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Elon Musk's Legacy Is Cruelty and Death
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).
Jun 07, 2025
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.
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Sanders-Led Panel Exposes Big Pharma for 'Ripping Off' Americans With Publicly Funded Meds
"It is unacceptable that half of new prescription drugs invented with the help of NIH scientists now cost more than $111,000," said the HELP Committee chair, urging action by the Biden administration to cut prices.
Jun 12, 2023
"What makes the greed of the pharmaceutical industry so reprehensible is the fact that the American people are paying twice for some of the most expensive prescription drugs on the market: First through their taxes and a second time at the pharmacy counter."
That's according to U.S. Sen. Bernie Sanders (I-Vt.), who chairs the Senate Health, Education, Labor, and Pension (HELP) Committee and on Monday released a report revealing how Big Pharma is "ripping off" Americans with medical treatments that publicly funded experts helped create.
Sanders' staff tracked the prices—generally set by private corporations—of medical treatments developed with the help of scientists from the U.S. National Institutes of Health (NIH) over the past two decades.
"It is unacceptable that half of new prescription drugs invented with the help of NIH scientists now cost more than $111,000," said Sanders, a longtime advocate of policies to reduce healthcare costs, including a nationwide shift to Medicare for All—the focus of a bill that the senator introduced last month with Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.).
\u201cEssential reading from @SenSanders @HELPCmteDems on US taxpayers' immense contributions through @NIH to the development of new treatments; despite this, median price is $111,000 & US taxpayers almost always pay more than other countries for these publicly-funded treatments.\u201d— Reshma Ramachandran (@Reshma Ramachandran) 1686604987
The new report states that "U.S. taxpayers virtually always pay more than people in other countries for treatments that NIH scientists helped invent."
For example, a trio of Johnson and Johson's HIV treatments—Prezcobix, Prezista, and Symtuza—cost from $25,000 to $56,000 annually in the U.S., while patients in various other countries can get them for $4,000 to $10,000 per year.
"The price of some of these taxpayer-funded drugs is now over $1.9 million," Sanders highlighted, referring to Myalept, which is manufactured by Amryt Pharma to treat leptin deficiency and costs $580,000 a year in France.
Tecartus and Yescarta, manufactured by Gilead Sciences to treat cancer, both cost $424,000 in the United States, while the price for Tecartus in Germany is $306,000 and Yescarta is $212,000 in Japan.
Yescarta is one of two case studies included in the report. The other is Hemgenix, used to treat hemophilia B. As the document details:
The world's most expensive medicine—with a $3.5 million price tag—is the culmination of major scientific breakthroughs led by researchers at St. Jude Children's Research Hospital and NIH. However, NIH appears to have handed over taxpayer technology while obtaining vanishingly little in return. Licensing agreements reveal that NIH negotiated royalties of around 1% on sales, without any pricing constraints. Meanwhile, the company behind Hemgenix, uniQure, quietly disclosed that the price was "significant" and "most patients and their families will not be capable of paying for our products themselves."
"Congress provided nearly $54 billion for biomedical research across the U.S. government this year" and NIH alone has a $47.5 billion budget, "making it the largest biomedical research funder in the world," the report notes, stressing that "the federal government sets the stage for new medicines with its substantial investments."
"At the earliest stage, the federal government plays a role in pushing forward research for virtually all new medicines," the publication explains. The U.S. government also "directly funds the invention of some medicines," and sometimes helps with testing.
There are even cases in which the government financially backs getting medicines through the Food and Drug Administration approval process and scaling up manufacturing, the report adds, pointing out that "many Covid-19 products developed as part of Operation Warp Speed benefited from this kind of support."
\u201cNow is the time for the Biden Administration to take executive action to substantially lower the price of prescription drugs and to take on the corporate greed of the pharmaceutical industry.\u201d— Bernie Sanders (@Bernie Sanders) 1686606120
The report draws from U.S. history to offer a solution, highlighting that "after a pharmaceutical company launched an AIDS drug developed with the help of NIH scientists at $10,000 per year, NIH responded in 1989 by inserting a 'reasonable pricing clause' into contracts when taxpayers supported new drugs. The clause was withdrawn six years later after industry pressure."
"The average price of new treatments that NIH scientists helped invent over the past 20 years is now more than 10 times the price that led NIH to first introduce a reasonable pricing clause in 1989," the document continues. "The federal government should reinstate and strengthen a 'reasonable pricing clause' in all future collaboration, funding, and licensing agreements for medical research."
Sanders argued Monday that "now is the time for the Biden administration to take executive action to substantially lower the price of prescription drugs and to take on the unacceptable corporate greed of the pharmaceutical industry."
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