Yes, the Cuts to USAID Have Killed

(Photo illustration by Bill Kuchman/The Bulwark | Photos: Getty)

IN A RECENT VIDEO, Elon Musk, the world’s first trillionaire, defended his decision last year to feed the United States Agency for International Development “into the wood chipper.” When someone on his social-media platform claimed that not a single child had died because of his destroying USAID, he reposted their argument with a single word of commentary: “Exactly.” Musk said that during his “DOGE” rampage he’d never been able to talk to any real children who could prove to him they were suffering and receiving help from the agency, because it was so full of “fraud and graft.”

But Musk is wrong. Many people, including many children, have died as a direct result of the cuts he and his DOGE team made to USAID. And the number of deaths no longer being prevented by the agency will only grow.

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To back up, USAID was established in 1961 to end extreme global poverty, promote democracy, and advance U.S. interests. In the five years prior to the second Trump administration, U.S. spending on foreign aid, a figure that includes but is not limited to the work of USAID, ranged from $35.6 billion to $61.2 billion per year, or less than 1 percent of the federal budget. It also typically accounted for over a quarter of total development assistance given by all countries put together. In some twenty developing countries, U.S. aid “equaled more than 10 percent of domestic health expenditure,” according to an analysis from the Center for Global Development; in one case, Afghanistan, American aid equaled three times the domestic health expenditure. In 2024, 50 to 60 percent of Côte D’Ivoire’s AIDS response was funded by the United States. In the Democratic Republic of Congo, that figure was 89 percent.

And if we define success as saving lives, USAID was working. Not by itself, but alongside parallel investments by Global South governments, advocacy by people, and economic growth. One study estimates that USAID saved around 92 million lives over the last two decades, including 30.4 million children under 5. Since 1990, the world has more than halved the number of children dying before the age of 5, from 13 million a year to 4.9 million. Between 2000 and 2023, we cut maternal deaths by 40 percent. USAID is an important part of that story.

These positive indicators are changing direction for the first time in thirty years. Around 200,000 more children are believed to have died in 2025 than in 2024. Over 1,300 health and family planning clinics have closed globally due to USAID cuts. Thousands of medical professionals were laid off. Studies show an increase in child marriages, violence against women and girls, and civil disorder, including riots and armed battles. Lancet modeling indicates USAID cuts may cause 14 million deaths, including those of 4.5 million children under age 5, by 2030.

IF MUSK SAYS he wasn’t able to talk to any suffering children, here is a sourced list of some children who died after USAID funding was axed. Of course, it’s for Musk and readers to decide whether USAID cuts can be said to have “caused” their deaths. But I would argue that abruptly withdrawing medication or food a child needs to stay alive, with no way for them to obtain that medicine or food themselves, qualifies as causing their death. Those children are not available for Musk’s phone call now, but perhaps the SpaceX owner could call their relatives and learn something about how much each of these children meant to their families.

Perhaps he could call Rovina Naboi in Kenya. She lost her little daughter Jane to starvation in a refugee camp. Jane’s death was documented by Dr. Atul Gawande, who headed USAID’s global health efforts under the Biden administration and now works at Harvard’s School of Public Health. As Gawande explained in a short documentary about Naboi and Jane’s situation, the food for the camp was provided by USAID. After the cuts, it was rationed to 40 percent of daily caloric needs, and one meal a day. Jane’s mother said, “After the changes in food rations, I realized my daughter Jane was sick. She had high fever and chills. Days later, she developed diarrhea and a skin rash. Then her whole body peeled into wounds and became swollen.” Jane died.

Or maybe Musk could call Yagana Bulama, who gave birth to twins in Nigeria last year. PBS documented that a USAID-funded Mercy Corps program provided the babies with a special nutrient-dense paste to treat severe acute malnutrition. When the twins were six months old, the Mercy Corps program ended abruptly because it lost all financing from USAID. Two weeks later, one of Yagana’s twins died. She had already buried three babies.

Musk could reach out to the family of little Mohammad Omar, aged 1, who died in Afghanistan last year suffering from malnutrition and meningitis. This CNN report tells the story. It’s not possible to say the cuts caused Mohammad’s death, but the doctors, nurses, and midwives, as well as the medication and equipment at the hospital where Mohammad was treated, used to be provided by USAID. But then funding stopped abruptly.

The Washington Post reports on Fatma Swak Fadul, who lost two of her children, Nada, eighteen months, and Omer, 3 years, after USAID cuts meant the soup kitchen they relied on for their one meal a day in Quaz Nafisa, Sudan ran out of food. Nada starved to death, too weak even to cry. Omer loved wrestling and dreamed of owning a bike. He first lost his sight, then he begged for porridge.

ProPublica reported that Tor Top lost his mother, Nyarietna, in South Sudan’s worst cholera outbreak in history. The local clinic, which could have treated his mother with IV bags for just 62 cents, was run by World Relief and funded by USAID. It closed because of USAID cuts two weeks before Nyarietna started vomiting. Top put his mother in his canoe and paddled eight hours toward the nearest hospital. She died less than halfway there. He turned around and took her home, where he buried her in their backyard.

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Al Jazeera and Save the Children tell the story of eight people, including five children, who died after walking several hours in three-digit heat to get cholera treatment in South Sudan, because their local USAID-funded clinic had closed, and the U.S.-funded transport service to a nearby hospital had also been shut down.

NPR takes us back to Afghanistan, where midwives report two pregnant women died when their USAID maternity clinic closed. One died in childbirth, the other bled to death while trying to get to a hospital. Their babies died, too.

Musk could learn about Omran, aged 3, who the Washington Post reports died of a chest infection in Sudan. His increasingly frantic mother took him to eleven clinics but none had medication. His doctor said basic antibiotics would probably have saved him. The antibiotics used to be provided by the International Rescue Committee, funded by USAID. They stopped providing them abruptly three months before Omran needed them.

Still in Sudan, the New York Times reports on Achol Deng, who was 8 years old. Her HIV medication and her health worker were funded by USAID. Achol died when she couldn’t get more medication. Jennifer Inyaa and her 5-year-old son Evan also had their HIV medication funded by USAID. It stopped abruptly. After a month without medication, Jennifer got sick and died. A week after losing his mother, Evan died too.

In Myanmar, the Associated Press tells us how Mohammed Taher clutched the frail body of his 2-year-old son as the toddler died in his arms from malnutrition. Before he died, the little boy suffered from diarrhea and begged for food. His name was Mohammed Hashim, and his food rations in Myanmar were stopped following Musk’s destruction of USAID. “I lost my son because of the funding cuts,” his dad wept.

In Afghanistan, USAID cuts closed more than four hundred medical clinics, many of which provided the only medical care in the region. Journalist Yogita Limaye spoke to Abdul about his pregnant wife Shahnaz. When Shahnaz was in labor, Abdul spent 50 to 70 percent of his monthly earnings to rent a car to drive to the USAID-funded clinic. But it was closed due to USAID cuts. Shahnaz delivered her baby on the way home. She lost a lot of blood, and she died where she delivered, on the side of a dirt road. Their baby girl died shortly after. Their graves are at the side of the road. The baby’s plot is tiny. Abdul covered it in thorns to stop animals digging it up.

Musk could also talk to children suffering because they lost their parents. Like Joseph, 17, Gift, 15, and Alumbwe, 12, from Zambia who lost both their parents to AIDS because the supply of antiretroviral that kept them alive ended when USAID was axed. The boys watched as, over the course of about a year, their parents grew weak, lost weight, and struggled with diarrhea. Their parents knew they were dying. Joseph dropped out of school to care for his brothers. The brothers sleep on a shared mat and blanket, their roof leaks, and they eat only once a day. I’m sure NPR, which reported the story, could assist in reaching the three boys, so the world’s first trillionaire could help the boys achieve their dreams, Joseph’s of becoming a doctor; Gift, an engineer; and Alumbwe, a soldier.

I could go on and on. Development aid is not perfect, and reform of the system is needed in many places. But it remains true that over 500,000 children have already died due to USAID cuts. Hundreds of thousands more children lost their parents. Every one of those children had a name. They had dreams, loves, and futures. Their lives were as valuable and special as your child’s or mine. They were loved, and somewhere, their families grieve for them.

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Lauren Dobson-Hughes runs a policy and advocacy organization that works on rights, democracy, and international affairs. She has a background in women’s rights and global health. She can be found at Bluesky or on LinkedIn.