If we can help turn a pandemic and culture around for the good, within reason, we want to do it.
Well, it’s good to know someone in the administration recognized what a mess the humanitarian-aid clean-up was earlier this year.
The Vanity Fair piece out today includes this:
Musk triggered the first true crisis of the Trump presidency and an early test for Wiles. Trump’s chief was shocked when the SpaceX founder eviscerated USAID, the United States Agency for International Development. “I was initially aghast,” Wiles told me. “Because I think anybody that pays attention to government and has ever paid attention to USAID believed, as I did, that they do very good work.”
In his executive order freezing foreign aid, Trump had decreed that lifesaving programs should be spared. Instead, they were shuttered. “When Elon said, ‘We’re doing this,’ he was already into it,” said Wiles. “And that’s probably because he knew it would be horrifying to others. But he decided that it was a better approach to shut it down, fire everybody, shut them out, and then go rebuild. Not the way I would do it.”
Wiles knew that fixing this was on her. “The president doesn’t know and never will,” she told me. “He doesn’t know the details of these smallish agencies.”
Wiles says she called Musk on the carpet. “You can’t just lock people out of their offices,” she recalls telling him. At first, Wiles didn’t grasp the effect that slashing USAID programs would have on humanitarian aid. “I didn’t know a lot about the extent of their grant making.” But with immunizations halted in Africa, lives would be lost. Soon she was getting frantic calls from relief agency heads and former government officials with a dire message: Thousands of lives were in the balance.
Wiles continued: “So Marco is on his way to Panama. We call him and say, ‘You’re Senate-confirmed. You’re going to have to be the custodian, essentially, of [USAID].’ ‘Okay,’ he says.” But Musk forged ahead—all throttle, no brake. “Elon’s attitude is you have to get it done fast. If you’re an incrementalist, you just won’t get your rocket to the moon,” Wiles said. “And so with that attitude, you’re going to break some china. But no rational person could think the USAID process was a good one. Nobody.”
The shuttering of USAID crippled the President’s Emergency Plan for AIDS Relief (PEPFAR). The antiretroviral program, launched with $15 billion by George W. Bush in 2003, was credited with preventing millions of deaths. It depended on USAID grants. In an interview with The Financial Times, Bill Gates remarked: “The picture of the world’s richest man killing the world’s poorest children is not a pretty one.”
While some of the rhetoric of the damage that was done is a wee bit hyperbolic, there was damage done — incalculable, the best I can tell. In some cases, clinics in rural areas of Africa disappeared overnight, as contacts’ e-mail accounts were eliminated, as were their jobs. (And it doesn’t help that people who are reachable don’t often want to go on record because of fear of a “vindictive” administration.)
The Chris Whipple piece also has this:
Privately, another drama was playing out.
Bush himself had gotten wind of the gutting of PEPFAR. He called Rubio to express alarm, according to a former aide close to Bush. “He’s been appalled by Trump from the beginning and he’s determined not to weigh in,” the aide said. But Musk’s attack on one of his legacy achievements was too much. Bush, said that person, “cares deeply about the PEPFAR program. That and Wounded Warriors are the two things where he will weigh in, not publicly, but with intention.”
Did Rubio have any regrets about the untold number of lives that PEPFAR’s evisceration might cost? “No. First of all, whoever says that, it’s just not being accurate,” he told me. “We are not eviscerating PEPFAR. PEPFAR has been rearranged and reorganized in such a way where we’re now going to be able to deliver aid in a way that has a goal. The goal is to help countries become self-sustaining.” With a note of “America First,” he added: “Let’s begin with the premise: Is it the United States’ fault? Why isn’t China paying for more immunizations? Why isn’t the UK or Canada or any of the G7 countries?” (The UK, following in the footsteps of the US, slashed foreign aid in 2025. In November, China, which funded the Africa CDC, pledged $3.5 million in AIDS prevention in South Africa alone.)
When I repeated Rubio’s comment to a former GOP White House chief of staff, he remarked: “I find that immoral.”
A few of us who aren’t former presidents were pleading for special care for PEPFAR — even as it needed to be reviewed. (See here and here.) I think if I were president, I’d put N.J. Congressman Chris Smith, a pro-life/human-rights stalwart, in charge of PEPFAR. I can imagine Marco Rubio wouldn’t mind the help.
It’s not immoral for the goal to be self-sustainability. That was the spirit of PEPFAR. But it’s also who we are. If we can help turn a pandemic and culture around for the good, within reason, we want to do it. PEPFAR was never near the most expensive program, and it was a lifesaver. I know a Republican president getting a Nobel Peace Prize is loaded now, but W. really did deserve one — for the people he brought together to save African lives.