Atul Gawande on Elon Musk’s “Surgery with a Chainsaw”
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What happened to USAID under Trump and Musk's administration?
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This is the New Yorker Radio Hour, a co-production of WNYC Studios and The New Yorker.
Welcome to the New Yorker Radio Hour. I'm David Remnick. Two weeks after the inauguration of Donald Trump, the new president's chief campaign funder, his consigliere, and the richest man in the world, Elon Musk, tweeted in a tone of glee, Musk was, of course, referring to the Agency for International Development, an agency that has saved millions of lives.
How did Atul Gawande contribute to global health at USAID?
If the power of the United States means something positive around the world, the efforts of thousands of foreign aid workers in USAID, doctors, nurses, logistics experts of all kinds, have a lot to do with that. But Musk and Trump see it otherwise, and they have decimated the agency. Into the wood chipper it has gone. Now the courts have blocked aspects of the federal purge of USAID. But the damage can't easily be undone. Atul Gawande was a senior leader of USAID during the Biden administration. He ran critical health programs all over the world. Gawande is a surgeon, an author, and my longtime colleague writing for The New Yorker. He's been watching in absolute horror as the agency has been summarily pulped. We spoke last week.
Atul, President Biden appointed you as the assistant administrator for global health at USAID, and you stepped down on Trump's inauguration day. And he immediately began targeting USAID with an executive order that halted all foreign aid. Did you know or did you intuit that Trump would act the way he has? No idea. previous Trump administration, they had embraced what they themselves called the normals. They had a head of USAID who was devoted to the idea of development and soft power in the world. Now, they had their own wrinkle on it. which I didn't disagree with. They called it the journey to self-reliance. They wanted to invest in Africa, in Asia, in Latin America to enable stronger economies, more capacity. And we weren't doing enough of that. And I actually continued much of the work that had occurred during that time.
Well, tell me a little bit about what you were in charge of, what the good that was being done in the world was. Yeah, so this is a job where I had 2,500 people between DC and 65 countries around the world working on advancing health and protecting Americans from diseases and outbreaks abroad. And the aim was to work with country to build their systems so that we protected the global health security and improved global outcomes of everything from reducing HIV, AIDS, and other infectious diseases like malaria and TB to strengthening primary healthcare systems so those countries would move on from depending on aid from donors. That work, in three years, we documented being able to save more than 1.2 million lives after COVID alone.
Well, let's pause on that. Yeah. Your part of USAID was responsible, demonstrably, for saving 1.2 million lives. Yeah. Part of my target was reduce the percentage of deaths in any given country that occur before the age of 50. And teams would focus on what were the top three to five killers. And in some places, that would be HIV. In some places, that would be TB. It would include, you know, safe childbirth was a huge part of the work. What in the world was the case against this kind of work? What could possibly be the case against it? So one case is that it could have been more efficient, right? That Americans imagine huge sums of money going to this work that, you know, polls show that they think that a quarter of our spending goes to foreign aid. So it's a minuscule amount. Yes.
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Chapters
7 chapters
1
What happened to USAID under Trump and Musk's administration?
0:02–1:27
2
How did Atul Gawande contribute to global health at USAID?
1:27–11:26
3
What are the consequences of cutting USAID funding?
11:26–21:49
4
What is soft power and why is it important?
21:49–23:03
5
How does the current administration view foreign aid?
23:03–25:48
6
What are the immediate effects of USAID's budget cuts?
25:48–28:32
7
What challenges do USAID workers face on the ground?
28:32–28:43
Speakers
4 identifiedMore from The New Yorker Radio Hour
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