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Gutting USAID: A Quick Dip (With Sources)

Gutting USAID: A Quick Dip (With Sources)
REUTERS/Kent Nishimura

So, Elon Musk wants USAID (the US Agency for International Development) shut down. His vague summary of why: “it’s beyond repair”.  And, indeed, cash outflows to USAID ceased around 27th January.

Here are some key things to know:

USAID's 2025 budget was projected to be around $31B - (the current year request was $42B, broken link here) with much targeting the poorest countries—particularly Madagascar and the Democratic Republic of Congo (the two largest recipients). Health took the largest slice, with over $3B, as USAID pivoted to NextGen, a new health supply and support program.

But Musk has his knife out for USAID, which he has termed a "criminal enterprise." After Musk declared it would be shut down, Marco Rubio instead said USAID will be folded into the US Department of State which he now heads. While its fate is a football being kicked around in Washington, we ask: Who loses if USAID goes away? Well beyond the agency’s 10,000 workers and contractors. The total downstream number of people employed and aided by USAID is around 3.5 million people.

This would wipe out other less obvious benefits to the US - personal, commercial, and professional relationships, and reputational strength - across the world. But we focus here on human health and suffering, and environmental harms.

This is a catastrophe in the making.

A health catastrophe:

  • Holding back PEPFAR will result in over 40,000 HIV-infected babies per month.
  • Tuberculosis and malaria infections will rise: USAID has been a major funder of programs targeting HIV/AIDS, malaria, tuberculosis, and neglected tropical diseases. Working in partnership with the US Centers for Disease Control, it leads the world in combating malaria, through interventions such as bed nets, drugs, spraying, hospital treatments, and more. Withdrawal would likely lead to increased infections, increased drug resistance, and higher mortality rates.  Studies estimate that reductions in funding for HIV/AIDS programs can lead to a proportional increase in new infections and AIDS-related deaths, with a 10% reduction in funding possibly leading to 5-10% increase in infections and deaths within a few years in the absence of replacement programs. These rates vary by region with countries most reliant on USAID seeing the most increases. With current funding levels, even incremental reductions (let alone a complete withdrawal) have potential to return disease burden to levels not seen in decades.
  • Maternal and child health: USAID programs support prenatal care, safe childbirth, immunization, and nutrition. Without this support, we can expect increases in maternal deaths, infant mortality, and childhood stunting. A study in sub-Saharan Africa showed a direct correlation between maternal mortality and health spending, suggesting significant increases in deaths without USAID support for maternal health. Estimates are generally in the low single-digit percent increase of maternal mortality and up to 15% of infant mortality. Sudan alone could face hundreds of deaths within days.
  • Malnutrition-related deaths in the hundreds per week would occur in Sudan: USAID is the world’s largest donor of international food assistance.
  • Surveillance of zoonotic (transferred from animals to humans) diseases would cease allowing the unchecked spread of Ebola, mpox and other diseases.

An education catastrophe:

  • Over 5,000 girls in Afghanistan receive education through programs supported by USAID and opposed by the Taliban.
  • USAID supports education for 80 million children in conflict zones: Ukraine, Sudan, and other places. Both USAID links referenced, HERE and HERE - are currently disabled.

An environmental catastrophe:

  • USAID’s climate initiatives, such as rainforest conservation in the Amazon and Congo Basin, protect 60 million hectares of carbon-rich land globally. Halting these programs would accelerate deforestation, potentially releasing 6 billion tons of CO₂ by 2030.  For every $1 million spent on forest protection, between 10,000 and 20,000 hectares of forest are conserved. The loss of funding would lead directly to a loss of forest cover and species loss if these programs are discontinued.
  • Renewable energy projects in countries like Indonesia and Nigeria would also collapse, delaying transitions to clean energy. LINK currently disabled.

Other notes and sources other than those embedded above

USAID, like all human organizations, is imperfect. And like all organizations that have grown over decades, it may have lost some focus. And, as the agency has itself admitted, too little of its spending goes to organizations local to the communities it aims to help. (Fixing this has been a stubborn challenge for the agency.). Our goal in this note is not to assert that it’s perfect. Rather, we wanted to tally some of the harms that would be inflicted on innocent bystanders by its sudden elimination.

We welcome input, and critique, particularly from USAID experts.

This Calx Quick Dip note was created early on 3rd February by a combination of human research, augmented by Perplexity / R1 and Google AI Studio running Gemini. Many of the links used have been broken since the first version was created, as the current administration scrubs more data from the internet. 

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