President Donald Trump and Elon Musk have essentially eviscerated the U.S. Agency for International Development (USAID). Given the many millions of lives the agency has helped save around the globe, the results will be devastating; we already have evidence of this as the U.S. fails to step in with assistance in the aftermath of the earthquake in Myanmar. Meanwhile, Trump’s abandonment of international aid also threatens the philanthropic legacy of the biggest global development donor of our time: Bill Gates.
Few people are better positioned than Gates to understand the human implications of the USAID cuts — and to do something about it. The Gates Foundation has given away over $77 billion in grants since it was founded, much of it to promote global development and health. The foundation has supported vaccine research, development and fair distribution; global family planning; safe water access; and sustainable development, just to name a few of its funding commitments. Gates’ philanthropy is informed by scientists, medical professionals, global health advocates and local leaders in pursuit of its mission: “To create a world where every person has the opportunity to live a healthy, productive life.”
Despite the vast fortune the foundation has already given away, Gates’ potential grantmaking resources are even vaster. The foundation’s current endowment exceeds $75 billion and it’s aiming to give away $9 billion a year. Bill Gates’ own fortune hovers at roughly $161 billion, according to Bloomberg (Forbes’ estimate is lower, but still exceeds $100 billion). The 69-year-old has said the majority of his wealth will end up at the foundation.
Given his monumental stake in the success of the global development project writ large — much bigger than any other philanthropist if we’re measuring by dollars alone — one might expect Gates to be up in arms right now. To date, however, his opposition to the cuts at USAID has been couched in polite language, and has received less press coverage than his new memoir. In one interview, Gates mildly suggested that Musk doesn’t appreciate what USAID does. In another interview with CNN’s Anderson Cooper, after pointing out that USAID represents just 1% of the federal budget, saves billions of lives and makes the U.S. stronger, Gates concluded, “Having all those people not come into work and characterizing the whole thing in a negative way — I’m a little disappointed in that.”
“A little disappointed?” To be fair, Gates has also gone directly to the president to express his support for USAID. In early February, Gates told NBC that he’d had a brief meeting with Trump and a longer meeting with Trump’s Chief of Staff Susie Wiles to talk about the agency’s work.
“I went through that ‘Hey, I’ve been out in the field with USAID,'” Gates told NBC’s Savannah Guthrie. “It’s unbelievable what an asset that is. I know all the development agencies of all the countries, and this is the best of them.” Asked if he thought Trump and Wiles were receptive to his arguments, Gates said he hoped so. However, shortly after the interview aired, the New York Times reported that nearly all of USAID staff would be laid off.
Since then, Gates has apparently continued to work behind the scenes to advocate for the aid agency. According to Reuters, he warned the administration and lawmakers in Washington that he can’t fill the gaps in global health funding that the administration’s cuts will create.
Gates, who has cultivated a mild-mannered, professorial style since he embarked on his groundbreaking career as a full-time philanthropist, appears to be most comfortable using his influence to persuade decision makers in cordial terms, rather than shouting from the rooftops.
However, while applying steady pressure in the halls of power might be an effective strategy in other administrations, it doesn’t seem to be getting anywhere in this one. Last week, the New York Times reported that the administration will cut support for Gavi, which helps purchase vaccines for children in developing countries (the Gates Foundation is a Gavi founding partner). The administration will also scale back support for efforts to fight malaria, which kills hundreds of thousands of people — mostly children — every year. And last Friday, the administration announced plans to reduce the USAID staff to 15 people — down from about 10,000 — who will work under the umbrella of the State Department. (Some USAID employees received termination notices when they were assisting victims in the wake of the Myanmar earthquake).
Trump and Musk don’t seem to be deterred by appeals either to compassion or to the facts. For example, even if one cares only about putting “America first,” diseases don’t recognize borders, so ignoring their spread overseas clearly threatens people here. Do we need to wait for the next global pandemic? USAID appears to have been in Trump’s sights for a long time, and it was one of his first targets after he took office. The president has called the agency “corrupt,” and charged that it is “run by radical lunatics.”
Elon Musk, whose philanthropy is lackluster despite his vast wealth, recently told Joe Rogan that empathy is “the fundamental weakness” and “a bug” of Western civilization. To justify slashing USAID, the billionaire has worked to undermine its image in the public eye. He has called it a “criminal organization”, a “radical left political psy-op” and a “ball of worms.” In early February, he sounded giddy when he bragged on X that he had missed “some great parties” to spend the weekend “feeding USAID into the wood chipper” instead.
“Shameful and evil”: other stakeholders speak out on the gutting of USAID
A number of prominent figures have been more outspoken than Gates in countering Trump and Musk’s dark view of USAID and its work.
Surgeon and writer Atul Gawande was a senior official for USAID in the Biden administration and resigned on the day Trump was inaugurated for the second time. In a recent interview with The New Yorker’s David Remnick, Gawande countered the popular misconception that the U.S. spends a substantial portion of its budget on humanitarian aid. Referring to the part of USAID he administered, Gawande said, “In fact, on a budget for our global health work, that is less than half the budget of the hospital where I did surgery here in Boston; we reached hundreds of millions of people, with programs that saved lives by the millions… It is at a level of scale I could never imagine experiencing.”
When Remnick suggested that the administration’s actions are “tragic and outrageous,” Gawande replied, ”That is beautifully put. What I say is — I’m a little stronger. It’s shameful and evil.”
In a New York Times column that should be required reading for anyone inclined to cheer on Musk and his chainsaw, journalist Nicholas Kristof disputed Musk’s claim that no one has died as a result of the USAID cuts. He provided examples of children who have already died, including 10-year-old Peter Donde, who contracted HIV from his mother when he was born. Donde had been receiving medication under the program PEPFAR, which has saved 26 million lives since it was created by President George W. Bush. Brookings has called PEPFAR “one of the most successful foreign policy programs in U.S. history.”
When Trump and Musk halted USAID programs, a health outreach worker was no longer able to deliver medication to Donde and other AIDS orphans. Donde died in February.
Citing Musk’s wood chipper tweet, Kristof wrote, “When you meet those dying children and look into their eyes and hold their hands and feel faint heartbeats flutter, you can’t bear the gleeful laughter. You see children just like your own and hang your head in shame.”
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A former USAID employee describes chaos and confusion after the purge
There are countless other examples of the devastating impacts of eliminating USAID. Efforts to gather data critical to global aid work are being undermined, for example, as well as programs to strengthen democracy and human rights. Initiatives aimed at cleaning up the damage caused by Agent Orange, the ultra-toxic “tactical herbicide” used by the American military during the Vietnam War, and supporting those exposed, have come to an abrupt halt. Programs across the globe that promote education and protections for girls have already been severely impacted, as Shanna Marzilli, the president and CEO of Plan International USA, recently detailed.
In an interview with Politico, Andrew Natsios, a Republican who ran USAID under George W. Bush, dismissed the administration’s plan to incorporate what remains of the agency into the State Department. “When Australia folded its aid agency into the secretary of state’s office — and they did the same thing in Canada with their Foreign Office — all of the development functions eventually withered away,” Natsious said. “There are no aid agencies in those countries now.”
One former USAID employee, who asked that her name not be disclosed, worked in the first Trump administration and in the Biden administration, doing disaster risk management. She was laid off along with thousands of other employees not long after Trump’s inauguration. She considers herself lucky because she has already found another job (she participates in an online chat group with over a thousand former USAID employees, many of them parents, and no one else in the group has found employment yet).
In her new position, the former employee has had contact with a number of representatives of NGOs that have long relied on USAID funding.
“The situation inside the nonprofits now is that they have had to terminate their staff because there’s so much uncertainty,” she said. “Some large NGOs have had to lay off over 50% of their staff; they’re doing massive layoffs in order to protect themselves from further financial exposure.” The Trump administration has given some organizations humanitarian waivers and said that funds will be restored, but so far, both communication and follow through has been limited to nonexistent.
“In the news, we’re seeing the administration saying that they are giving humanitarian waivers, but no one is communicating with the organizations, and the good faith is not there,” she said. “There’s just so much uncertainty that people would rather self-terminate their programs than risk the financial exposure, which could bankrupt them. We’re not talking pennies, right? We’re talking millions of dollars a month.”
The employee is concerned that more private funders haven’t stepped in to help NGOs continue their work, if only on a temporary basis. “I’ve been quite shocked to see the silence from some of the big philanthropies,” she said. “Where are the foundations? I’m thinking about the big family foundations, where there is significant amounts of money — not enough to fill the gaps, but enough to keep some of these programs on a lifeline while everyone figures out what is going on. Because I’m watching these programs close in front of my eyes, and they are genuinely life saving. How is it that we have all these wealthy individuals and foundations in the United States, and there is so little understanding of how organizations can access that money? I just don’t understand.”
Time for the biggest global development funders to speak up
Philanthropy is known to move slowly and deliberately, and some foundations, including the Gates Foundation, are no doubt making plans to step in and fill some of the gaps in aid funding. (To date, Gates Foundation CEO Mark Suzman has released a number of politely worded statements disagreeing with the administration’s direction on global funding.)
The former USAID employee hopes funders are making plans, but she pointed out that time is of the essence because staff are being cut and programs demolished right now — and the need is greater than ever.
This is also the time for those who oppose the administration’s actions to defend USAID — before people move on to the next blaring headline. To date, the Trump administration’s “flood the zone” strategy has made it difficult to keep track of the firehose of executive actions and agency plunders, and since USAID operates overseas, life-saving programs are at risk of drying up and disappearing far from the public spotlight.
A federal judge recently called DOGE’s USAID cuts unconstitutional, but this administration does not appear inclined to abide by court orders and is going ahead with plans to scrap the agency “in all but name.” The former USAID employee pointed out that since the earthquake in Myanmar, where the death toll has already passed 2,000 and is expected to go far higher, Trump has said the U.S. will respond, but so far it hasn’t done so. “My question is, how?” she asked. “How are we going to respond? This is a great example of where USAID would formerly be involved and cannot now, because it’s debilitated.”
Bill Gates is hardly a radical and he’s clearly more comfortable with reasoned persuasion and maintaining a certain distance from politics in his philanthropy. But as IP Editor-in-Chief David Callahan recently argued, this business-as-usual approach hasn’t done liberal philanthropy any favors lately. With his core values and philanthropic legacy under attack, now is the time for Gates to take a stronger stance — by speaking out more forcefully in the media and in as many forums as possible to raise public awareness, for example. Or by partnering with global health leaders and other foundations to amplify the importance of USAID’s work.
The spectacle of an ultra-wealthy president and the richest man in the world snatching food and healthcare away from those who need it and allowing millions to die is shameful and evil, as Gawande observed. Bill Gates’ wealth and humanitarian history give him a major voice; now would be a good time to get louder.
