It receives relatively little attention now, but in terms of sheer numbers the cuts to the USAID program have had and will continue to have the largest death toll of anything this administration does.

I'm sure the economic suicide will have its victims, and who knows how many have died in detention facilities, but it would be damn-near impossible to match up the the loss of human life seen in poor countries without access to the basic supplies and medical care that USAID delivered.

> who knows how many have died in detention facilities

If you're talking about ICE, it's officially 15 so far this year. [0]

While this outbreak is bad for DR Congo, I wonder whether they will be able to contain it within their borders without adequate support.

[0] https://www.borderreport.com/hot-topics/border-report-live/b...

That doesn't count any of the 1,800 missing from Florida's recently-closed detention center.

I hope you're not implying they're already digging mass graves. Some are unaccounted for--they're probably in Guatemala or something. Some will die. But I don't see the gas chambers being built for, like, another six months at least.

I don't think they're all dead, but with no accounting, we don't know how many.

If you mean short term impacts that may be true, but I wonder if the medicaid, aca and likely medicare cuts will have material impacts on mortality. It will not be as easy to attribute, and therefore it’ll be hard to quantify (you might say that’s “convenient”), but the number of people impacted will be well into the tens of millions.

> if you mean short term impacts that may be true, but I wonder if the medicaid, aca and likely medicare cuts will have material impacts on mortality. It will not be as easy to attribute, and therefore it’ll be hard to quantify (you might say that’s “convenient”), but the number of people impacted will be well into the tens of millions.

I think these can't possible be commensurate - just consider how many more HIV cases there will be without US funding for overseas HIV prevention.

I’m not so sure. 630,000 total HIV deaths annually. What percent are impacted by USAID and then how much growth in HIV deaths without USAID? My tens of millions comment is the people whose health care will potentially be impacted short term (medicaid and aca changes; Medicaid is currently 70 million people. ACA is 24 million) plus potential aggressive efforts to move medicare people to medicare advantage and you have another 68 million potentially exposed (that number isn’t actually that large today because a majority of those people will likely pass before the medicare changes have a negative impact, but over time, as people enter the system with worse coverage, the deaths will climb).

Please understand I’m not saying I’m right about this but just that the vast number of people impacted by the admin’s policies re domestic health care makes me think it could be greater than USAID.

edit: grammar and spelling

I am very genuinely interpreting all of this and I recognize you are just reviewing the data.

HIV deaths are a lagging indicator, so any effect of today's policy will be delayed - as a general matter. But HIV in newborns will lead to death within a year if untreated, and adults with untreated HIV/AIDS will die from other communicable disease sooner than if they were treated.

Since US hospitals public obligation in the US to treat people who are gravely ill, we're 'only' going to see a marked increase in deaths attributable to chronic disease, and I don't think the Medicaid cuts will survive in their current state.

But it's true I don't have numbers on this and won't have a chance to get them this morning. Please share if you have a sense of comparative DALY/QALYs lost through USAID funding cuts vs Medicaid changes.

I really don't have a concrete sense. My comment was very much predicated on the sheer number of folks who would be negatively impacted by the changes to existing domestic healthcare programs. And to put a fine point on my own comment in case you think I'm attempting to downplay USAID impacts, both of these things are materially negative from a healthcare perspective.

It will be impossible to effectively quantify the impacts on mortality of the medicaid/medicare/aca changes, but they are (if implemented) going to impact great numbers of people and their health. USAID absolutely the same as you're pointing out and those impacts will be much more measurable. You're going to have about as good a linear test as you can get given how abruptly that funding will disappear (abrupt in contrast to the long, drawn out medicaid/medicare/aca changes (though the initial aca changes, assuming they do happen, will likely be the most abrupt of the three domestic programs because they will happen cleanly on January 1, 2026)).

The US is not responsible for fixing every world issue. Just because they've helped in the past doesn't make them morally responsible for every current and future crisis.

No but keeping Ebola from becoming a world wide problem is in the US interests and USAID was a very cheap way to advance that goal. We funded USAID out of decency (and to gain a reputation for decency, which is worth a lot of money) sure, but also to protect ourselves.

> (and to gain a reputation for decency, which is worth a lot of money)

And how is America's reputation for decency doing these days, a mere year into cutting some of this funding?

Sounds like a job for the WHO - maybe the UN can do it's job.

> Sounds like a job for the WHO - maybe the UN can do it's job.

Ah, the WHO that has recently lost money from its largest contributor, a contributor that unexpectedly stopped its contributions without explanation.

There you go again -you want the US government to solve the world's problems. Also, you're passively calling the WHO an infective organization because it can't handle this outbreak on its own without US funding. That implies it's a useless organization and therefore the US was justified removing funding.

Maybe you should be advocating for the 194 member states of the WHO to contribute more so the world doesn't need to rely on the political winds of the US election cycle.

I replied to one of your sibling posts. You can re-interpret these facts as you wish, but the WHO was working in December and radically transformed in February.

I think that indicates inefficacy and poor insight, but not in the WHO.

> you want the US government to solve the world's problems

It's called leading. You've voluntarily thrown in the towel on US leadership. Good job.

Good thing it's called the World Health Organization and not the American Health Organization, that way the 95.9% of the world that is not America can contribute to it.

> Good thing it's called the World Health Organization and not the American Health Organization, that way the 95.9% of the world that is not America can contribute to it.

First, imagine that your boss/largest customer decided, on a whim, to reduce your remuneration by half on the first of January. Where are you making up that money if there's nowhere else in the world that you can immediately turn to?

Anyway, other nations are spending more.

The World Health Organization and UN are just politically convenient names. These organizations were created by a victorious America to project power, like the takeover of UK military bases and exportation of US culture in the Marshall Plan.

How reprehensible that we throw away such power without receiving anything in exchange.

[1] Helpful example - we initially blocked penicillin production in other countries, despite having joined WHO, in furtherance of American interests https://www.discovermagazine.com/the-cold-wars-lasting-effec...

> No but keeping Ebola from becoming a world wide problem is in the US interests and USAID was a very cheap way to advance that goal. We funded USAID out of decency (and to gain a reputation for decency, which is worth a lot of money) sure, but also to protect ourselves.

Foreign aid also sustains armed conflict in DRC, because international health groups have to bribe military groups for security... perpetuating the civil war, a fallout of the Tusti Genocide in Rwanda.

The situation is bad... 6 million people died since 1996... the majority from indirect consequences of the conflict... (thus disease, famine and co), and to access these victims and help them, international organisations have to pay off the very military groups that wage that civil war, thus sustaining them...

>> It receives relatively little attention now, but in terms of sheer numbers the cuts to the USAID program have had and will continue to have the largest death toll of anything this administration does.

> The US is not responsible for fixing every world issue. Just because they've helped in the past doesn't make them morally responsible for every current and future crisis.

Your answer doesn't quite respond to the GP but instead feels like an expression of political opinion.

From a moral stance, the action of stopping something seems quite distinct from a position in which the thing had never occurred.

That which you did not do for the least of these, you also did not do for me.

I'm not a highly religious person so I may well be wrong about this, but my understanding of Christian principles (as you referenced in your Bible quote) is that you, the individual, should do these kind things to other individuals personally; and in that act of doing so personally, you become closer to God.

What we have instead is that taxes are collected by an entity with the monopoly on violence (and of course, it's understood that the people making more than you are not paying their "fair share") whether you like it or not, spent by people who generally have boundless disdain for the very people who pay those taxes, on people and causes on the other side of the planet. There's no connection between people, or between people and God, in this scenario.

> I'm not a highly religious person so I may well be wrong about this, but my understanding of Christian principles (as you referenced in your Bible quote) is that you, the individual, should do these kind things to other individuals personally; and in that act of doing so personally, you become closer to God.

Why not read the verse and see that this refers to collections of people? The source material is readily available, no reason to speculate.

https://biblehub.com/nkjv/matthew/25.htm

I have read the source material. It says nothing about the morality of an intermediary forcibly redistributing wealth.

Again, the onus is on the individual to act kindly. If anything, handing that duty off to a third party is a reduction of morals. You are also speculating if you claim that there is a moral equivalence between the two.

I think we're going to disagree, which is fine, but I'll post the text and let others assess what the meanings of 'nations' is in the context of the quotation.

--

https://biblehub.com/nkjv/matthew/25.htm

31“When the Son of Man comes in His glory, and all the [c]holy angels with Him, then He will sit on the throne of His glory. 32All the nations will be gathered before Him, and He will separate them one from another, as a shepherd divides his sheep from the goats. 33And He will set the sheep on His right hand, but the goats on the left.

[...]

41“Then He will also say to those on the left hand, ‘Depart from Me, you cursed, into the everlasting fire prepared for the devil and his angels: 42for I was hungry and you gave Me no food; I was thirsty and you gave Me no drink; 43I was a stranger and you did not take Me in, naked and you did not clothe Me, sick and in prison and you did not visit Me.’

44“Then they also will answer [d]Him, saying, ‘Lord, when did we see You hungry or thirsty or a stranger or naked or sick or in prison, and did not minister to You?’ 45Then He will answer them, saying, ‘Assuredly, I say to you, inasmuch as you did not do it to one of the least of these, you did not do it to Me.’ 46And these will go away into everlasting punishment, but the righteous into eternal life.”

It's easy to demand that other people be generous with their resources.

>> That which you did not do for the least of these, you also did not do for me.

> It's easy to demand that other people be generous with their resources.

This is a reference to the Bible, a sentence that Jesus delivered.

I think helping control ebola pays a few dividends for the US. It was not completely selfless.

No dollar was ever spent by the US government outside of the US if not in self interest. Failing to see these cuts as sabotaging US interests is very, very naïve.

It's simple self-interest. Sure, sit on your money and smile while your neighbors die of Ebola. It won't happen here? Sure it could. When the chumps in DC tear down the infrastructure that managed things like this, then we become massively vulnerable.

Facts my friend, facts. You may not like them, you may think they are out of context and/or misused, but they are still facts.

Another fact is that the money saved went to fund a (small) portion of the big beautiful bill, which doesn't exactly focus on helping the average american Joe.

Perhaps the American taxpayer could be incentivized to continue financially supporting the DR Congo in other ways? Maybe they could apply to become a protectorate or somesuch. You can't have your sovereign cake and eat it, too.

In other words: if a country cannot actually exist without being propped up by another, at some point it may be better for everyone to just break the illusion. Like someone complaining that they can't afford to live in a nice apartment in Brooklyn anymore because their trust fund got cut off; in the long run, it's better to base expectations around reality.

This is the type of short-sighted ignorance that will ultimately doom us.

The unspoken mission of USAID and the CDC is to deal with these issues "over there" before they get "here."

Think all these HIV drugs now on the market were tested on American or Europeans?

We disagree on the unspoken missions of those agencies, I guess. From what I've seen, the unspoken mission is actually providing sinecures for political allies. Or have you forgotten about a worldwide pandemic that happened just a few short years back which revealed that the top priority of many authority figures in public health organizations was to make themselves look good and their opposition bad?

Why are so many people blind to the idea that the name and stated purpose of an organization can and many times do differ from the actual real-world outcomes that organization produces?

> Or have you forgotten about a worldwide pandemic that happened just a few short years back which revealed that the top priority of many authority figures in public health organizations was to make themselves look good and their opposition bad?

I don't remember this because it did not happen.

However, I do recall our own (Trump-run) CDC putting out ineffective testing materials, while the (admittedly Trump-supported) WHO made the testing resources the whole world, including the US, relied on in the first months of the pandemic.

> I don't remember this because it did not happen.

There was a whole-of-government approach to silencing factually true statements about the pandemic because it either made officials look bad or Trump look good. There was a whole Supreme Court case around this that was sidestepped on grounds of standing, not on the facts of the case.

Anthony Fauci, a prominent NIH official who was the initial public face of the government's response to the pandemic, was revealed to have exhibited a significant lack of candor around the origins of Covid and his involvement in funding gain-of-function research. This was discovered by a House subcommittee formed by a Democratic majority and continued by a subsequent Republican majority.

>There was a whole-of-government approach to silencing factually true statements about the pandemic because it either made officials look bad or Trump look good. There was a whole Supreme Court case around this that was sidestepped on grounds of standing, not on the facts of the case.

> Anthony Fauci, a prominent NIH official who was the initial public face of the government's response to the pandemic, was revealed to have exhibited a significant lack of candor around the origins of Covid and his involvement in funding gain-of-function research. This was discovered by a House subcommittee formed by a Democratic majority and continued by a subsequent Republican majority.

These are very peculiar claims that I, despite very close following of factual news sources, have not seen.

What are your sources for these claims?

Containing Ebola where it happens is of value to the world; if the places where it happens can't contain it, the consequences of spread are pretty costly for everywhere it ends up.

The article says they're looking for $25M or so. If any cases make it to the US, that much money will only cover a small number of patients. In 2014, $1M covered two patients. [1] Much better to spend the money on containment overseas than not spend it overseas and have (more) cases arrive here. It's also much better for the country where the outbreak is occuring. If said country could manage the response on its own, that would be great, but outside help in outbreaks is a good thing anyway --- there's valuable exchange of information between doctors and nurses from different areas in addition to filling the need for additional capacity for care.

[1] https://www.nbcnews.com/storyline/ebola-virus-outbreak/cost-...

This is a bad take, even if we step away from your comparison of a body of millions of people to a someone living in Brooklyn with a trust fund.

> Perhaps the American taxpayer could be incentivized to continue financially supporting the DR Congo in other ways? Maybe they could apply to become a protectorate or somesuch. You can't have your sovereign cake and eat it, too.

We weren't asked about the abrupt change. I am sure that the average taxpayer supports maintaining lives overseas at minimal costs. She also probably wants pandemics not to infect her children on US shores.

> In other words: if a country cannot actually exist without being propped up by another, at some point it may be better for everyone to just break the illusion.

On a geopolitical sense, this is absurd. Just consider Poland: do they wish Ukraine didn't exist because of the amount of resources they expend on Ukraine's defense?

> even if we step away from your comparison of a body of millions of people to a someone living in Brooklyn with a trust fund

The article claims 57 cases and 35 deaths. Globally, Ebola killed 15k people over the past 50 years[0]. In the last big outbreak in the DR Congo, it infected less than 4k people in a country of roughly 100 million.

Perhaps I'm misunderstanding your sentence, but your way of phrasing ("a body of millions") seems to dramatically overstate the impact.

> We weren't asked about the abrupt change.

There was a hotly contested election with one side promising abrupt change and the other side promising a maintenance of the status quo. It's really not like they were hiding their intentions. Broadly speaking, the electorate wanted to take a wrecking ball to what they saw as Washington excess, whether that characterization is fair or not.

> Just consider Poland: do they wish Ukraine didn't exist because of the amount of resources they expend on Ukraine's defense?

Poland shares a border with Ukraine, who is being invaded by a nation that has also been a historical aggressor against Poland. I don't believe this is a good comparison to the US funding healthcare in the DR Congo.

[0]: https://pmc.ncbi.nlm.nih.gov/articles/PMC7326525/

> Perhaps I'm misunderstanding your sentence, but your way of phrasing ("a body of millions") seems to dramatically overstate the impact.

You compared a sovereign nation to an apartment, sorry I was unclear.

> There was a hotly contested election with one side promising abrupt change and the other side promising a maintenance of the status quo.

There's good polling about this sort of thing - Americans don't want to cause the death of other people. You may construe the electioneering to mean otherwise, but I was not alluding to this.

https://www.pewresearch.org/global/2025/05/01/majorities-of-...

> Poland shares a border with Ukraine, who is being invaded by a nation that has also been a historical aggressor against Poland. I don't believe this is a good comparison to the US funding healthcare in the DR Congo.

I disagree, because allowing infectious disease to fester slowly allows the development of antibiotic resistance and magnification of problems that could otherwise be contained.

In a sense, we're all closer to infections in the developing world than we recognize - despite the US efforts to dismantle the system that has surveilled these infections up to now.

> a sovereign nation

A sovereign nation in name only, who cannot adequately protect its people against disease without Uncle Sam's backstop.

> Americans don't want to cause the death of other people

Your concept of causation here is tortured. Americans are not spraying Ebola from airplanes. Can you equally say that you caused the death of a beggar who you passed by without sparing a dollar?

> Your concept of causation here is tortured. Americans are not spraying Ebola from airplanes. Can you equally say that you caused the death of a beggar who you passed by without sparing a dollar?

I can say that, having promised to deliver medication to someone, a capricious cut in medication supply will be causative in whatever change may result. And that is exactly the setting in which this poll was conducted.

Two things:

First, what you propose may work only if happenings in other countries don't affect the US, which I very much doubt.

Second, in most of these countries, it is actually the drip-feed of supposed western "help" that props up corruption and prevents any real change. The "aid" is a form of control, not actual help.

If western nations wanted to actually help, they would support the Grand Inga dam project [1] to actually lift people out of poverty. Instead, they oppose it on environmental grounds, never mind that their industrialization was built on the back of massive pollution.

1. https://en.wikipedia.org/wiki/Grand_Inga_Dam

Where foreign aid is concerned, I would much rather that my tax dollars go into building the Grand Inga Dam over the kind of "aid" you describe.

Wow, magas are really something

You have a good point except slightly misguided.

The rich wants more tax breaks so they can gobble up more money and own more assets at US citizens expense.

How’s that sound?

I'm not sure if I follow. Are you positing that American spending on foreign aid uplifts middle-class Americans and make material improvements to their lives?

All the spending cuts DOGE did wasn’t for Americans. It’s for the rich elite.

America first. Certainly those resources have been shifted to help Americans. Right guys?

Stopping Ebola from becoming a global disease helped Americans.

Keep Ebola in Congo! /s

even worse, the local services have also been gutted and lobotomized, so once one of these outbreaks gets to CONUS, they'll be praying hard and dropping like flies.

The Trump cult is really, in fact a death cult.