The Death of USAID

The most consequential legacy of DOGE will be human misery on a massive scale

This is a summary of a longer open-access piece appearing in the journal Public Administration and Development co-authored with Rachael Zuppke.

This is how Elon Musk, the richest man in the world, announced the end of America's primary aid and development funder on February 3. By February 7, 2025, almost all USAID's 10,000 employees were on forced leave, and by the end of February 2025, 90% of the agency's contracts and grants were canceled.

Created in 1961, USAID was the largest provider of food aid in the world, and the dominant means by which the US distributed foreign aid. It also provided crucial help to those at risk of HIV/AIDS, It has been characterized as a tool of US power, but has embraced bottom-up and participatory approaches to aid. USAID oversaw $40 billion in spending, which relied extensively on funding local providers and a network of grants, which were canceled by Musk.

The destruction of USAID had less to do with the actions of the agency than with the broader governing context of an American presidency that has embraced an authoritarian, conspiracy-driven and populist approach to governing. USAID may be the first case of a government agency killed by conspiracy theories.

Secretary of State Marco Rubio has announced the cancelation of 83% of USAID's programs, ending the agency, while moving what remained into the State Department.

DOGE engaged in a massive downsizing project across the federal government during the initial months of Trump's second term, but it's worth exploring why USAID was the first and most aggressively targeted federal agency. Trump had campaigned on eliminating the Department of Education, but there was little emphasis on USAID.

While Trump said he supported the elimination of the agency after Musk initiated it, the pursuit of USAID seemed to be Musk's project. Musk made a series of false claims about USAID, repeating online conspiracy theories targeting the agency. USAID's dismantling was not merely an attempt to improve government efficiency or solely an ideological opposition to foreign aid distribution. Instead, it relied on strategies—such as leveraging unitary executive control—that reveal a broader seizure of power that pose real threats to US government capacity at home and credibility abroad.

The Role of Unitary Executive Theory

The actions against USAID, and other agencies, invoke constitutional questions about US executive power and their limits. Historically, there is wide acceptance that the creation of agencies and programs—and by extension their elimination—are Congressional decisions in the US system of government.

While USAID was created by executive order it was codified in statute by Congress in 1998. Nevertheless, Musk and Trump claimed the legal right to eliminate the agency, while firing employees in legally dubious ways, provoking legal challenges. USAID was the first and most extreme example, but President Trump has also sought to eliminate other agencies, such as the US Agency for Global Media, Americorps, and the US Consumer Financial Protection Bureau.

To do so, Trump has relied on unitary executive theory. This theory is a relatively novel reading of the constitution that holds that the President is the personification of the executive branch, and therefore holds all executive power. Moreover, efforts by other branches, such as the judiciary or Congress, to limit executive power are unconstitutional. On its face, the theory seems at odds with the origins of the US state, which emphasized a rejection of centralized, King-like authority and a strong emphasis on separation of powers.

Unitary executive theory finds its roots in the conservative legal movement, such as the private Federalist Society and lawyers who worked in Republican presidential administrations and were frustrated by limits on Presidential power. As it stands, the conservative majority of the Supreme Court are tied to the Federalist Society, and five of the nine Justices have served as lawyers in Republican administrations. The Trump administration therefore finds itself with the most sympathetic audience the Court has ever offered to unitary executive theory.

The Role of Elon Musk and DOGE

Musk promised to save the US government $2 trillion, then $1 trillion, though actual claimed spending reductions were dramatically less and exaggerated. Musk's ambitions were great: he did not want to run a government reform commission that just made recommendations, but instead to have authority to actually make cuts. This created two problems. One was constitutional: DOGE had no such authority to cut. Here, the unitary executive theory created a legal pretext for such authority. The second problem was logistical: DOGE could operate more quickly if it could take control of payment and data systems.

In addition to mass firing of public servants, Musk's team executed a takeover of the Treasury payment system. David Lebryk, the civil servant who was acting Treasury Secretary, pushed back against the Musk official, Tom Krause, who demanded control over the payment system and specifically to pause USAID payments. Lebryk informed Krause that Treasury could not legally stop payments, and recommended to work through USAID instead. Krause then threatened Lebryk: “I would also recommend you consider an equal alternative liability.” By the next week Lebryk announced his retirement, and Musk announced he was shutting down the agency.

It was later revealed that the other DOGE official who had sought to take control of Treasury spending, Marko Elez, was a self-avowed racist with a record of making disparaging remarks about foreigners, including “I would not mind at all if Gaza and Israel were both wiped off the face of the Earth.” After he resigned, Musk led a successful campaign to bring Elez back into government, even as he pushed out those doing actual life-saving work.

The executive order that established DOGE created not an organization, but a network. DOGE employees were embedded in all major federal agencies, and granted access to key systems. This meant potential for conflict between the heads of those organizations, and the goals of DOGE. For example, Secretary of State Marco Rubio publicly ordered that any pause on spending exclude life-saving foreign aid. Nevertheless, DOGE officials were able to manually block such payments, violating the intent of Rubio's orders.

The Role of Conspiracy Theories

While we know a lot about the effects of misinformation and social media on public beliefs about government, there are few instances where we can observe the effects on senior policymakers.

The destruction of USAID was remarkable in that it did not reflect any sort of broad-based consensus. While other actors in Trump's political environment—such as the Project 2025, or the budget blueprint from the Center for Renewing America, led by Trump's budget chief Russ Vought—called for reductions in USAID spending, they did not seek to eliminate it. Vought would help provide a blueprint to vastly reduce USAID to Musk, who articulated a series of claims largely disconnected from the reality of what USAID did.

For example:

• Musk said that 90% of USAID spending never reaches communities, implying that most funding was wasted. But this claim demonstrates a misunderstanding of the budget. While 10% of the budget goes to direct payments to local organizations, another 46% goes to funding to multilateral agencies and 31% to American companies and nonprofits, much of which goes to direct provision, such as HIV programs, anti-malaria products, and emergency food services.

• Musk claimed that $50 million was spent to send condoms to Hamas. Trump repeated this false claim, as did members of Congress. The organization that receives the funds does provide family planning, but its USAID funds were providing emergency health support to refugees in Gaza.

• Musk has repeated other conspiracy theories about USAID found online including that it helped to create COVID-19, is rigging elections, and manufacturing media consent.

• Musk elevated claims that USAID was protected by journalists because it had been secretly funding the media, based on government subscription services to media outlets.

Musk was not atypical of the broader Trump movement, which held conspiratorial worldviews about other parts of government it labeled as “the deep state,” but the effect on USAID was the most immediate and consequential. Such views could have been easily debunked, had DOGE been willing to talk to and trust career officials. But Musk displayed deep distrust of civil servants, labeling USAID “a viper's nest of radical-left Marxists who hate America,” and “a criminal organization.”

Musk elevated these conspiracy theories to the mainstream on his social media platform X, reposting a small group of fringe accounts on X and promoting posts from Mike Benz, a former Trump administration official and key voice behind USAID conspiracy theories. Benz has argued that “USAID is notorious for funding the darkest, most controversial, most horrifying projects known to all of mankind” and Musk believed him. In the space of a year, Musk engaged with or elevated Benz’s messaging 160 times. Unsurprisingly, Benz has also embraced white supremacy politics.

Benz has not stopped. Even now, Benz is connecting USAID to…Epstein!

Renee DiResta, a disinformation expert, explained Benz’s approach, which appealed directly to Musk’s worldview.

He picks a villain, pretends it has ties to the CIA or some 'deep state' and acts as if he has inside knowledge when he’s really just decontextualizing public content. The remarkable thing is that the masters of the universe seem to repeatedly fall for it.

In effect, the online conspiracy theorists and MAGA opponents to foreign aid found a powerful government official who agreed with them, operating in an environment where he had unchecked power, and was willing to take radical action.

In a normal government setting, someone holding conspiracy theories would not be given control of the objects of their mistaken beliefs. Or they would have been checked by other parts of government. Or they would have learned that their beliefs were false.

Trump’s Chief of Staff, Susie Wiles, revealed how haphazard the process was, the fundamental lack of accountability, and how disengaged Trump was from one of the most consequential actions of his administration:

I was initially aghast. 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…When Elon said, ‘We’re doing this,’ he was already into it. 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…The president doesn’t know and never will. He doesn’t know the details of these smallish agencies…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. 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.

With DOGE, Musk was given extraordinary power to pursue his agenda. He worked in an administration that was largely indifferent to disruption and damage, open to conspiracy theories and, using unitary executive theory, willing to claim and delegate extraordinary powers. USAID was especially vulnerable to this context, falling at the intersection of different aspects of Trumpism: hostility toward the bureaucracy, international commitments, and the global south.

This will be one of Elon Musk’s legacies, and the most consequential one for human life. A man who talks about saving our species condemned millions to death because he could not discern reality from a paranoid fantasy. While DOGE massively exaggerated its contributions — remember when the Trump administration said it cared about deficits? — it should not be allowed to minimize its greatest one, which is to dramatically increase human misery and death among the most vulnerable. No-one associated with that organization should be allowed to wash away the the stain of death.

Unlike Musk, Marco Rubio cannot claim he did not know better. In between posting Bible verses, Rubio had praised the agency for years prior to becoming complicit in its downfall.

Now Rubio boasts that the logos on the remaining aid packages are patriotic. What a consolation to the people not receiving the aid!

The Consequences of Ending USAID

At some point the rhetoric about USAID's role had to meet the reality of what it actually did. USAID has played a critical role in delivering humanitarian and emergency relief, combating diseases including HIV-AIDS, malaria and tuberculosis, and serving as the world's largest provider of food aid.

A retrospective evaluation of US AID's work published in the medical journal The Lancet found that it had prevented 92 million deaths between 2001 and 2021, including 30 million children. The PEPFAR HIV-AIDS program alone claimed to have saved more than 26 million lives since its establishment under President George W. Bush. As a result of the dismantling of USAID, the Lancet analysis predicts 14 million avoidable deaths over the next 5 years, including 4.5 million children under the age of 5.

An impact counter created by Brooke Nichols, professor of public health at Boston University, estimated almost 350,000 deaths already because of aid cuts.

Such estimates are difficult to verify, and assume no change in behavior by local populations, governments or other donors. Nonetheless, they provide a sense of scale of the effects of USAID cuts, as well as the moral atrocity that came with the choice to eliminate it. The rapid collapse of USAID meant there was little opportunity to reduce immediate harm. American USAID staff and contractors working in the field were immediately recalled, and local contractors were laid off.

The abrupt closure was anything but efficient, with internal memos estimating that it would cost $6 billion to wind down USAID, partly because some contracts would have to be paid out even if not delivering services, and partly because of the barrage of lawsuits.

USAID served not just altruistic purposes, but also other US goals. It had long collected health data in poorer countries, providing an early warning system to flag and address infectious disease outbreaks. It purchased hundreds of millions of dollars worth of food from US farmers and emergency food producers, much of which was left to rot in warehouses, or be incinerated rather than provided to starving people. Such spending helped to prevent mass migration associated with food insecurity.

USAID spending also helped to underwrite civil society organizations. It was because USAID operated as a source of US soft power that US adversaries have long viewed it with suspicion. Russia, El Salvador, and Hungary cheered Musk targeting USAID.

Foreign AID and Soft Power without USAID

Public support for foreign aid is often weak, and as governments are pressured to ramp up military spending, foreign aid is an obvious target for further cuts. Globally, international aid dropped in 2024 by 7.1% in real terms compared to the previous year. The general pattern of overseas development aid from government is on the decline, according to the Center for Global Development.

The US is not the only example where aid agencies have been eliminated. In the United Kingdom, the Department for International Development was dissolved and its functions subsumed within a new Foreign, Commonwealth and Development Office (FCDO) as a cost-cutting measure in 2020. Major donors like Germany, France, Switzerland and Canada are also doing less.

As countries like the United States and the United Kingdom step back from foreign aid, other countries may play a larger role. The BRICS alliance is premised on the claim that Western institutions have not served the global south. It is possible that a decline in Western influence will see greater focus on local needs rather than funder priorities. In 2018, China formed the China International Development Cooperation Agency, which accompanied its Belt and Road Initiative to build its influence in other countries.

But China and other countries have their own domestic goals, such expanding exports of their goods and services. Their aid spending is less tied to democratic or human rights concerns, and without dramatic expansion, would not fill the void left by USAID. By one estimate, China spent $2.85 billion on foreign aid in 2024, compared to approximately $40 billion from USAID.

For Trump and his supporters, the attack on USAID reflected a broader “America First” isolationism that was suspicious of foreign spending and collaboration. The Trump administration was hostile toward international institutions like the United Nations, the World Health Organization and NATO, withdrew from the Paris Agreement on climate change, and broke trade agreements.

DOGE officials also moved to close other, smaller institutions engaged in overseas work: the Inter-American Foundation, the African Development Foundation, and the Institute of Peace. Trump sought to eliminate the US Agency for Global Media, which broadcast news around the world.

The traditional tools of soft power are seen as signs of weakness. The underlying irony is that since World War II, the US built and benefited from the global order that it now dismantles. The institutional arrangements associated with America's greatest period of global power are treated as threats by a political movement that called for making America great again.

Even if the Trump administration continues to spend more on aid than China, it's broad withdrawal from aid and “America First” messaging, makes it easy for other countries to frame America as an unreliable ally. And even if a future Congress or President restores much of the funding, the damage to America's status on the global stage is irreparable. For those that live in the global south, the dismantling of US capacity in domains such as poverty, food security, health, and natural disaster prevention will make them more vulnerable to disease, disaster and death.