Wednesday, June 11, 2025

Trump and DOGE’s Global Health Assault

 Kwei--Wed


How a presidential directive and a shadow agency unraveled decades of progress



🧨 A Calculated Dismantling

On January 20, 2025, Donald Trump returned to office and wasted no time dismantling the global health infrastructure that the U.S. had helped build over the previous decades. Within hours, he signed executive orders freezing U.S. foreign aid—including the lifesaving PEPFAR program, most of USAID’s funding streams, and broad swaths of maternal and child health initiatives.

Enter DOGE—the Department of Government Efficiency—an agency hastily constructed during Trump’s transition and weaponized to shut down federal systems from the inside. With Elon Musk in a senior advisory role, DOGE halted Treasury disbursements, tore up contracts, and gutted agencies under the guise of streamlining. In truth, it was liquidation.

DOGE wasn’t about trimming fat. It was about obliterating aid.

💔 A Trail of Lives Lost

The human toll is staggering.

PEPFAR, long hailed as the most effective HIV program in history, had supported HIV treatment for 20.6 million people and prevented millions of perinatal transmissions. But with the aid freeze, countries like South Africa and Eswatini were left scrambling to keep clinics open. Modeling by global health researchers predicts that stopping PEPFAR could cause over 600,000 HIV-related deaths in South Africa alone over a decade.

USAID, the U.S. government’s principal development agency, was crippled almost overnight. Roughly 90% of its global health awards were canceled. The workforce has been reduced from 10,000 to a skeleton staff of fewer than 300. Outreach programs for HIV, TB, malaria, maternal health, and vaccinations were decimated.

As of mid-2025, a conservative estimate attributes more than 300,000 preventable deaths to the aid freeze, including 208,000 children. These aren’t hypothetical models. These are real-world numbers with names and faces behind them.

The scale of the fallout is almost unfathomable:

  • 26 million condoms and HIV prevention tools are stranded in warehouses, now expiring

  • $12 million worth of essential drugs locked up due to frozen logistics

  • Vaccine campaigns in several African nations have been halted, risking outbreaks of polio, measles, and cholera

  • Maternal mortality, which had declined by 40% in some regions over the last five years, is now spiking again

🔮 The Road Ahead: Resurgence and Collapse

Health experts warn of a ripple effect that could set back global disease prevention by decades.

The UN Development Programme (UNDP) forecasts as many as 25 million excess deaths over 15 years if U.S. aid remains frozen. Beyond the moral failure, there’s a realpolitik threat: weakened global health systems make fertile ground for pandemics, forced migration, extremism, and authoritarian expansion.

If the U.S. once had global goodwill from its support of public health, that trust is rapidly disintegrating.

🧭 This Is Direct Responsibility

Let’s be clear: this wasn’t a budgetary fluke or congressional gridlock. It was intentional, executed with precision. Trump gave the orders. DOGE carried them out. The architects knew exactly what they were doing.

This is Trump’s legacy. These are DOGE’s fingerprints.

Global health professionals have used restrained language in public, such as “disruption,” “setback,” and “challenge.” But we should not. This was sabotage. The scale of harm deserves to be named for what it is: state-sanctioned abandonment of the world’s most vulnerable.

✍🏾 Final Word

The dismantling of PEPFAR and USAID isn't just an American betrayal—it’s a global one. And while other nations and NGOs are scrambling to fill the vacuum, the U.S. has made its message clear: lives outside its borders are expendable.

Trump and DOGE didn’t just cut aid. They weaponized neglect.

📚 References

at 2:57 PM
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