Latest news with #'sEmergencyPlanforAIDSRelief
Miami Herald
a day ago
- Business
- Miami Herald
House considers Trump cuts as Senate Republicans work on reconciliation bill
WASHINGTON - As Senate committees continue to release their proposals for the House-passed reconciliation package this week, the House plans to vote on President Donald Trump's proposals to rescind foreign aid and other spending, including for public broadcasting. 'The rescissions request sent to Congress by the Trump Administration takes the federal government in a new direction where we actually cut waste, fraud, and abuse and hold agencies accountable to the American people,' House Majority Leader Steve Scalise, R-La., said in a statement. The path to House passage of the $9.4 billion package is still far from clear. Rep. Don Bacon, R-Neb., has already indicated he would vote against the package if it includes cuts to the George W. Bush-era program known as the President's Emergency Plan for AIDS Relief, or PEPFAR, which provides foreign aid to fight HIV and AIDS. 'I just want to make sure we're funding the medicine. We want to prevent AIDS, it's a noble program, it's George Bush's legacy. I put the marker out there; we'll see,' Bacon said in an interview with the New York Times. The rescissions package could be just the first of several from Trump and his Office of Management and Budget. The House also will take up bills this week targeting local operations in Washington, D.C. One measure would bar noncitizens from voting in local elections in the District of Columbia. Another seeks to overturn a D.C. policing overhaul law. While Republicans are often critical of public employee unions, police unions have long been an exception. Scalise's office says the bill would restore 'collective bargaining rights for MPD officers and a statute of limitations on disciplinary cases.' Senate Republicans are still working behind the scenes to draft their version of the reconciliation bill. The Senate Banking, Housing and Urban Affairs Committee released its text last week. The draft would shut off the Consumer Financial Protection Bureau's funding stream from the Federal Reserve. The Senate process continues amid ongoing criticism from Elon Musk, the billionaire businessman who was until recently leading the White House office known as the Department of Government Efficiency, but who had a very public split from Trump over the last week. Musk has come out against the House-passed reconciliation measure, criticizing the debt and deficit effects of the bill (while also predicting that Trump's tariff agenda could lead to a recession in the back half of 2025). But Speaker Mike Johnson, R-La., said the spat largely playing out on social media platforms was not spilling over to the Capitol phone lines. 'We've got almost no calls to the offices, any Republican member of Congress. And I think that indicates that people are taking a wait-and-see attitude,' Johnson said on ABC's 'This Week.' The Senate is in the process of tweaking the product both to meet the needs of the chamber's budgetary rules, as well as the interests of GOP senators. Senate Democrats plan to keep up the criticisms of Republicans for potential cuts affecting health care services, including potential closures to rural hospitals. While the background work is underway, the Senate starts the week with additional votes to confirm Trump nominees. Also still on the to-do list is the stablecoin regulation bill that has been pending business for weeks. Committee work continues Another digital asset regulatory measure is on the agenda for the House Financial Services Committee on Tuesday, with a new substitute amendment posted on Sunday. The committee plans to take up other bills, including housing legislation, at the same markup. The headline committee action for the week is Tuesday's kickoff of the regular appropriations markup process for fiscal 2026. The House Appropriations Committee on Tuesday will consider its subcommittee allocations, as well as the Military Construction-VA spending bill. The full committee is scheduled to mark up the Agriculture spending bill on Wednesday, as well as both the Homeland Security bill and the Defense bill on Thursday. Senate appropriators are continuing to hold subcommittee hearings this week. The agenda includes a Defense Appropriations Subcommittee hearing with Defense Secretary Pete Hegseth and Joint Chiefs of Staff Chairman Gen. Dan Caine scheduled to appear on Tuesday. Former Senate Majority Leader Mitch McConnell, R-Ky., who chairs the Defense Subcommittee, has been a critic of Hegseth and voted against his confirmation. Also on the subcommittee are the other two Republicans who voted against Hegseth: Sen. Susan Collins of Maine, who chairs the full committee, and Sen. Lisa Murkowski of Alaska. Another key hearing takes place Wednesday, when Treasury Secretary Scott Bessent scheduled to appear before the Financial Services Appropriations Subcommittee amid ongoing tax and trade debates, in which Bessent has emerged as a key negotiator. Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.
Yahoo
19-02-2025
- Health
- Yahoo
Elon Musk's Empty Hunt for Condoms Is Causing Real Harm
Multiple aid agencies have effectively ceased operations preventing the global spread of HIV and treating patients with AIDS in the wake of funding cuts by the Trump administration. That's the result of Elon Musk and his so-called Department of Government Efficiency (DOGE) appearing to take special aim at programs that include the word 'condoms' or 'contraceptives' in their funding documents. This includes virtually every initiative related to a global HIV/AIDS response program administered by the State Department known as the President's Emergency Plan for AIDS Relief, or PEPFAR. The furor over aid funding that includes contraceptives eventually led to the false allegation that the U.S. Agency for International Development, or USAID, was trying to supply condoms to a designated terror group, Hamas. White House Press Secretary Karoline Leavitt said late last month that Musk's so-called Department of Government Efficiency (DOGE) had found that $50 million worth of taxpayer money was ready to go 'out the door to fund condoms in Gaza,' adding: 'That is a preposterous waste of taxpayer money.' President Donald Trump, himself, claimed: 'We identified and stopped $50 million being sent to Gaza to buy condoms for Hamas.' The allegation formed the centerpiece of the campaign to abolish USAID amid claims of 'massive fraud' at the agency. More than 39.9 million people worldwide live with HIV, with nearly 630,000 dying annually, according to U.S. government data. PEPFAR has been central to providing education, prevention and treatment of the illness. The program describes itself as 'the largest commitment by any nation to address a single disease in history, enabled by strong bipartisan support across ten U.S. congresses and four presidential administrations, and through the American people's generosity.' PEPFAR's success has been measurable. The rate of new HIV infections has declined 39 percent since 2010. Around 77 percent of those suffering from the virus receive some kind of antiretroviral therapy. Despite a waiver issued by the State Department for a number of critical PEPFAR programs, uncertainty about what is included in the exemption has effectively frozen much of the work. 'More than three weeks since the U.S. government froze PEPFAR funding, there is still widespread confusion and uncertainty as to whether this critical lifeline for millions of people has been cut off,' Avril Benoît, chief executive officer of the American section of Doctors Without Borders, or MSF, said in a statement. 'Despite a limited waiver covering some activities, what our teams are seeing in many of the countries where we work is that people have already lost access to lifesaving care and have no idea whether or when their treatment will continue.' MSF does not accept government funding. Many other aid groups rely on government grants, and don't feel comfortable sounding the alarm. Multiple humanitarian workers privately told Rolling Stone that their organizations are reluctant to plunge into the political battle, with one international aid worker saying their organization's leadership was trying to 'keep their heads down,' to avoid antagonizing the Trump administration. The hope, the aid worker says, is that a bipartisan consensus on the importance of critical aid would prevail and at least partial funding would be restored — once the Trump administration had 'collected scalps from USAID.' The Elizabeth Glaser Pediatric AIDS Foundation, which provides contraceptives as part of a complex program preventing and treating HIV/AIDS in Mozambique, may have been the origin of the '$50 million condoms for Gaza' claim. Gaza Province is a rural area in the country's south. Having heard that the Glaser Foundation's program treating children born with AIDS had been caught up in the freeze, Rolling Stone reached out, seeking to verify if the foundation had ceased operations in Mozambique. There was no response. When a reporter at the White House asked if the Gaza condoms might actually be meant for Mozambique's Gaza Province, Musk acknowledged that even he makes mistakes. 'No one bats a thousand,' he said, but he stuck to his guns that this was a clear sign of wasteful spending, later tweeting: '$50 million of condoms is A LOT of condoms.' It most certainly would be. The USAID-funded U.N. sexual and reproductive health agency UNFPA, responsible for procuring and distributing contraceptives, spends an average of 2.7¢ per condom, according to publicly available budget documents. At that rate, $50 million of USAID cash would purchase 1.85 billion condoms. That's more than four times the number of condoms sold in the United States each year. The total population of the Gaza Strip is 0.6 percent the size of America's. It's hard to picture 1.85 billion condoms. Here's another way to think of it: Assuming the condoms meet the ISO standard minimum length of 6.3 inches, then laid end to end, that many condoms would encircle the Earth seven times. An industrial box of condoms contains 1,000 condoms. A pallet contains 32 boxes, or 32,000 condoms. Shipping containers, known as TEUs, or Twenty-Foot Equivalents, each hold 10 pallets — or 320,000 condoms. If you have 1.85 billion condoms, you'd have nearly 5,800 shipping containers to move. If the point has not yet been made, a humanitarian aid official with expertise in logistics tells Rolling Stone: 'No aid organization is shipping thousands of containers of condoms anywhere, let alone to Gaza.' So what about the $50 million supposedly seized by DOGE? 'First of all, any funding document that referenced 'condoms' was likely part of an extended, comprehensive medical aid package covering multiple programs and procurement initiatives, such as PEPFAR,' the aid official says, requesting not to be named given the negative impact the funding freeze was already having on their work. But for the sake of argument, the aid official continues, if someone really did have $50 million to spend just on distributing condoms to remote war-torn areas with limited infrastructure, they'd have a lot of overhead: procurement, shipping, warehousing, security, tracking, as well as work to develop partnerships with local organizations, hire staff and organize distribution. 'You're not sending it with Amazon,' the aid official says, noting that a program shipping prophylactics from a developed country to remote areas would at best look like someone on a motorbike being sent to a village which is not accessible most of the year, with a single box of condoms. More typically, contraceptives are supplied to clinics run by local health authorities or partner organizations, and included in kits or education programs designed to address a range of health care needs. 'It would be incredibly inefficient and irresponsible if setting up a logistics chain for condoms was the full extent of an aid initiative. I just haven't heard of any program like that. Ever.' A spokesperson for the International Medical Corps — a USAID-funded group initially suspected of being the source of the 'condoms-for-Hamas' claim, as it operates in the Gaza Strip — points to a statement the organization released in the immediate wake of the White House's claims, which says: 'No U.S. government funding was used to procure or distribute condoms, nor to provide family-planning services' by IMC in Gaza. Instead, IMC says, their $68 million in funding from USAID was used to run 'two major field hospitals' providing medical care to 338,000 people over the past year and a half. Despite such denials, conservatives continue to use contraception as a whip with which to flog USAID spending as criminal and fraudulent. Trump said at one point that America has actually spent '$100 million on condoms to Hamas.' Hamas was using condoms to make balloons which it uses to drop explosives on Israel, a Fox News host claimed, pointing at five-year-old photos of masked men apparently doing that. USAID has also spent millions supplying condoms to the Taliban, says Rep. Brian Mast (R-Fla.), the chair of the House Foreign Affairs committee, lambasting his 'Democrat colleagues that are trying to spread misinformation, saying that 'people are going to die,'' because DOGE had precipitously pulled all USAID funding. 'I don't think anybody's going to die because we don't give the Taliban any more condoms,' Mast growled in a video posted on YouTube. Who is responsible for approving these funding requests? Well, there is at least one culprit: Rep. Brian Mast. 'Every dollar that USAID requests from Congress goes through White House review,' notes Jeremy Konyndyk, the president of Refugees International and a former lead for disaster relief at USAID. 'Congress sets the budget… Once USAID gets its budget from Congress, it must go straight back to Congress again with a further level of detail on how it will satisfy the various budget directives — via 'Congressional Notifications.'' A detailed breakdown for each program is then sent to four committees, including the House Foreign Affairs Committee, where the money can be cleared or held. Mast has served on that committee since first joining Congress in 2017, approving tens of millions in health care initiatives that included contraceptives, in some shape or form. The Trump administration has made it increasingly difficult to get answers about the impact of the funding freeze. The handful of USAID employees who remain on government payrolls have been explicitly told they will be fired for speaking to the press. Meanwhile, the White House and its allies have widened their net, taking aim at government spending that they view as subsidies for supposedly 'left-wing' news outlets. This includes subscriptions to Politico Pro, a platform used to track public policy developments, and a contract with Thomson Reuters — a financial data and risk management firm. 'Reuters was paid millions of dollars by the U.S. government for 'large scale social deception.' That is literally what it says on the purchase order! They're a total scam,' Musk claimed. The funding was actually intended for a program designed to combat disinformation. DOGE has repeatedly promised to release specific documentation proving its claims of government fraud — and released a website it claims has 'a wall of receipts.' The site, which claims to have saved taxpayers $55 billion, appears to include multiple basic data errors — such as listing a consulting contract for U.S. Customs and Immigration Enforcement as being worth $8 billion, instead of the actual amount of $8 million. One item not currently listed on the website among DOGE's wall of receipts: anything resembling $50 million worth of condoms for Gaza, Mozambique, or elsewhere. More from Rolling Stone Eric Adams' Lawyers Offered Trump DOJ an 'Ever-Present Partner' Octavia Spencer Offers Elon Musk's DOGE Workers Poop Pie From 'The Help' Musk Argues 'Democracy' Is Trump Being Able to Do Whatever He Wants Best of Rolling Stone The Useful Idiots New Guide to the Most Stoned Moments of the 2020 Presidential Campaign Anatomy of a Fake News Scandal The Radical Crusade of Mike Pence
Yahoo
04-02-2025
- Business
- Yahoo
‘What Elon Musk Said Is a Bold-Faced Lie'
In recent days, the Trump administration has taken steps to shutter the United States Agency for International Development, or USAID, which distributes billions of dollars worldwide annually to help alleviate poverty, treat diseases and respond to famines and natural disasters, as well as promote development and democracy. President Donald Trump has said USAID is run by 'lunatic radicals' who promote leftist causes and his appointed efficiency expert, billionaire Elon Musk, has called USAID a 'criminal organization' that 'needs to die.' Now Secretary of State Marco Rubio says he's the acting director of USAID, and the administration is reportedly trying to fold the agency into the State Department. But Andrew Natsios, who ran USAID under President George W. Bush and is a lifelong conservative Republican, calls such moves 'illegal' and 'outrageous.' What Musk and Rubio are doing 'is criminal. They can't abolish the aid program without a vote of Congress.' Moreover, Natsios says, they miss the point that USAID is critical to winning the competition with China and reflects longstanding Republican priorities. 'It's just 1 percent of the federal budget, right?' says Natsios, who also played a leading role in building World Vision, the largest Christian nongovernmental organization in the world with programs in 103 countries. 'And it builds goodwill and political influence and economic influence. It promotes American business. It protects us in terms of disease threats around the world. It is in our national interest to run these programs.' Under Natsios, who now teaches at the Bush School of Government and Public Service at Texas A&M, USAID nearly doubled its budget to $14 billion with a worldwide workforce of 8,100 employees operating in more than 80 countries, including major aid projects in three war zones — Iraq, Afghanistan and Sudan. Natsios was also instrumental in launching one of the most successful programs in USAID history, the President's Emergency Plan for AIDS Relief or PEPFAR, which has saved some 25 million lives since 2003, and a public-private partnership program entitled the Global Development Alliance. USAID currently manages more than $40 billion annually, as of fiscal year 2023. This interview has been edited for length and clarity. What is your response to what's happened to USAID at the hands of the Trump administration over the last several days? First, what Elon Musk said is a bold-faced lie. Second, it's the worst idea I could possibly imagine to fold it into State. When Australia folded its aid agency into the secretary of State's office — and they did the same thing in Canada with their Foreign Office — all of the development functions eventually withered away. There are no aid agencies in those countries now. Why is it a terrible idea? I think the State Department is one of the best diplomatic institutions in the world. I have great respect for our diplomats, but they are not program managers. They don't do assessments, they don't do evaluations of aid programs. They don't understand how you quantify data. They don't have agricultural economists. They don't have public health expertise. The people in State are policy people. And what's going to happen over time is they're going to hire generalists, not specialists. We hire people with PhDs. We need people of expertise in education or in health or in agricultural development or these different development disciplines. The other problem is that the State Department's time horizon is six months, a year, two years, and that's it. For USAID it is 10 years, 15 years, 20 years. You do not build institutions in a couple of years. [Former Secretary of State] Madeleine Albright tried to do the same thing [fold USAID into State] in the 1990s. So this is not new. There's a larger question of whether or not Trump and his supporters really care about development projects succeeding in any of these countries. You pointed out what happened in Canada and Australia, but Trump's response might well be, that proves my point. These countries no longer have development aid programs so why should we? Because it gives us influence around the world. It's in our national interest. For example, we have a disease reporting system that is in 90 countries. It allows us to monitor what's going on locally. Do you want disease to get to the United States, a new epidemic? The reason that we didn't know about what happened in China in Wuhan [with the Covid-19 pandemic] is because there's no aid mission in China. And I'm not suggesting we have one either. But my point is we have aid missions in which the largest sector program, other than humanitarian assistance, is public health. It is in our interest to know what's happening with the disease presence in these countries — particularly new diseases. There's just been an outbreak of Ebola, for example, in Kampala, Uganda. And how did we find out about it? Through the USAID mission. The other interesting thing in terms of influence, and the State Department versus USAID, is that unlike the U.S. Foreign Service, three quarters of the people we [at USAID] hire are not Americans. They're from the country that we work in. Many of them go on to become heads of state, ministers of finance, members of parliament, and they have a history with the U.S. I can go through the list. The first woman president of Costa Rica was a Foreign Service national who worked for USAID for 10 years. The first woman vice president of El Salvador was a USAID worker, a 10-year Foreign Service national. I could go through countries all over the world with similar stories. I remember once I said on a country visit, 'Anybody here ever think of running for office?' Two guys said, we just got elected to parliament last week running on the platform that we work for USAID. So we have a presence in the world that's very influential, but it has to be separate from the State Department. And in any case, do we already do what the State Department wants in the field? Yes. The USAID mission director reports to the ambassador, and he or she writes their performance evaluation. So of course they're going to be responsive to the State Department. Could you specifically respond to what Elon Musk's functionaries at the Department of Government Efficiency (DOGE) have done in terms of actually shutting down USAID? It's illegal and it's outrageous. They have no right to abolish an agency, a statutory agency in the federal government. Congress appropriated money for us to spend, and we're spending it now, right? So what do you think happens now? I hope someone will sue them, because if this goes to court, they're going to lose. And that's why Marco Rubio said that he's the new head of USAID. That's not what Musk said. Musk said we're abolishing USAID. He didn't say we're merging it into State. That is criminal. They can't abolish the aid program without a vote of Congress. They also took down all of the plaques [honoring murdered USAID officials]. We had a wall. I had it installed myself. For every USAID officer who's been murdered in the last 70 years, we have a plaque commemorating them. They took the whole thing down. That is a desecration of sacred space. For people who sacrifice themselves for the United States to be treated that way is outrageous. Can you address the criticism from Trump, who said USAID was 'run by a bunch of radical lunatics,' and others on the right who say the agency is serving a leftist agenda? The Project 2025 manifesto had a chapter that described USAID as promoting abortion, climate extremism and gender radicalism, among other things. Those are baited questions intended for domestic political purposes. In most countries in the developing world [where USAID operates], particularly in the Middle East and Africa, abortion is illegal. There's one or two countries that have legalized it. Muslim and Christian societies and developing countries are very conservative on the abortion issue. To be very frank with you, that's already been decided. This is a domestic attempt by both the left and the right — both sides do it — to rev up the base on this issue. Number two, in the developing world, in Africa especially, if you run around with the LGBTQ flag and make that a big issue, Africans get very upset. Even [Biden administration USAID Director] Samantha Power said, and I'm quoting her, that we need to find a different way of talking about these issues. In the Middle East and in Africa, pushing a very aggressive gay [rights] agenda is offensive to the church and to the mosque both. It is not helping us in those countries. Now, I don't want any kind of violence against gays, but why is that a USAID issue? That's not a development issue. It's a human rights issue. What would you say to the American people who are being told USAID is a worthless organization that doesn't add anything to their lives? The whole theme that's coming out of this administration is that the world is taking advantage of the U.S., that we have to stop spending money on other people and spend it on ourselves. I'm tired of listening to that argument. It's just 1 percent of the federal budget, right? And it builds goodwill and political influence and economic influence. It promotes American business. It protects us in terms of disease threats around the world. It is in our national interest to run these programs. Also, we don't want a large number of people to starve to death, because it's destabilizing and it's frankly intolerable from an ethical point of view. And the polling data, by the way, shows that the great majority of the American people, when you specify what the program is, they support it. Another area where USAID has been criticized — not just people with a political agenda like Musk but also some development aid experts — is that it's said that many of its programs are ineffective. They are in the hands of a few very large government contractors who don't monitor results or work with the local community enough. Even the agency's own inspector general concluded in recent years that 43 percent of USAID programs failed to achieve about half of the intended results and yet contractors still got paid in full. A couple of points here. One, we are so obsessed with accountability that it actually paralyzes the agency so much we're so worried about any money disappearing. There's an independent nonprofit that judges the quality of management in the federal government. It's called the Federal Invest in What Works Index and it's very technical. Guess what agency the federal government ranks second in quality of management and competence? USAID. I wrote an op-ed piece in The Washington Post on this. Beyond that, there is not one single country in the world that developed as a result of small community action projects [that hand over funds and responsibility directly to local activists], not one. The only country where we flooded the country with community action is Haiti. Do you think Haiti is a success story? Right? I don't think so. [A 2023 U.S. Government Accountabilliy Office report on such programs found that USAID had failed to 'fully track data on its local partnerships' in post-earthquake Haiti.] Okay, so, with all due respect, local community action, I think we should do it just to develop civil society, but the notion that we should be spending most of our money on small community projects is utterly ridiculous. And more importantly, we would need 10 times the staff we had now in order to manage very small grants to a lot of groups. So do we need the large contracts? Yes, we do. As I mentioned, we did a worldwide system for collecting data on diseases, and it's in 90 different countries. Even big NGOs couldn't have done this. Only big contractors can do it. Are there any programs you think should be cut from USAID? Yes, I think the family planning budget is too big. I think it should not be abolished but it should be shut down in Asia, because the Asian countries have been running this on their own for 50 years. I'd take half of that money and put it in Africa. And the notion that USAID assistance is going to have any impact on carbon emissions is a real stretch. What we should be spending our money on is adaptation [to climate change]. We need to be developing seed rice that can sustain higher temperatures and still produce. We're developing it now but it's too slow. Do you think that some of the reform programs that were put in place at USAID in Trump's first term could work — for example 'journey towards self-reliance' embraced by Trump's former USAID administrator Mark Green? The idea was that foreign aid should have the measurable goal of building self-reliance in partner nations as soon as possible, so the U.S. can get out. Well, I have been very critical of that. We closed the aid mission in Panama, and the Chinese moved in, right? Some [critics] say, if a country is middle-income, we shouldn't be providing any money. That's baloney. We are in great power competition right now, and if a country's got serious social problems — and Panama does — just because their income has gone up, that doesn't mean the problems have been dealt with. There are more poor people in India than there are in sub-Saharan Africa. I think the notion that we should 'graduate countries' [and wean them from U.S. aid] made sense in the post-Cold War world. It does not make any sense right now in terms of competition [with China]. We need to focus on the geography of our aid programs, where our missions are and whether they're critically important to the national interest of the United States. We should always have a mission in Egypt. We should always have a mission in Panama. We should always have a mission in Morocco, because of the Straits of Gibraltar, these are critical transportation [routes], and they affect global food security, because the global food system relies on these choke points in order to deliver food. So I don't think we should be graduating countries unless they become as rich as South Korea or Taiwan, which we once had massive aid programs for but we can't justify any longer. Are there any lessons to be drawn on what works and what doesn't for USAID overall? I can tell you that you need at least 15 to 20 years to build institutions that are sustainable. You can't do it overnight. Two, you can't have programs turned on and off. And both administrations did this. The Biden people would stop something they didn't like for policy reasons. Then they started again, and then they stopped it again. You can't run a program that way. That's the first lesson. The second lesson is that you have to have local leadership. If there's no local leadership, these programs don't work that well.
Politico
04-02-2025
- Business
- Politico
‘What Elon Musk Said Is a Bold-Faced Lie'
In recent days, the Trump administration has taken steps to shutter the United States Agency for International Development, or USAID, which distributes billions of dollars worldwide annually to help alleviate poverty, treat diseases and respond to famines and natural disasters, as well as promote development and democracy. President Donald Trump has said USAID is run by 'lunatic radicals' who promote leftist causes and his appointed efficiency expert, billionaire Elon Musk, has called USAID a 'criminal organization' that 'needs to die.' Now Secretary of State Marco Rubio says he's the acting director of USAID, and the administration is reportedly trying to fold the agency into the State Department. But Andrew Natsios, who ran USAID under President George W. Bush and is a lifelong conservative Republican, calls such moves 'illegal' and 'outrageous.' What Musk and Rubio are doing 'is criminal. They can't abolish the aid program without a vote of Congress.' Moreover, Natsios says, they miss the point that USAID is critical to winning the competition with China and reflects longstanding Republican priorities. 'It's just 1 percent of the federal budget, right?' says Natsios, who also played a leading role in building World Vision, the largest Christian nongovernmental organization in the world with programs in 103 countries. 'And it builds goodwill and political influence and economic influence. It promotes American business. It protects us in terms of disease threats around the world. It is in our national interest to run these programs.' Under Natsios, who now teaches at the Bush School of Government and Public Service at Texas A&M, USAID nearly doubled its budget to $14 billion with a worldwide workforce of 8,100 employees operating in more than 80 countries, including major aid projects in three war zones — Iraq, Afghanistan and Sudan. Natsios was also instrumental in launching one of the most successful programs in USAID history, the President's Emergency Plan for AIDS Relief or PEPFAR, which has saved some 25 million lives since 2003, and a public-private partnership program entitled the Global Development Alliance. USAID currently manages more than $40 billion annually, as of fiscal year 2023. This interview has been edited for length and clarity. What is your response to what's happened to USAID at the hands of the Trump administration over the last several days? First, what Elon Musk said is a bold-faced lie. Second, it's the worst idea I could possibly imagine to fold it into State. When Australia folded its aid agency into the secretary of State's office — and they did the same thing in Canada with their Foreign Office — all of the development functions eventually withered away. There are no aid agencies in those countries now. Why is it a terrible idea? I think the State Department is one of the best diplomatic institutions in the world. I have great respect for our diplomats, but they are not program managers. They don't do assessments, they don't do evaluations of aid programs. They don't understand how you quantify data. They don't have agricultural economists. They don't have public health expertise. The people in State are policy people. And what's going to happen over time is they're going to hire generalists, not specialists. We hire people with PhDs. We need people of expertise in education or in health or in agricultural development or these different development disciplines. The other problem is that the State Department's time horizon is six months, a year, two years, and that's it. For USAID it is 10 years, 15 years, 20 years. You do not build institutions in a couple of years. [Former Secretary of State] Madeleine Albright tried to do the same thing [fold USAID into State] in the 1990s. So this is not new. There's a larger question of whether or not Trump and his supporters really care about development projects succeeding in any of these countries. You pointed out what happened in Canada and Australia, but Trump's response might well be, that proves my point. These countries no longer have development aid programs so why should we? Because it gives us influence around the world. It's in our national interest. For example, we have a disease reporting system that is in 90 countries. It allows us to monitor what's going on locally. Do you want disease to get to the United States, a new epidemic? The reason that we didn't know about what happened in China in Wuhan [with the Covid-19 pandemic] is because there's no aid mission in China. And I'm not suggesting we have one either. But my point is we have aid missions in which the largest sector program, other than humanitarian assistance, is public health. It is in our interest to know what's happening with the disease presence in these countries — particularly new diseases. There's just been an outbreak of Ebola, for example, in Kampala, Uganda. And how did we find out about it? Through the USAID mission. The other interesting thing in terms of influence, and the State Department versus USAID, is that unlike the U.S. Foreign Service, three quarters of the people we [at USAID] hire are not Americans. They're from the country that we work in. Many of them go on to become heads of state, ministers of finance, members of parliament, and they have a history with the U.S. I can go through the list. The first woman president of Costa Rica was a Foreign Service national who worked for USAID for 10 years. The first woman vice president of El Salvador was a USAID worker, a 10-year Foreign Service national. I could go through countries all over the world with similar stories. I remember once I said on a country visit, 'Anybody here ever think of running for office?' Two guys said, we just got elected to parliament last week running on the platform that we work for USAID. So we have a presence in the world that's very influential, but it has to be separate from the State Department. And in any case, do we already do what the State Department wants in the field? Yes. The USAID mission director reports to the ambassador, and he or she writes their performance evaluation. So of course they're going to be responsive to the State Department. Could you specifically respond to what Elon Musk's functionaries at the Department of Government Efficiency (DOGE) have done in terms of actually shutting down USAID? It's illegal and it's outrageous. They have no right to abolish an agency, a statutory agency in the federal government. Congress appropriated money for us to spend, and we're spending it now, right? So what do you think happens now? I hope someone will sue them, because if this goes to court, they're going to lose. And that's why Marco Rubio said that he's the new head of USAID. That's not what Musk said. Musk said we're abolishing USAID. He didn't say we're merging it into State. That is criminal. They can't abolish the aid program without a vote of Congress. They also took down all of the plaques [honoring murdered USAID officials]. We had a wall. I had it installed myself. For every USAID officer who's been murdered in the last 70 years, we have a plaque commemorating them. They took the whole thing down. That is a desecration of sacred space. For people who sacrifice themselves for the United States to be treated that way is outrageous. Can you address the criticism from Trump, who said USAID was 'run by a bunch of radical lunatics,' and others on the right who say the agency is serving a leftist agenda? The Project 2025 manifesto had a chapter that described USAID as promoting abortion, climate extremism and gender radicalism, among other things. Those are baited questions intended for domestic political purposes. In most countries in the developing world [where USAID operates], particularly in the Middle East and Africa, abortion is illegal. There's one or two countries that have legalized it. Muslim and Christian societies and developing countries are very conservative on the abortion issue. To be very frank with you, that's already been decided. This is a domestic attempt by both the left and the right — both sides do it — to rev up the base on this issue. Number two, in the developing world, in Africa especially, if you run around with the LGBTQ flag and make that a big issue, Africans get very upset. Even [Biden administration USAID Director] Samantha Power said, and I'm quoting her, that we need to find a different way of talking about these issues. In the Middle East and in Africa, pushing a very aggressive gay [rights] agenda is offensive to the church and to the mosque both. It is not helping us in those countries. Now, I don't want any kind of violence against gays, but why is that a USAID issue? That's not a development issue. It's a human rights issue. What would you say to the American people who are being told USAID is a worthless organization that doesn't add anything to their lives? The whole theme that's coming out of this administration is that the world is taking advantage of the U.S., that we have to stop spending money on other people and spend it on ourselves. I'm tired of listening to that argument. It's just 1 percent of the federal budget, right? And it builds goodwill and political influence and economic influence. It promotes American business. It protects us in terms of disease threats around the world. It is in our national interest to run these programs. Also, we don't want a large number of people to starve to death, because it's destabilizing and it's frankly intolerable from an ethical point of view. And the polling data, by the way, shows that the great majority of the American people, when you specify what the program is, they support it. Another area where USAID has been criticized — not just people with a political agenda like Musk but also some development aid experts — is that it's said that many of its programs are ineffective. They are in the hands of a few very large government contractors who don't monitor results or work with the local community enough. Even the agency's own inspector general concluded in recent years that 43 percent of USAID programs failed to achieve about half of the intended results and yet contractors still got paid in full. A couple of points here. One, we are so obsessed with accountability that it actually paralyzes the agency so much we're so worried about any money disappearing. There's an independent nonprofit that judges the quality of management in the federal government. It's called the Federal Invest in What Works Index and it's very technical. Guess what agency the federal government ranks second in quality of management and competence? USAID. I wrote an op-ed piece in The Washington Post on this. Beyond that, there is not one single country in the world that developed as a result of small community action projects [that hand over funds and responsibility directly to local activists], not one. The only country where we flooded the country with community action is Haiti. Do you think Haiti is a success story? Right? I don't think so. [A 2023 U.S. Government Accountabilliy Office report on such programs found that USAID had failed to 'fully track data on its local partnerships' in post-earthquake Haiti.] Okay, so, with all due respect, local community action, I think we should do it just to develop civil society, but the notion that we should be spending most of our money on small community projects is utterly ridiculous. And more importantly, we would need 10 times the staff we had now in order to manage very small grants to a lot of groups. So do we need the large contracts? Yes, we do. As I mentioned, we did a worldwide system for collecting data on diseases, and it's in 90 different countries. Even big NGOs couldn't have done this. Only big contractors can do it. Are there any programs you think should be cut from USAID? Yes, I think the family planning budget is too big. I think it should not be abolished but it should be shut down in Asia, because the Asian countries have been running this on their own for 50 years. I'd take half of that money and put it in Africa. And the notion that USAID assistance is going to have any impact on carbon emissions is a real stretch. What we should be spending our money on is adaptation [to climate change]. We need to be developing seed rice that can sustain higher temperatures and still produce. We're developing it now but it's too slow. Do you think that some of the reform programs that were put in place at USAID in Trump's first term could work — for example 'journey towards self-reliance' embraced by Trump's former USAID administrator Mark Green? The idea was that foreign aid should have the measurable goal of building self-reliance in partner nations as soon as possible, so the U.S. can get out. Well, I have been very critical of that. We closed the aid mission in Panama, and the Chinese moved in, right? Some [critics] say, if a country is middle-income, we shouldn't be providing any money. That's baloney. We are in great power competition right now, and if a country's got serious social problems — and Panama does — just because their income has gone up, that doesn't mean the problems have been dealt with. There are more poor people in India than there are in sub-Saharan Africa. I think the notion that we should 'graduate countries' [and wean them from U.S. aid] made sense in the post-Cold War world. It does not make any sense right now in terms of competition [with China]. We need to focus on the geography of our aid programs, where our missions are and whether they're critically important to the national interest of the United States. We should always have a mission in Egypt. We should always have a mission in Panama. We should always have a mission in Morocco, because of the Straits of Gibraltar, these are critical transportation [routes], and they affect global food security, because the global food system relies on these choke points in order to deliver food. So I don't think we should be graduating countries unless they become as rich as South Korea or Taiwan, which we once had massive aid programs for but we can't justify any longer. Are there any lessons to be drawn on what works and what doesn't for USAID overall? I can tell you that you need at least 15 to 20 years to build institutions that are sustainable. You can't do it overnight. Two, you can't have programs turned on and off. And both administrations did this. The Biden people would stop something they didn't like for policy reasons. Then they started again, and then they stopped it again. You can't run a program that way. That's the first lesson. The second lesson is that you have to have local leadership. If there's no local leadership, these programs don't work that well.
