The richest man in the world and the President of the United States sent a message over the weekend to USAID, the world’s largest provider of humanitarian assistance depended on for survival by millions of the world’s poorest people: “Time to die.”

Two weeks into Donald Trump’s return to the Oval Office, the Washington headquarters of the US Agency for International Development (USAID) shuttered its doors on Monday, making it the latest, most visible casualty in the new administration’s sweeping dismantling of America’s foreign aid apparatus. 

Hours later, USAID employees couldn’t tell if their agency still existed. Its website went dark, social media accounts vanished, and staff found themselves locked out of email servers. Overnight, photos documenting decades of aid work and agency logos vanished from the Washington office’s walls.

The unravelling of the agency, which employs over 10,000 people who assist tens of millions worldwide every year, began last week with sweeping personnel cuts: half its global health staff dismissed, 60% of its humanitarian assistance bureau eliminated, and 500 employees terminated, including at least 56 senior officials. 

By Saturday night, two top security officials were placed on administrative leave for refusing to grant billionaire Elon Musk’s personnel access to classified agency systems.

The assault further escalated as Musk announced he had secured the president’s support to abolish USAID entirely after over six decades of operation.

“I went over it with him in detail, and he agreed that we should shut it down,” Musk said. “USAID is a criminal organization. It’s time for it to die.”

Speaking to reporters in front of Air Force One on Sunday night, Trump tore into the agency and confirmed Musk had his support.

“It’s been run by a bunch of radical lunatics,” Trump said. “And we’re going to get them out.”

USAID’s $42.8 billion budget represents just 2.14% of America’s annual domestic healthcare spending of $2 trillion.

Agency under attack 

We spent the weekend feeding USAID into the wood chipper.

Could gone to some great parties.

Did that instead. https://t.co/0V35nacICW

— Elon Musk (@elonmusk) February 3, 2025

Musk’s Department of Government Efficiency (DOGE) leading the attack on USAID has no official status, as Congress would need to approve establishing such an agency. Musk is neither a federal employee nor a government official. The question of who, if anyone, DOGE is accountable to, remains unresolved.

“We spent the weekend feeding USAID into the wood chipper,” Musk said, noting he had foregone “some great parties” to focus on dismantling the aid agency that tens of millions in over 150 countries rely upon for health care, education, emergency assistance and economic development. 

Amid a barrage of over 200 tweets in 24 hours, the DOGE chief described the agency as “a viper’s nest full of radical left Marxists who hate America,” “evil,” and “beyond repair.” The volume aligns with Musk’s typical social media presence – a Financial Times analysis found he averaged 168 tweets daily over a recent week, totalling more than 1,180 posts.

In one exchange, Musk responded with a bullseye icon to far-right commentator Milo Yiannopoulos’s statement: “By closing USAID, Trump and Musk have toppled the most gigantic global terror organization in history.”

Veterans of the agency quickly fired back at the accusations. 

“I oversaw global health programs at USAID. They reached hundreds of millions of people, added six extra years to the lifespan of children in partner countries, and were eradicating health threats worldwide,” said Atul Gawande, former global health lead at USAID. “What insanity and cruelty to break that.”

‘Another assault on the constitution’

Democrats defending the agency argue Trump has no authority to unilaterally dismantle USAID, which Congress created under John F. Kennedy in 1961.

“Trump isn’t satisfied just to close programs and fire staff. He is now planning to ELIMINATE THE ENTIRE AGENCY,” said Connecticut Senator Chris Murphy. “That would be illegal. He cannot unilaterally close a federal agency. Another assault on the Constitution.”

Yet since retaking office, Trump’s administration has repeatedly exceeded executive authority with little resistance from the Republican-controlled House and Senate, including overturning a congressional ban on TikTok. His iron grip on the party has so far prevented any meaningful pushback.

The involvement of Musk’s unofficial Department of Government Efficiency in the weekend raid on USAID headquarters triggered additional alarms. Senate Democrats sent an urgent letter to Secretary of State Marco Rubio demanding explanations for the agency headquarters’ closure and potential unauthorized access to classified information by DOGE appointees. 

“It is unclear whether those who accessed secure classified facilities had proper clearance or what they were seeking to access,” the ranking members of the Senate Foreign Relations Committee wrote. “We understand that security guards present at the facility were threatened when they raised questions.”

The letter expressed “deep concern” that officials from DOGE may have compromised national security in their rush to dismantle the agency.

“Staff tell me, “It is frightening being inside USAID right now,”” Gawande said. “Our checks and balances failed,” current staffers told him. “Congress has abdicated its responsibilities.” 

USAID goes dark 

The shredding of USAID led by Musk halted long-running programs protecting millions from AIDS, infectious diseases, tuberculosis, malaria, pregnancy and childbirth complications. Aid providing electricity to Ukrainian refugees, medical care for displaced Palestinians and Yemenis, mpox surveillance, and HIV medications are also among the long list of casualties. 

Thousands enrolled in clinical trials backed by USAID now find themselves stranded, the New York Times reported, unable to continue experimental treatments as researchers and medicines are withdrawn. The world’s largest anti-malaria donor, the President’s Malaria Initiative established under former President George W. Bush funded by USAID, has terminated two-thirds of its workforce.

Though Secretary of State Marco Rubio moved to exempt “lifesaving humanitarian assistance” from the funding freeze at USAID last week, aid workers remain paralyzed by confusion. 

Staff on the ground cannot resume work without explicit USAID approval. But with mass layoffs at the agency, including hundreds of staff who handle communications with aid recipients, there is no one left to process these lifesaving waiver requests that would allow partners to resume operations. 

Speaking from El Salvador, Rubio defended the organizational changes at USAID, accusing its officials of acting like “a global charity separate from the national interest” and failing to cooperate with Trump administration inquiries. He insisted the agency’s core programs would continue under State Department oversight, though he did not name who would lead them.

“The sudden freeze on US-funded aid programs will put millions of lives at risk, including some of the most vulnerable people on the planet,” Suerie Moon, a global health expert at the Geneva Graduate Institute told Health Policy Watch. “It is sickening to watch the world’s richest man toying so carelessly with the lives of infants, children, the sick, victims of natural disasters and war.” 

“Aid programs are not rockets to be tinkered with,” Moon added. “There are millions of lives and livelihoods at stake.” 

Third of global health aid at risk of vanishing 

USAID is the backbone of global health assistance. For two decades, the US has been the largest contributor to global health programs, providing $11.4 billion in health aid in 2022 — nearly a third of the $33.9 billion spent globally. The agency’s programs have saved tens of millions of lives through work targeting maternal and newborn health, malnutrition, malaria, tuberculosis and HIV.

Thousands of aid organizations now face an impossible choice: defy the order and continue working, or halt care and watch patients die. In famine-stricken Sudan, staff at US-funded medical facilities told ProPublica that complying with Trump’s order would mean the death of 100 babies and toddlers in their care overnight. They chose to continue working, knowing their supplies would last only days.

Their dilemma is replicated across the globe. Medical facilities, nutrition programs, and disease prevention initiatives must each decide whether to risk operating without guaranteed funding or shut down immediately. Health workers and organizations staying open to help patients have only one question left: not if, but when their last medical supplies will run out.

“Cutting that support overnight is sowing chaos in dozens of countries,” Moon said.

Low-income countries on average depend on foreign aid for one-third of their national health spending. Facing their highest debt burdens in decades, many of the world’s poorest nations are unlikely to be able to compensate for the budget hole blown open by USAID’s withdrawal.

During his first term, Trump’s “America First” budget proposed a 28% reduction to State Department and USAID funding. An impact assessment by PATH at the time estimated that just a 33% cut to maternal health services would result in 20.5 million women and children losing access to essential care, leading to approximately 2 million deaths over two years.

The total closure of USAID would prove deadlier than the projections issued by PATH in 2019. 

“The immediate consequences of this are cataclysmic. Malnourished babies who depend on US aid will die,” Murphy said. “Diseases that threaten the US will go unabated and reach our shores faster.”

How much does America pay? 

The US leads global aid spending, providing  42% of worldwide humanitarian assistance tracked by the United Nations in 2024. But these figures reflect its economic dominance more than exceptional generosity.

Measured against economic capacity data, US aid flows tell a different story. The US economy exceeds China’s, its nearest rival, by over $10 trillion – two-thirds of China’s economy – and is five times larger than third-ranked Japan’s. Yet America ranks 25th in development assistance as a percentage of gross national income, contributing 0.24% in 2023. 

This falls well short of the 0.7% target United Nations member states agreed to in 1970. Only five European countries meet this benchmark, while OECD countries countries average 0.37% – triple the US contribution.

“Of all the targets of the administration’s ire, why USAID?” Professor Lawrence Gostin, a public health expert at Georgetown University, asked on social media. “It gives vital assistance to people in poverty, suffering in a disaster, or in dire health conditions. All for under 1% of the federal budget.”

A legacy of lives saved, a gift to America’s rivals  

In 2023 alone, USAID provided essential healthcare to 92 million women and children. Over the past decade, its programs saved more than 7.4 million lives, helping slash global child mortality by more than half and reducing maternal deaths by a third.

The agency’s flagship program PEPFAR has saved an estimated 26 million lives through HIV treatment and prevention. Its collapse would have immediate, devastating consequences: in just three months, nearly 136,000 babies – about 1,500 each day – would be born with HIV as pregnant women lose access to transmission-prevention medication.

As USAID’s operations grind to a halt, America’s geopolitical rivals are celebrating. Russian state media quickly declared “USAID is dead,” while former Russian President Dmitry Medvedev publicly endorsed Musk’s dismantling of the agency. 

“Smart move by Elon Musk,” Medvedev said. “Let’s hope the notorious deep state doesn’t swallow him whole.” 

The vacuum created by USAID’s collapse threatens to reshape global influence. Policymakers across party lines warn that USAID’s dissolution could create a vacuum for geopolitical adversaries, particularly in Africa. 

“China – where Musk makes his money – wants USAID destroyed. So does Russia,” said Murphy. “As developing countries will now only be able to rely on China for help, they will cut more deals with Beijing to give them control of ports, critical mineral deposits. US power will shrink.”

USAID’s work extends far beyond humanitarian aid, including supporting allies against Chinese economic coercion in Asia, combating fentanyl trafficking, and providing military assistance to key allies like Taiwan, South Korea, and Ukraine. All this was achieved for just one cent of every American tax dollar.

“Having an unelected billionaire, with his own foreign debts and motives, raiding US classified information is a grave threat to national security,” warned Congresswoman Alexandria Ocasio-Cortez. “The people elected Donald Trump to be President – not Elon Musk.” 

Image Credits: White House , Reuters Youtube, ONE Data , USAID Archive.