Elon Musk's Legacy Is Cruelty and Death

Elon Musk is leaving the White House — and leaving a trail of destruction in his wake. But of all the actions Musk and President Trump set in motion, nothing will hurt more people around the world than their dismantling of the U.S. Agency for International Development (USAID).

By making disease-stemming drugs, clean water, and food available to millions, USAID has probably saved more lives worldwide than any entity in history.

Since 2000, USAID’s programs have prevented the deaths of 58 million people from tuberculosis, 25 million from HIV/AIDS, and over 11 million from malaria. It’s given 70 million people access to safe drinking water and, working in concert with global vaccine initiatives, helped to nearly eradicate polio.

As the main funder of global health interventions, USAID served as a bulwark against diseases that don’t halt at national borders. Its programs identified emerging epidemics and minimized the spread of drug-resistant diseases that threaten Americans as well.

Although it’s commonly assumed to be much higher, foreign aid is just 1 percent of federal spending, so cutting it won’t begin to balance the budget. So instead Trump and Musk attacked USAID by slandering it, calling it a “criminal agency” (Musk) that’s “run by a bunch of radical lunatics” (Trump).

This, of course, was a lie. USAID was known for having rigorous oversight, with 275 investigators and auditors in its watchdog office.

Most USAID funding in low-income countries targets disease prevention, economic growth, and disaster relief. But DOGE and Trump made staggering false claims, like Trump’s that USAID was sending “$50 million to Gaza to buy condoms for Hamas.”

As a result, USAID was the first casualty in the Trump administration’s struggle to make the federal government subservient not to the Constitution but to one man. And Musk — the world’s richest man, whose income last year exceeded USAID’s entire budget — and his fellow billionaire President Trump withdrew medicines and food from millions of the world’s most vulnerable people. Afterward, Musk gleefully announced that they’d fed “USAID into the wood chipper.”

I’ve followed USAID since seeing its economic and agricultural programs in the African Sahel in the 1980s, and I’ve spent 40 years heading nonprofits working to provide clean drinking water internationally.

No organization I’ve led has received USAID funding, but over the years I’ve known scores of USAID staff who were hard working and conscientious about spending U.S. tax dollars. Trump owes an apology to USAID’s employees, now indiscriminately fired or coerced into early retirement.

Every federal agency can stand being streamlined. But what happened to USAID wasn’t reform — it was destruction. “They didn’t know what they were doing or care to find out, but I came to realize that cruelty is their purpose,” one senator told me in April. “Cruelty is how they think they demonstrate power.”

It’s fair to say American voters didn’t ask for this. USAID went unmentioned during the 2024 presidential campaign — and bipartisan majorities continue to say they oppose gutting the agency.

American entities which partnered with USAID — including corporations, faith-based organizations, foundations, universities, and civic groups like Rotary International — will continue to raise their own private funds. But by themselves they can’t replace USAID’s leadership abroad.

Now that Trump and Musk have eviscerated the agency, millions will suffer. The Center for Global Development estimates that U.S. foreign assistance has been saving 3 million lives annually. The journal Nature calculates that the loss of U.S. global health funding alone could result in 25 million additional deaths over the next 15 years.

For Americans — including Trump voters — feeling queasy over what’s been carried out in their name, it’s not too late to convey to Congress your support for life-saving foreign assistance.

Regardless of how they voted, Americans should be proud of how their foreign aid has reduced worldwide poverty, sickness, hunger, and thirst — all for 1 percent of the federal budget. The future cost to the United States, if it abandons its leadership in global health and development, will prove incalculable.