The Opinions - U.S.A.I.D. Might Be Dead, but the Waste Is Alive and Well

Episode Date: July 2, 2025

The United States Agency for International Development no longer exists. As of July 1, what’s left of it has been absorbed into the State Department. President Trump and Elon Musk dismissed the agency as wasteful spending. But on a reporting trip to West Africa, the columnist Nicholas Kristof found that by eliminating U.S.A.I.D., America has left lifesaving resources to deteriorate — with deadly consequences.Thoughts? Email us at [e-mail] episode of “The Opinions” was produced by Kristina Samulewski. It was edited by Alison Bruzek, Kaari Pitkin and Jillian Weinberger. The rest of the show's production team includes Derek Arthur, Vishakha Darbha and Jillian Weinberger. Mixing by Carole Sabouraud. Original music by Pat McCusker and Carole Sabouraud. Fact-checking by Mary Marge Locker, Michelle Harris and Kate Sinclair. Audience strategy by Shannon Busta and Kristina Samulewski. The director of Opinion Audio is Annie-Rose Strasser. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This is The Opinions, a show that brings you a mix of voices from New York Times opinion. You've heard the news. Here's what to make of it. I'm Nicholas Christoph. I'm a columnist for the New York Times. This year, I've been reporting a great deal on the cuts in American aid funding. USAID has provided humanitarian assistance all over the world, and it's had an enormous impact. By one count, it saved more than 3 million lives each year. And then this year, it was dismantled over a weekend by Elon Musk. You know, I keep thinking that Elon Musk and Donald Trump,

they promised that they were rooting out waste in USAID, but instead what I see is that they created it. I'm just back from Sierra Leone and Liberia in West Africa. And there are two countries where you see, as you walk through the villages, as you go to clinics and schools, you see the impact of USAID cuts. You see kids dying. You see aid not being available.

And in Sierra Leone, I had just spent a morning in villages where kids were not getting the medicine they needed. And then I went to a warehouse behind a fence and a security guard let me in. And I found millions of doses of medicine. of medicines that have been donated to Sierra Leone. These boxes are stacked high on all sides. They would help millions of children.

And they're free. Merck and other pharma companies donated these medicines as part of what's called mass drug administrations for diseases like blindness, like chistosomiasis to kill parasites. And because these are donated drugs, this kind of thing is incredibly cost effective for every dollar cost you leverage $26 in private donations.

But they are gathering dust, and some of them are approaching their expiration date and may have to be destroyed at very significant cost because Trump administration canceled the program to distribute them. In Sierra Leone, I met a social worker called Paios, who has been supporting HIV-positive patients. And he said that for several months, they ran out of antiretroviral drugs that keep AIDS patients alive. Many of our clients are dying because of lack of medication. If there's any disruption at the end of the day, we also have many deaths.

Do you know the name of the American president who made these decisions? Yeah, Donald Trump. So President Trump, your right to denounce waste and abuse. in government programs. But if you care about waste, then I hope you'll intervene to try to use this medicine in this warehouse in Sierra Leone before it expires

so that some kids can have their lives saved with all this donated American medicine. There were some places on this trip that I just wanted to break down and weep. There was one village in Liberia where I met the family of a woman called Yama Freeman, a mother of two, who was pregnant for a third time and went into labor in April and hemorrhaged. And there was a system in place to help women like her. The U.S. had donated ambulances to rush women with labor problems to a hospital that could have saved her

life. But when USAID cuts were made, one of those cuts was to the fuel to support those ambulances. So when Yama's family called the ambulance, they said, look, we have the ambulance, but we don't have fuel. If you want to come rescue Yama, you've got to send somebody by with fuel. The family couldn't do that. So the strongest young men in the village gathered Yama in a hammock. They put her on their shoulders as she's bleeding, and they race down this red mud path toward the town and the shouting encouragement as they go. But it's too far. And she dies along the way, along with her unborn son. And I just think of that human and financial waste alike, that we were willing to provide $50,000 for each for ambulances

and unwilling to provide a few dollars for the gas to enable those ambulances to save lives. Some folks are probably thinking, look, it's too bad about Yama. It's too bad about what is happening, but this isn't my problem. These countries have to look after themselves. And I guess to them, I'd say that, you know,

United States has values at stake, but we also have interests at stake. This is a moral crisis, but it's also a national security crisis in a couple of respects. One is that when John Kennedy started USAID, he did this in part to advance American soft power around the world. The people who are opposed to aid should realize that this is a very powerful source of strength for us. It permits us to exert influence for the maintenance of freedom. At that time, our soft power was vis-a-vis the Soviet Union. Now it's principally vis-a-vis China. And now with this gap, China is stepping in to win friends and influence around the world.

And I think the other thing I'd mention is that we protect Americans not only with aircraft carriers, but also with health surveillance systems and by treating diseases like Ebola and tuberculosis. abroad before they can come to the United States. So this collapse of American humanitarian aid, I believe contradicts our values, but it also undermines our own national interests. Look, I recognize that USAID was imperfect, that there was some spending that was not optimal. And at the end of the day, we can't save every child's life around the world. But what I see when I travel in these villages is that we can sure save some really inexpensively. And we can have this transformative impact on so many lives for negligible costs with these donated drugs, for example.

And now it just feels that there are these folks in Washington who had no idea what they were doing. and because of their somewhat random decisions, you have these medicines going to waste and perhaps having to be destroyed at great cost, their children or moms dying in Sierra Leone, in Liberia, and in villages all around the world. It's just heartbreaking. If you like this show, follow it on Spotify, Apple,

or wherever you get your podcasts. The Opinions is produced by Derek Arthur, Bishaka, Christina Samuelski and Jillian Weinberger. It's edited by Kari Pitkin and Alison Bruzick. Engineering, mixing, and original music by Isaac Jones, Sonia Herrero, Pat McCusker, Carol Sabro, and Afim Shapiro. Additional music by Amon Sahota. The fact check team is Kate Sinclair,

Mary Marge Locker, and Michelle Harris. Audience Strategy by Shannon Busta and Christina Samuelski. The director of Times Opinion Audio is Annie Rose Strasser.