For context: Tuberculosis treatment requires strict, months-long medication adherence. Even a brief disruption means patients may not complete their courses, allowing drug-resistant TB to emerge. These strains are far harder and more expensive to treat, spreading across borders and undoing decades of progress.
The brief (?) interruption to PEPFAR (Bush's HIV/AIDS aid program) has major impacts too. One of the plainest ones is that infants with HIV can, if anti-retrovirals are paused, die more or less right away.
- "In children who acquired H.I.V. at birth, the infection can progress very quickly to illness, with death occurring as early as eight to 12 weeks after birth — shorter than the 90-day pause on foreign aid."
It also makes the point that, under some reasonable assumptions, you could assume that any domestic program you could theoretically redirect the funding to would likely be ~100x less effective than PEPFAR, which is an abnormally effective aid program.
Reasonable assumptions would not assume you to assuming the US' top medical bureaucrat being a conspiracy theorist who denies the existence of HIV (and asserts AIDS is environmental and that anti-retroviral drugs are dangerous toxins).
Why is the US contribution so critical to anything outside the US when there so many other rich countries that could pick up the slack? Does this mean that besides US no one else cares? I can't believe that's true.
Because we already volunteered to do this specific thing, so it's incredibly disruptive for us to back out at (or well after) the last minute. Other countries do other things, and it would be similarly disruptive if they pulled or froze funding and operational support with 0 notice.
It'd be like if Microsoft donated free copies of Windows to a hospital and then one day was like "Actually we've been donating too much stuff, your licenses are invalid as of today, your computers will now not work." It would be similarly strange to ask why Microsoft's contribution is so critical to anything outside their own company, when it's because they made it that way on purpose, partially for PR purposes, partially from genuine altruism, and partially to tie Microsoft's well-being to the hospital's.
That's now how it works in the US. Every 2 years we have an opportunity to vote for our representatives. They set the budget, and if we don't like it we can elect new representatives who will set a budget closer to our liking.
This isn't a matter of taxes being spent on things we didn't agree to, because spending this money is a priority for many Americans. For other's it's not, but that doesn't mean the money is being coerced. That's the deal with living in a pluralistic society; your personal priorities aren't the only ones. Sometimes public money is spent on things you don't like, and that's okay because other people don't like their money being spent on the things you do like. Everyone is happy yet unhappy - compromise.
Not really. Forceful taxation (by jail) to redistribute the money to states or national security is a boring topic, but redistribution of wealth to ‘for n in NATIONS’ is worth an intellectual challenge.
And even if you don’t care about taxation, why is the US running this entity and not supprting an international donation match to the UN? The US is running a deficit if you haven’t noticed, not a surplus.
There's also an underlying validity to the "property is theft" argument. They both have a correct underlying principle. And both are wrong in the totality.
> a deficit
A deficit in little pieces of paper they print themselves, and most of that debt is to themselves.
It's always a shame when people get used to free things because they lose the ability to provide for themselves.
I say we stop so other countries can spin up their own programs and pay for it. I have zero interest in using TAX dollars to fund medical programs outside the US.
For people down-voting, it's no different than being told "Don't feed the bears" and Yellowstone Park. It's worse off for the animals because they become dependent.
Many other rich countries give more on a per capita basis.[1]
Indeed the U.S. has been kinda cheap, on a percent of gross national income basis.[2]
It could be countered, of course, that the U.S. has paid substantially more for defense, and for the defense of many donor countries.
This data only includes government spending, which leaves out private and NGO spending. Many Americans prefer that their charity funds be spent outside of the control of the government.
Because the US is the de-facto leader of the Free World, the wealthiest country in the Western hemisphere and the winner of the Cold War. Heavy Lies the Crown. Especially when it's about fighting the deadliest infectious disease known to man.
Just the interest on the US debt is almost a trillion dollars a year now which is 3% of GDP and the debt is ~35 trillion. Deficit spending is higher than federal taxes on the paycheck, which means you're basically paying double of what your paycheck shows.
Meanwhile Norway's sovereign wealth fund has $1.75 trillion dollars.
Norway and Singapore are petro-states. Alaska and Texas (to a much smaller degree) have wealth funds off of resources. Whether they're fiscally responsible with that is up to the state.
Labelling Singapore as a petro-state is a stretch. Collecting taxes from refining is a very different thing than reaping the benefits of royalties from oil production.
TB is vastly underestimated here in the US where we have largely eliminated it, but it is indeed the deadliest infectious disease known to man. It killed 1.25 million people in 2023.
This is nitpicking, but I guess which disease bears the title depends on how you define it. I remember seeing some estimate that malaria has killed ~40% of all humans that have ever lived.
The goodwill the US gets from soft and hard power projection is precisely what allows us to have the world reserve currency. This allows the government to print large amounts of new money with much smaller consequences. The US is basically the center of an economic empire, which the neofascists are intent on destroying - either out of mistaken adherence to the political tropes of analyzing a country like a household (eg the harping on "government debt"), or it's likely they are just overtly selling us out to the rising empire of China.
Because we get a lot of travelers through our country who may otherwise spread TB here if we made no effort to control it outside of the country, and it would be a huge public health problem for us despite the fact that treatment for it is readily available in our country.
If we're going to do this we should probably institute some kind of health screening during the immigration process at entry points.
> Because we get a lot of travelers through our country who may otherwise spread TB here if we made no effort to control it outside of the country
A dozen of vaccines and a proof (from the doctors certified by the US officials) that you have no contagious diseases (including TB) is a prerequisite to get any US visa. The only way to bring TB to the US, I presume, is to jump over the fence at the border.
It's the same rationale we used for the Iraq War - fight the terrorists there so we don't have to fight them here. People understand that intuitively. But when it's framed as helping people, there's a big question mark as to the utility.
The USA is the wealthiest and most powerful nation in the world. Why would ceding this soft power to other countries benefit the USA? These cuts will be meaningless in cutting the deficit while harming the USA's global influence.
It's been interesting seeing Western European NGO's struggle to find funding without USAID as well. I don't like Trump, I don't like much of what he's doing, but this at least has been a bit of a wake-up call for me. While the US is rich and should provide what it can, the degree to which the rest of the world (and the rest of the West) has clearly just shrugged and let us carry them is... interesting.
while it makes perfect sense in a democracy to argue about funding levels or even if the program should exist and make your voice hear through your representatives.
Turning it off without any planning like its the back up server for a social media company is irresponsible and will cause people to die.
Of course, what we're seeing is careless and foolish, I'm not endorsing any of it. I am however somewhat enlightened by the consequences of that foolish endeavor.
As a percentage of GDP alright. Now how about absolute numbers, because pretending that doesn't matter isn't particularly helpful, and feels like playing with numbers rather than dealing with reality.
Although I am not a Christian, the parable of the poor widows offering always resonated with me.
"Jesus sat down opposite the place where the offerings were put and watched the crowd putting their money into the temple treasury. Many rich people threw in large amounts. But a poor widow came and put in two very small copper coins, worth only a few cents.
Calling his disciples to him, Jesus said, “Truly I tell you, this poor widow has put more into the treasury than all the others. They all gave out of their wealth; but she, out of her poverty, put in everything—all she had to live on.”
I see that as different, it is first and foremost an American project, born from a conflict between superpowers. I don't think the same is true about global charity.
It was a conflict between Communism/Socialism and Capitalism on the world stage and the proxy wars were fought over those ideologies. Now that communism is mostly recognized as a dead end, I wonder if the world order will slowly re-align. Socialism is taking off with Gen Z(see Reddit) so maybe the next administration will be socialist with AOC, Warren and Bernie.
I don’t understand what bubble Elon Musk is living in where the ruthless slashing of USAID spending won’t have huge negative repercussions for the US.
I think the rest of the world will withdraw from trusting the US after this and other actions. A lot of trust in the world leadership positions the US takes are being torched by these vandals right now and while I hope for an amazing US comeback in 4 years it looks a lot more like China will step in as a stable partner for a lot of countries after an almost complete betrayal of western values.
That's such an apt phrase. It goes back to the time Rome was a great and prosperous civilization, and there was a barbarian tribe–"Vandals" is a proper name–who were incompatible with kind of high civilization, who rode into a weakened Rome and looted various treasures they liked. And torched the rest.
It's an apt language to talk about people who seemingly don't comprehend the value of the institutions America built up over a century, the deep soft power behind them; who see only fistfuls of cash that can be grabbed.
What trust? Other governments trust the USA as much as people trust Facebook to deliver them non brain rot content or McDonalds to serve them a healthy nutritious meal.
Countries have a mutually beneficial relationship with the US out of need(world's biggest economy and consumer market), out of fear(world's biggest military), and out o necessity (Russia and China being worse alternatives) not out of trust. Basically, Realpolitik. Trump didn't move the needle on that front at all despite the optics in the eyes of the plebs.
If by some hypothetical scenario, tomorrow the US would disappear from the world and its status as the leading world super-power be replaced by a country like Russia or China, then the other countries on the planet would kiss their ring, just as how in a herd/pack all the males succumb to the alpha male. It's nothing to do with trust, it's all to do with power and influence.
Talk to any Canadian and tell me that trust in the US as an ally hasn't been irreparably damaged.
Global geopolitics are complicated. It's true on some level that no one trusts anyone else, but relative levels of trust still matter. There aren't many superpowers out there, if the US is seen as unreliable, China and the EU can step in and replace US influence. This has been happening in Africa for a couple decades or so, with China becoming increasingly influential.
These actions will drive US allies into partnerships with our rivals, which will make the US weaker. Everyone on both sides of the aisle understood this from 1946-2016.
>Talk to any Canadian and tell me that trust in the US as an ally hasn't been irreparably damaged.
Firstly, I have no sympathy here. If you trust any foreign government that's not accountable to you to begin with, that's on you.
The upshot is that this serves as a good lesson and wake-up call for Canadians and for us in EU as well that we need to start pulling our weight in the world and looking out for our own interests instead of letting ourselves at the mercy of foreign powers.
People need to learn lessons the hard way on their own skin if they're too stupid to learn from past history, like how Czechoslovakia was fucked over by its allies in WW2 and gave to Hitler on a platter. Don't rely on supposed allies to fight your battles, look out for yourself. That's why I'm a big fan of the Swiss's neutrality system and France's post-WW2 nuclear deterrent program. A strong military is better than stronger allies that can change their mind.
And secondly, nothing is ever irreparably damaged. 80 years ago Japan and US were at war and for over 50 years they've been strong allies. Canada also invaded the US in 1814 and burned down the White House and yet they've been each other closest allies after that. Similarly, in 20 years Russia could be the west's best friend. So relationships between countries change all the time based on how the wind blows. Nothing ever lasts forever, only gullible fools with no understanding of history try to hang onto such idealistic beliefs.
The Swiss trust their neighbors in most things. They have extensive trading relationships with their neighbors, many treaties and relatively open borders. There military is structured under the assumption their neighbors won't invade.
Sure, but that was only a personal opinion tangent and not the core of my argument which still stands. That's like the safari guide telling you to stay in the vehicle because the Bengali tigers outside will maul you and you go "Ackshually, those are Siberian Tigers, not Bengali." While you're technically correct, it doesn't change the point.
Trust isn't a binary. If everybody trusted all of their neighbors as much as South Korea trusts North Korea then the world economy would collapse and we'd likely have billions of deaths.
It isn't binary but clever countries with a strong defense policy like the US and Switzerland also have insurance polices and backup plans for the case their allies turn against them since it's better to be a warrior in a garden than a gardener in a war. Guess in which case Europe is a the moment?
> I think the rest of the world will withdraw from trusting the US after this and other actions
The USA currently has a problem where a large portion of the US population no longer trusts the USA. That population shifts depending on whichever group is in charge of the federal government
Maybe this is not the way to repair that trust, I don't know. But I think for a lot of people, "Stop sending tons of our tax money to other countries" is a step to repair some of that trust with the population
The next step would have to be "start re-investing that money back into America" but we'll see if that actually happens
> But I think for a lot of people, "Stop sending tons of our tax money to other countries" is a step to repair some of that trust with the population
Yes, bingo. On both sides, people have become extremely sick of seeing "billions of dollars sent to X" in the news knowing that we, American citizens, will never receive anything like that amount of aid
If you are a young person today, your chance of getting Social Security is low because it will be scrapped by the time we reach that age. Medicare also is for seniors, Medicaid is for the impoverished. Veteran services are for veterans.
Most of what you describe is not for the average American citizen. But it is the average American citizen who has more credit card debt than ever before, whose wages don't keep pace with inflation, whose ability to buy a home for his family drifts further and further away every year.
Why can't we take that 1% that we send to foreign "allies" (who themselves have better social services and spend more on their populations than we do) and give it to the average American who works hard and makes this country what it is?
I mean, they basically are. They are slashing foreign aid, slashing Medicaid $800B, slashing SNAP programs 20%, and they're giving the money back to the American people in the form of tax breaks.
But not average Americans, no, don't be silly. It's going back to the 1% and corporations, the "real Americans" who built this country.
Average Americans get nothing. Actually, it's worse than that we get less than nothing; we are losing social welfare programs that keep up alive and healthy. Instead, the plan as far as I can tell is to just let people who depend on those programs die.
Your first claim was "we, American citizens, will never receive anything like that" and after that's been thoroughly debunked, you're conveniently moving the goalposts. Now it's suddenly all about some ill-defined "average citizen", and I'm sure your next claim is that veterans, people on welfare, and people with medical problems are all somehow not average.
People with medical problems don't receive Medicare and Medicaid, the impoverished and senior citizens do.
Say what you will, but if the only American citizens who receive aid from their country are senior citizens, veterans, and the impoverished, then the rest are gonna be mad when they see billions of their hard earned taxes flying out to other countries instead of spent on them. That just is what it is. Especially as the economic prospects for an average working man in the US gets worse and worse every year
1% is small in terms of the national budget but massive in terms of the average American
If the argument is "it's not that much money and it wouldn't help Americans much" then can't people also turn that on it's head? "It's not that much money, so it's not actually doing much real good overseas either"
It's not the spending itself that's the problem. It's the the waste in each program. The middle men and NGO's that are hovering up free money from the tax payers that is the problem.
All these programs are treated like cookie jars and everyone gets a nibble.
Do you have any proof of this assertion? Most government agencies outside of the military have passed financial audits. People who have worked as auditors in the public and private sectors generally report more waste and fraud in the private sector by far.
No, it's the spending. I'm sick of looking at our "allies" having the social programs our "leaders" tell us we can't have while we subsidize their countries
1) Elon isn't a fraction as bright as he thinks he is
2) Elon suffers from extreme Dunning-Kruger
3) His boss only cares about adulation & retribution
4) Their enablers are willing to sit on the sideline as the side effects are destroying their political opposition
He's not interested in helping anyone but himself. IDK how stopping this stuff helps him exactly, but his actions make a lot more sense if you look at them through that lens. Negative repercussions for the US aren't necessarily negative for him, or they may be outweighed by something positive for him.
I think the goal is to destroy US soft power on the way to undermining the rule of law and destroying what passes for a rules-based international order. Once that's done they can really get busy stamping out democracy.
I don't think USAID is the core of US soft power, Hollywood is. Our tech industry is. Our food and our language and the way our culture seeps into everything is.
If USAID and aid to places in much of Africa was our soft power, I'd expect to see a lot less pivoting to China and Russia in those places. On that note, perhaps the countries that decided to invite Wagner or enter the Chinese BRI can ask their new friends for some TB meds?
We're on track for TB to become a problem again, even in the west. Global eradication efforts were put on massive pause during covid. Some governments are downplaying the issue to appear on track to meet arbitrary eradication deadlines. It's been cropping up around North America. Just as a reminder, there isn't an effective vaccine (BCG is not what we would consider a modern vaccine). Current treatment regimen is 6 months daily antibiotics. Throw in any complications (paradoxical reactions, resistance) and get ready for that to become much longer.
I had watched a loved one suffer from this disease. The pills were huge. Waiting too long to start treatment causes a lot of complications. These aren't well understood, given the massive TB funding deficits. Even when the disease is cleared from your lungs, it leaves plenty of things behind.
If you or somebody you know is coughing persistently for weeks, losing weight, has evening fevers, just get the quantiferon gold test. Be persistent with your doctor, just mention past TB exposure. Your insurance should cover it. Don't wait around months trying to look at every other avenue. It'll look very similar to aspergillosis on x-rays.
The TB that does exist out there in the world is increasingly multi-drug resistant, which means most antibiotics won't work on it. Once it starts spreading abroad and later in the US, a lot like Covid did, it's game over.
That USAID was Trump and Musk's first target after taking office is peculiar. They made no mention of it during the campaign and most people were unaware of it's existence until a couple weeks ago. The only group with any strong negative opinion of USAID is foreign adversaries.
I know farmers hate it with all those billions of $ in extra cash from selling food that was going to waste anyway. I'm sure the rural communities will hate it too when all that money isn't going to the love communities either.
My SO suggested that USAID was a target because during the elimination of Apartheid in South Africa it was a critical component of empowering the black population there. Elon Musk's family apparently lost a lot of their political power as a result of that, and this might be payback.
It's similar to why a lot of people thought George W. Bush rolled invading Iraq into his plan to take down Al-Qaeda despite Iraq not apparently harboring them.
I do think it's crazy the degree to which the entire world seems to rely on us.
And our own politicians are the ones who have sent our hard-earned billions of dollars away to foreign countries, many of whom feign being allies but really provide us with no benefit at all
