Former USAID Global Health director Dr. Atul Gawande criticized the Trump administration’s plan to merge the United States Agency for International Development into the State Department and the funding freezes that are putting key aid programs in jeopardy. Asked about the changes, he said, “It’s not an overhaul. It’s a destruction.”
Gawande, a surgeon, medical professor and best-selling author, told CBS News on Monday that the “destruction” began a week ago after the White House Office of Management and Budget released a memo that ordered a freeze on federal assistance. The memo was walked back days later and the ordered freeze has been halted by a federal court, but programs appear to still be halted or in limbo.
“You’re talking about 20 million people in the global HIV program that has reduced HIV around the world, they are going without medication that keeps them alive,” Gawande said. “You’re talking about disease outbreaks that are not being stopped, like bird flu, where monitoring has been turned off in 49 countries.”
“There is a great deal of harm being done, and this change to take away the independent status [of USAID] is just a nail in the coffin after a purge of personnel that has decimated the agency,” Gawande said.
Other former USAID workers expressed similar concerns.
Maura Reap, who was a USAID contractor with the Bureau for Global Health until last week, had just arrived on a two-week assignment in Ethiopia when Secretary of State Marco Rubio ordered a pause on all new U.S. foreign assistance programs funded by the State Department and USAID. During the first week of the assignment, Reap was supposed to be focused on designing a project supporting survivors of sexual and gender-based violence. Reap, whose expertise is in mental health, said the program had been planned for months.
“We had some meetings over the weekend, and there was just a lot of uncertainty,” Reap said in an interview with CBS News. “It was like a slow train wreck.”
Eventually, she got an email saying she had to return to Washington, D.C. While she was in the air, she and her two colleagues had received termination notices.
“This terrible waste of a [temporary duty travel] with all the planning and investment that had gone into it, and it was for nothing,” she said.
Gawande also hit back at Mr. Trump and billionaire Elon Musk‘s comments, who have both slammed the agency, with Mr. Trump recently saying the USAID is “run by a bunch of radical lunatics.” Musk said the agency “is not an apple with a worm in it, what we have actually, just a ball of worms.”
Gawande countered, “What we’re talking about are disaster relief workers, we’re talking about health workers and people who are doing good and protecting America around the world.”
The Trump administration is expected to announce details in the coming days about the disruption to the USAID, a 60-year-old organization that provides humanitarian aid to more than 100 countries. The agency provides humanitarian assistance abroad, particularly to countries recovering from disaster and trying to escape poverty. In fiscal year 2023, USAID managed more than $40 billion in appropriations, the Congressional Research Service said, a figure that is less than 1% of the federal budget.
Mr. Trump has vowed to cut the size of the federal government, and USAID has been a recent target of his and Musk’s, who is tasked with leading the newly created Department of Government Efficiency, or DOGE. Earlier Monday, the White House released a list of examples of what it deemed wasteful spending by USAID in recent years. Democratic lawmakers, however, have warned that any attempt to change USAID’s structure and funding would require an act of Congress.
Reap expressed dismay that “somebody who’s not even elected can come in and just take this 60-year-old institution that has accomplished so much … and to have so much disregard and to take it and to turn it and to throw it on his back and to say, this is not — this is, we’re throwing it out.”
Gawande said it’s “dangerous for the country to denigrate” the agency, saying it’s the country’s “largest civilian operational capacity for advancing” the work of the U.S. abroad.
“We’re talking about world-class expertise. For example, the malaria program. Two-thirds have been fired, and the activity shutdown includes one of the global experts in malaria for us. How does that make us safer? How does that make us stronger?” Gawande said.
Reap also argued that the work USAID does saves lives and supports policies that benefit the United States.
“Because, I mean, there’s so many things related to the work we do,” Reap said. “Stopping outbreaks, reducing the push and pull factors for migration at our southern — at our borders. The work we do counters extremism, and it leads — it contributes to stable communities by the work we’re doing by keeping people healthy so they can contribute to their communities.”
Gawande noted, “Every administration goes through an overhaul that says they want to change policy, they want to change some direction, but you don’t decimate and demolish the institution in the process. There was no need to close down all of its functions, which is harming people.”
