Dr Atul Gawande updates Senators on the destruction of USAID

Earlier this month, Dr Atul Gawande briefed US Senators on the effects that the destruction of USAID is already having. Dr Gawande, until noon on 20 January 2025, ran global health for USAID.

While the Supreme Court ruled last month that the Trump administration still has to pay its bills for work already completed by USAID contractors, that was not exactly a high bar to clear—and even that decision was a narrow 5-4 ruling. Meanwhile, all of the contract terminations and personnel purges have been permitted to go through while the overall issues are litigated. Therefore, the reality is that even if the courts eventually determine that the complete gutting of USAID was not lawful, it will already be a fait accompli—that is, practically impossible to reverse.

So, what of USAID’s crucial work remains, and what has—in Elon Musk’s own words—already been ‘fed to the wood chipper’?

In testimony to members of the US Senate, Dr Gawande summarised what has already been destroyed by callous and brutal DOGE-directed terminations since January. We are only just beginning to be able to estimate the number of deaths these cuts will cause in the coming months and years, but unless something changes, it will surely amount to millions of human lives lost. A particularly depressing aspect is that these are senseless deaths (not to mention other suffering from disease and poverty), without reasonable or accurate justifications, as Dr. Gawande explicitly delineated in his presentation.

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Source: Inside Medicine, 6 April 2025