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

Summary

Podcast Summary: "U.S.A.I.D. Might Be Dead, but the Waste Is Alive and Well"

Podcast Information:

• Title: The Opinions
• Host/Author: The New York Times Opinion
• Description: You've heard the news, here's what to make of it.
• Episode: U.S.A.I.D. Might Be Dead, but the Waste Is Alive and Well
• Release Date: July 2, 2025

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Introduction

In the episode titled "U.S.A.I.D. Might Be Dead, but the Waste Is Alive and Well," Nicholas Kristof, a renowned New York Times columnist, delves deep into the ramifications of the drastic cuts to the United States Agency for International Development (USAID). Together with contributions from Helene Cooper, a military correspondent for the New York Times, the discussion highlights the human and financial toll of dismantling one of America's key humanitarian aid organizations.

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The Dismantling of USAID

Nicholas Kristof opens the episode by addressing the significant reduction in American aid funding orchestrated under the Trump administration, a move he attributes to both Donald Trump and Elon Musk. He emphasizes USAID's crucial role in providing humanitarian assistance, noting its profound impact:

"USAID has provided humanitarian assistance always, and it's had an enormous impact. By one count, it saved more than 3 million lives each year." [00:46]

Kristof criticizes the approach taken by Trump and Musk, arguing that their promises to eliminate waste within U.S. aid programs have instead resulted in increased inefficiencies and lost lives.

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Humanitarian Impact in West Africa

Kristof provides firsthand accounts from his visits to Sierra Leone and Liberia, illustrating the dire consequences of USAID's budget cuts:

1. Medicines Left Unused:

   • Sierra Leone: Kristof recounts discovering a warehouse filled with millions of doses of donated medicines intended for mass drug administrations to combat diseases like blindness and schistosomiasis. These drugs, donated by pharmaceutical giants like Merck, are highly cost-effective:

     "For every dollar it costs, you leverage $26 in private donations." [02:35]

     However, due to the cancellation of distribution programs, these life-saving medicines are now gathering dust, nearing expiration, and face potential destruction.

2. Lack of Antiretroviral Drugs:

   • Liberia: A social worker, referred to as PIOS, shares the devastating impact of USAID cuts on HIV-positive patients:

     "Do you know the name of the American president who made these decisions?" [03:22] "Yeah, Donald Trump." [03:26]

     The cessation of essential drug supplies has led to shortages of antiretroviral medications, leaving many patients vulnerable and leading to increased mortality rates.

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A Heartbreaking Case: Yama Freeman

One of the most poignant stories Kristof shares is that of Yama Freeman, a pregnant woman in Liberia whose life was tragically cut short due to USAID's funding cuts:

"The US 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." [05:10]

When Yama hemorrhaged during labor, the ambulance was unavailable due to fuel shortages. Her family had to make a harrowing decision to transport her manually, resulting in her death and that of her unborn son. Kristof underscores the irony of prioritizing expensive ambulance units over the relatively minimal cost of fuel that could save lives:

"We were willing to provide $50,000 each for ambulances and unwilling to provide a few dollars for the gas to enable those ambulances to save lives." [06:00]

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Economic and Moral Implications

Kristof argues that the dismantling of USAID not only represents a moral failing but also poses significant national security risks:

1. Soft Power and Global Influence:

   • Originally established by John F. Kennedy to counter Soviet influence, USAID has been a cornerstone of American soft power. Its reduction cedes ground to competitors like China:

     "China is stepping in to win friends and influence around the world." [07:00]

2. Disease Surveillance and Public Health:

   • USAID's role extends beyond aid; it helps prevent global diseases from reaching American shores by treating ailments like Ebola and tuberculosis abroad:

     "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." [07:45]

By weakening USAID, the U.S. undermines both its values and its own security interests.

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Call to Action and Conclusion

Kristof concludes with a heartfelt plea to policymakers and the American public:

"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." [08:05]

He urges immediate intervention to repurpose the unused medicines in Sierra Leone and Liberia, emphasizing that the waste resulting from USAID's dismantlement is both financially and morally untenable. The episode serves as a compelling reminder of the tangible human costs borne from policy decisions and the broader implications for America's standing in the world.

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Notable Quotes:

• "Under the Trump administration, USAID was dismantled over a weekend by Elon Musk." — Nicholas Kristof [00:46]

• "For every dollar it costs, you leverage $26 in private donations." — Nicholas Kristof [02:35]

• "Do you know the name of the American president who made these decisions?" — Nicholas Kristof [03:22]

• "We were willing to provide $50,000 each for ambulances and unwilling to provide a few dollars for the gas to enable those ambulances to save lives." — Nicholas Kristof [06:00]

• "China is stepping in to win friends and influence around the world." — Nicholas Kristof [07:00]

• "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." — Nicholas Kristof [07:45]

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This episode of "The Opinions" offers a critical examination of the consequences stemming from the reduction of USAID funding, blending statistical analysis with deeply moving personal narratives to underscore the urgency of reversing these policy decisions.

Transcript

[Helene Cooper]

I'm Helene Cooper. I cover the US Military for the New York Times. So I'm sitting in my car in a parking lot outside the Pentagon. I had a cubicle with a desk inside the building for years, but the Trump administration has taken that away. People in power have always made it difficult for journalists. It hasn't stopped us in the past, it's not going to stop us now. I will keep working to get you the facts. This work doesn't happen without subscribers to the New York Times.

[Unknown Host]

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.

[Nicholas Kristof]

I'm Nicholas Kristof. 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 always, 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 US Aid, 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 medicines that had 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 schistosomiasis, to kill parasites. And because these are donated drugs, this kind of thing is incredibly cost effective. For every dollar it costs, 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 the Trump administration canceled the program to distribute them in Sierra Leone. I met a social worker called PIOS 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.

[Helene Cooper]

Many of our clients are dying because of lack of medication. If there's any disruption, at the end of the day, we're going to have many deaths.

[Nicholas Kristof]

Do you know the name of the American president who made these decisions?

[Helene Cooper]

Yeah, Donald Trump.

[Nicholas Kristof]

So, President Trump, you're 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 US 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 each for ambulances and unwilling to provide a few dollars for the gas to enable those ambulances to save lives. 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 the 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. There are children or moms dying in Sierra Leone, in Liberia, and in villages all around the world. It's just heartbreaking.

[Unknown Host]

Foreign. If you like this show, follow it on Spotify, Apple, or wherever you get your podcasts. The Opinions is produced by Derek Arthur Vishaka Darba, Christina Samulewski and Gillian Weinberger. It's edited by Kari Pitkin and Alison Bruzek. Engineering, mixing and original music by Isaac Jones, sonia Herrero, Pat McCusker, Carol Sabaro and Afim Shapiro. Additional music by Amin Sahota. The Fact Checked team is Kate Sinclair, Mary March Locker and Michelle Harris. Audience strategy by Shannon Busta and Christina Samulewski. The director of Times Opinion Audio is Annie Rose Strasser.