The great adventure of my birth family was the fifteen months we lived in New Delhi, from June of 1961, on a USAID-sponsored educational mission. So the destruction of USAID feels personal. I’m only now realizing that we were there at the very beginning of USAID, during what Jackie Kennedy later mythologized as the Camelot era. On a tour of India, at a meet-and-greet in New Delhi, she appears in this family photo.
We must have been at the embassy, she’s surrounded by Americans. You can see a few South Asian faces in the background. The young boy at the center of the photo, gazing up at the queen of Camelot, is five-year-old me.
It could have been a Life Magazine cover: “A vision in white, Jackie represents America’s commitment to be of service to the world.” As corny as that sounds, though, the commitment was real. Our nation upheld it for sixty years and then, a few months ago, fed it to the wood chipper and set in motion a Holocaust-scale massacre.
We suggest the number of lives saved per year may range between 2.3 to 5.6 million with our preferred number resting on gross estimates of 3.3 million.
The shutdown likely won’t kill 3.3 million people annually, say its “only” a million. Per year. For six years. It adds up.
Atul Gawande was leader of global public health for USAID. On a recent podcast he runs some more numbers.
On USAID “waste”:
“It’s 0.35% of the federal budget, but that doesn’t help you, right? Try this. The average American paid $14,600 in taxes in 2024. The amount that went to USAID is under $50. For that we got control of an HIV epidemic that is at minuscule levels compared to what it was before. We had control of measles and TB. And it goes beyond public health. You also have agricultural programs that helped move India from being chronically food-aid-dependent to being an agricultural exporter. Many of our top trading partners once received USAID assistance that helped them achieve economic development.”
On USAID “fraud”:
“When Russia invaded Ukraine they cut off its access to medicine, bombed the factories that made oxygen, ran cyberattacks. The global health team moved the entire country’s electronic health record system to the cloud, and got a supply chain up and running for every HIV and TB patient in the country.”
On USAID “abuse”:
“The countries where we worked had at least 1.2 million lives saved. In addition, there was a vaccine campaign for measles and for HPV. For every 70 girls in low income countries who are vaccinated against cervical cancer from HPV, one life is saved. It’s one of the most life-saving things in our portfolio. Our vaccine programs would have saved an additional 8 million lives over the next five years.”
America has never been a shining city on the hill but USAID represented our best aspirations. In the throes of the Maoist cultural revolution that tore it down there are many other horrors to confront, but for me this one hits hardest.
