(CBSN) – Dr. Atul Gawande, former director of Global Health at the United States Agency for International Development (USAID), has strongly criticized the Trump administration’s proposed merger of USAID into the State Department and its funding freezes, arguing that these actions amount to “destruction” rather than an “overhaul.”
Gawande, a surgeon and medical professor, spoke with CBS News on Monday, highlighting that the “destruction” began after the White House Office of Management and Budget issued a memo freezing federal assistance. Although the memo was later rescinded and the freeze was halted by a federal court, several aid programs remain in limbo.
“You’re talking about 20 million people in the global HIV program that has reduced HIV around the world; they are going without medication that keeps them alive,” Gawande said. “You’re talking about disease outbreaks that are not being stopped, like bird flu, where monitoring has been turned off in 49 countries.”
He further warned, “There is a great deal of harm being done, and this change to take away the independent status is just a nail in the coffin after a purge of personnel that has decimated the agency.”
Concerns from Former USAID Staff
Other former USAID personnel have echoed Gawande’s concerns.
Maura Reap, a former contractor with USAID’s Bureau for Global Health, had just arrived in Ethiopia for a two-week assignment when Secretary of State Marco Rubio ordered a pause on all new U.S. foreign assistance programs funded by the State Department and USAID. Reap, whose expertise is in mental health, was set to help design a project supporting survivors of sexual and gender-based violence—an initiative that had been months in the making.
“We had some meetings over the weekend, and there was just a lot of uncertainty,” Reap told CBS News. “It was like a slow train wreck.”
Shortly afterward, she received an email instructing her to return to Washington, D.C. While in transit, she and two colleagues were notified that their contracts had been terminated.
“This terrible waste of a [temporary duty travel] with all the planning and investment that had gone into it, and it was for nothing,” she lamented.
Response to Trump and Musk’s Criticism
Gawande also pushed back against criticisms from former President Donald Trump and billionaire Elon Musk. Trump recently described USAID as “run by a bunch of radical lunatics,” while Musk likened it to “a ball of worms.”
Gawande countered, stating, “What we’re talking about are disaster relief workers. We’re talking about health workers and people who are doing good and protecting America around the world.”
Uncertainty Over USAID’s Future
The Trump administration is expected to announce further details regarding the restructuring of USAID, a 60-year-old agency that provides humanitarian aid to more than 100 countries. USAID plays a crucial role in disaster relief and poverty reduction efforts. In fiscal year 2023, it managed over $40 billion in appropriations—less than 1% of the federal budget, according to the Congressional Research Service.
Trump has pledged to reduce the size of the federal government, making USAID a key target. Musk, now leading the newly created Department of Government Efficiency, has also advocated for significant cuts. The White House recently released a list of what it considers wasteful USAID expenditures. However, Democratic lawmakers have cautioned that any major structural or funding changes would require congressional approval.
Expressing frustration over the agency’s uncertain future, Reap remarked, “Somebody who’s not even elected can come in and just take this 60-year-old institution that has accomplished so much … and to have so much disregard, to take it, turn it, and throw it on his back and say, ‘We’re throwing it out.’”
Implications for Global Health and Stability
Gawande warned that dismantling USAID would have serious consequences for global health and national security.
“We’re talking about world-class expertise. For example, the malaria program—two-thirds of its staff have been fired, and the shutdown includes one of the world’s leading malaria experts. How does that make us safer? How does that make us stronger?” he asked.
Reap also emphasized USAID’s critical role in international stability.
“The work we do stops outbreaks, reduces migration pressures at our southern borders, counters extremism, and helps create stable communities by keeping people healthy so they can contribute to society,” she said.
Gawande concluded, “Every administration undergoes an overhaul, seeking policy changes and new directions. But you don’t decimate and demolish the institution in the process. There was no need to shut down all its functions, causing harm to countless people.”