This American Life: Episode 862 - Some Things We Don't Do Anymore

Host: Ira Glass
Release Date: June 22, 2025

Introduction

In Episode 862 of This American Life, host Ira Glass delves into the unforeseen consequences of the abrupt shutdown of the United States Agency for International Development (USAID) under the Trump administration. Titled "Some Things We Don't Do Anymore," this episode explores how the sudden halt in foreign aid disrupted life-saving programs across the globe, leaving millions vulnerable. Through personal stories, expert interviews, and on-the-ground reporting, the episode uncovers the intricate web of dependency, bureaucracy, and unintended repercussions resulting from policy changes.

The Shutdown of USAID and Immediate Impacts

The episode opens with David Kestenbaum describing a vast warehouse in Rhode Island filled with boxes of Ready-to-Use Therapeutic Food (RUTF), a critical nutritional aid for severely malnourished children. He likens the warehouse to the iconic final scene of Raiders of the Lost Ark (01:12).

David Kestenbaum:
"Most of these cardboard boxes contain this nutritional peanut paste. Each box has two months' worth, enough to save the life of one severely malnourished child." (00:50)

Naven Salem, the head of Edezia—a non-profit organization manufacturing RUTF—explains that over 200,000 boxes are stalled in the warehouse due to the collapse of USAID and the subsequent bureaucratic limbo (01:21). The abrupt cessation of foreign aid by President Trump left vital resources stranded, jeopardizing the lives of children in countries like the Democratic Republic of the Congo, Sudan, and South Sudan.

Case Study: Edezia and Naven Salem's Struggle

Naven Salem recounts her relentless efforts to navigate the shutdown. With USAID employees let go and contracts left in disarray, Salem faces the daunting task of securing the necessary signatures to release the aid. This impediment not only halts production but also endangers the lives of children awaiting assistance.

Naven Salem:
"I feel like I'm in a movie that I don't want to be in. I don't sleep. I get up at 5 o'clock in the morning every day." (03:02)

Salem's narrative highlights the human cost of policy decisions, emphasizing the urgent need for continuity in foreign aid operations.

Reflecting on USAID's History: Insights from Experts

To provide context, the episode features interviews with John Norris and Joshua Craze, who discuss the inception and evolution of USAID. Founded in 1961 under President John F. Kennedy, USAID was designed to aid emerging nations post-colonial rule, primarily to prevent the spread of communism during the Cold War.

Joshua Craze:
"For Kennedy, the goal is to bring development to the rest of the world...he didn't want them to become communist." (15:14)

While USAID achieved notable successes, such as the eradication of smallpox and significant advancements in countries like South Korea and Taiwan, it also faced substantial challenges. Projects aimed at economic reforms and democracy-building often faltered in the face of local autocracies or systemic corruption.

John Norris:
"For development to work, the country's government has to make a bunch of difficult changes... Some countries were run by autocrats who didn't really care for helping the general population." (17:40)

The shift from development-focused initiatives to humanitarian aid and health programs marked a significant transformation in USAID's mission, reflecting broader geopolitical shifts post-Cold War.

Case Study: The Luke Commission in Eswatini

A poignant segment of the episode examines the Luke Commission, a health provider in Eswatini (formerly Swaziland) heavily reliant on USAID funding. Founded by Harry and Echo van der Waal, the Luke Commission became one of the largest recipients of American aid, transforming from a modest clinic to a sprawling medical campus funded by President George W. Bush's PEPFAR initiative.

Harry van der Waal:
"PEPFAR money completely changed the course of the AIDS epidemic. In Eswatini, the number of people dying from AIDS went down by half." (34:42)

The Commission's rapid expansion facilitated advanced healthcare technologies and treatments, but also inadvertently fostered corruption within the local government. When USAID funding abruptly ceased, the Commission faced financial ruin, leading to layoffs and the closure of critical services.

Sarah Rumsey:
"We have not transitioned like we should. By now we should have transitioned it to being locally supported..." (49:22)

The sudden withdrawal of aid exposed systemic vulnerabilities, revealing that despite improvements, local infrastructures were not fully equipped to sustain the programs independently.

The Aftermath and Human Stories

The episode shifts focus to the real-life implications of aid cuts, featuring heartbreaking testimonies from individuals like Jay and Nakayo. Jay, a 24-year-old from Mombasa, struggled to access his HIV medication following the funding freeze, leading to severe health deterioration (58:00). Similarly, Nakayo's tragic suicide underscores the devastating personal toll.

Nakayo's Story:
"Nyakayo died by suicide on May 1. She was 22 years old and three months pregnant." (63:36)

These narratives humanize the abstract statistics, illustrating the immediate and long-term consequences of disrupted aid—ranging from medical shortages to increased mortality rates.

Conclusion: The Broader Implications of the Shutdown

As the episode draws to a close, experts like Charles Kenny warn of the extensive death toll resulting from the aid cuts, estimating upwards of half a million deaths annually due to interrupted programs (56:29). The abrupt policy shift not only reverses years of progress but also destabilizes global health initiatives, highlighting the critical need for strategic, sustainable foreign aid policies.

Charles Kenny:
"The modeled estimate is that 200,000 or so people will die due to the cuts to awards this year." (55:40)

The episode culminates in a reflective discourse on the importance of foreign aid, the complexities of international development, and the moral imperative to ensure that life-saving programs remain uninterrupted and adaptable to changing political landscapes.

Notable Quotes

• Naven Salem (03:02):
  "I feel like I'm in a movie that I don't want to be in."

• Joshua Craze (15:14):
  "For Kennedy, the goal is to bring development to the rest of the world."

• John Norris (17:40):
  "Some countries were run by autocrats who didn't really care for helping the general population."

• Harry van der Waal (34:42):
  "PEPFAR money completely changed the course of the AIDS epidemic."

• Charles Kenny (55:40):
  "The modeled estimate is that 200,000 or so people will die due to the cuts to awards this year."

Final Thoughts

This American Life masterfully weaves together policy analysis, historical context, and personal tragedy to paint a comprehensive picture of the ripple effects caused by the cessation of USAID funding. Episode 862 serves as a poignant reminder of the fragile interdependencies in global aid and the profound human impact of political decisions.

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Note: Timestamps correspond to the transcript provided and are indicative of where the quotes and events occur within the episode.