 21-year period.
The study found that USAID’s programs are associated with a 15% reduction in all-cause mortality and a 32% reduction in mortality among children under five in low- and middle-income countries.
USAID also supports specific initiatives, such as the President’s Emergency Plan for AIDS Relief (PEPFAR), which has been credited with saving 26 million lives from HIV/AIDS and enabling 7.8 million babies to be born without HIV infection.
Oxfam, the global organization that fights inequality and to end poverty and injustice, summarizes the work of USAID:
USAID facilitated much of the U.S. government’s humanitarian and foreign development assistance over the decades since its establishment in 1961. USAID brought lifesaving medicines, food, clean water, assistance for farmers, kept women and girls safe, and promoted peace-all for less than one percent of our federal budget.
“There is not a single area of development and humanitarian assistance USAID has not been involved in,” said Oxfam America’s President and CEO Abby Maxman, who has been working in international development for 30 years. “People at USAID have been thought leaders implementing ideas at scale, in wide ranging areas — I don’t think there is a major area of the development system in which USAID did not bring its technical know-how, research, and evidence.”
The Carnegie Endowment for International Peace reported a critique of the Trump administration’s destruction of USAID:
No recent move tells us more about President Donald Trump and his administration’s disdain for America’s global reputation than their reckless (and arguably illegal and unconstitutional) effort to dismantle the U.S. Agency for International Development (USAID) without legislative approval. The episode reveals the transactional nihilism at the heart of Trump’s foreign policy, which recognizes no positive purpose for the United States in world affairs. Americans themselves will reap the damage from these misguided decisions.”
A group of anonymous former and current USAID employees filed a lawsuit against Elon Musk and the Department of Government Efficiency (DOGE), alleging that they decimated USAID without authority to do so. Additional defendants were later added. While this and other related lawsuits wind their way through the courts, it is not too early to assess the most critical damage being done.
The researchers in the Lancet study estimate that if the current cuts continue through 2030, 14 million people who might have otherwise lived could die. Some of these deaths are already occurring. Brooke Nichols, the Boston University epidemiologist and mathematical modeler, has maintained a respected tracker of current impact. The model is conservative, assuming, for example, that the State Department will fully sustain the remaining programs. However, as of November 5th, the model estimates that USAID’s dismantling has already caused the deaths of six hundred thousand people, two-thirds of
them children.
We are now witnessing what historian Richard Rhodes called “public man-made death.” He noted that previous scholarship had distinguished between biologic death – death from natural causes directly – and man-made death – death from war, political violence, and their attendant deprivations. Rhodes then divides man-made death into private man-made deaths (e.g., war casualties) and public man-made deaths (e.g., noncombatants). He then asks if medicine and public health are concerned with private man-made death, should not public man-made death be similarly addressed?
The death toll from the absence of USAID is appalling and will continue to grow. But these losses will be harder to see than those of war. The Trump Administration has denied causing widespread harm, even as it has made the scale of the damage harder to measure by halting data monitoring and dismissing the inspectors general who might have documented it.
Extremely wealthy men killing extremely impoverished children, indeed.
