Doge cuts to USAid blamed for 300k deaths – most of them children

When Brooke Nichols plugged in the data, she couldn’t comprehend what she was seeing.

The mathematician and professor of infectious diseases at Boston University had created a model to predict the human cost of the Department of Government Efficiency’s (Doge) USAid funding cuts.

Brooke Nichols, an associate professor of global health at Boston University

BOSTON UNIVERSITY

What Nichols had not appreciated was what was killing people, and just how quickly it appeared to be killing them. A death was estimated to be happening somewhere in the world every three minutes. “It was just unbelievable,” she said.

As Elon Musk, the head of Doge, arrived at the White House on Friday afternoon to be congratulated by President Trump for his work slashing the federal budget, the number of deaths on Nichols’s tracker hit 300,000, more than 200,000 of them children.

“The world’s richest man taking from its poorest and getting thanked for it,” said Nichols, associate professor of global health at the university’s school of public health. “The optics are horrifying.”

Elon Musk was congratulated by President Trump during a press conference in the Oval Office on Friday

KEVIN DIETSCH/GETTY IMAGES

She came up with the idea for the tracker when the Trump administration announced a 90-day freeze of USAid funding back in late January. “I’ve been working on HIV most of my career, so I was thinking, of course it wouldn’t be targeting HIV money because that would kill people,” she said. “Then I read they were including Pepfar (President’s Emergency Plan for Aids Relief) too and I was like, ‘are you kidding me?’”

While the State Department later issued a waiver for some humanitarian assistance programmes, including Pepfar, aid workers say the funding remains suspended and is not getting through. The world had been on track to end the Aids pandemic by 2030, according to UNAids, but the death toll is now set to triple by the decade’s end if US funding is not quickly reinstated.

For decades, USAid provided the largest source of international assistance to more than 120 countries through food programmes, clean water initiatives and infectious disease outbreak responses.

USAid’s budget was about $42 billion in 2023, the last fiscal year recorded. More than 80 per cent of its funding was cut overnight, leaving beneficiaries scrambling to find alternatives.

“I immediately thought about the potentially enormous human impact of this and that people should know that,” Nichols said. “I wanted to try to communicate that relatively rapidly to as many people as we could.”

Food and diarrhoea programmes are among the first to have an impact on countries reliant on USAid

AP/FARAH ABDI WARSAMEH

She made some “back-of-the-envelope” calculations and sent them to Eric Moakley, a product development expert, who told her she should “put this on the internet” so that people could really “understand the numbers”.

The result was the Impact Counter website.

Nichols’s modelling looked at the loss of USAid funding for global malaria initiatives in places like Kenya and Uganda, but also at money rescinded from food programmes.

“You look at how much funding was being put to these different disease areas, how many people were being served with these different conditions, and what we know about the mortality rate with and without those interventions,” she said.

“For example, for diarrhoea, if you don’t have oral rehydration we know that the mortality rate is much higher than when you do have oral rehydration available at a clinic or at a hospital. You then [input] how much money and how many people were served and what we know the effect of those interventions to be.”

Before starting work on her tracker Nichols, who is based in the Netherlands, had predicted most of the deaths would be from HIV and Aids, which would probably be seen in the months and years to come. But the effect of the cuts was much more immediate and much more catastrophic, according to the model.

“Because I’ve been doing HIV [research] for so long, I just assumed that would be where the biggest impact would occur,” Nichols said. “But I was really shocked by the child deaths from diarrhoea, pneumonia and malnutrition. Tens of thousands of children have died because we’ve pulled out our funding from diarrhoea, pneumonia and food programmes.”

Volunteers at the Zanzalima Camp for Internally Displaced People in Ethiopia

J COUNTESS/GETTY IMAGES

The World Food Programme, the world’s largest humanitarian food provider, had projected a 40 per cent decrease in funding compared with last year and warned of the life-threatening consequences.

“These are 100 per cent preventable deaths,” Nichols added. “They all happened because of the abrupt halt in funding.”

Nichols said the death toll would not be so high had the administration phased out funding over a 12-month period, which would have allowed for contingency planning.

She readily recognises the shortcomings of her modelling. The numbers are not recorded deaths, but rather predictions. “They’re modelled numbers and I recognise the limitations that that comes with,” she said. “We don’t have routine data sets that we can measure someone as ‘killed by the US lack of funding’.”

With any such calculation, a lot depends on assumptions. Her methodology uses a straight-line estimate of programme terminations based on data from last year and published mortality data to estimate the impact of loss of treatment.

But Nichols’s tracker has been peer-reviewed by colleagues at the HIV Modelling Consortium, who have endorsed her numbers.

As Musk sat down with Trump to declare the end of the billionaire’s work with Doge, Nichols’s ticker went up by 93 deaths.

Musk had made the slashing of USAid’s budget a cornerstone of his cost-cutting, calling the agency a “radical-left political psy op” and sharing posts on his social media site X smearing it as “the most gigantic global terror organisation in history”.

However the billionaire has been forced to acknowledge mistakes in Doge’s analysis of the efficacy of USAid programmes, including a false claim that 50 million condoms were being sent to Gaza.

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Trump himself has repeatedly said that the US spends too much on foreign aid and accused the agency, which last year received 1 per cent of the government’s total budget, of being corrupt and pushing a liberal “woke” agenda.

At a hearing in the House of Representatives last week, Democrats confronted Marco Rubio, the secretary of state, with Nichols’s modelling. Rubio denied the numbers. “No one has died because of USAid [cuts],” he said, calling any claims to the contrary “fake”. “No children are dying on my watch,” he told members of Congress.

“I want people to see these numbers and feel something, be outraged,” said Nichols, who predicted the cuts would most likely lead to significantly more deaths by the end of the year. “And more importantly: do something about it.”