Title: Opinion | This Is What Happened After We Gutted U.S.A.I.D.
Author: Nicholas Kristof
Publication: The New York Times
Date: May 9, 2026
A touching, powerful op-ed by Nick Kristoff.
Most Americans fret about the high gas prices as the big consequence of the US-Israel war on Iran. Nick Kristoff points to the incalculable damage to the lives and livelihoods of millions of the poorest people throughout the world, and the hypocrisy of "trade, not aid" platitude.
Summary: The opinion piece criticizes President Trump's 71 percent cut in humanitarian aid from 2024 to 2025 as his most lethal policy. A Boston University researcher estimated these cuts caused over 750,000 deaths globally in their first year. A Lancet study predicts that continued defunding could lead to 9.4 million deaths by 2030, including 2 million children under five.
Quotes:
"Trump's most lethal policy will almost surely be his 71 percent cut in humanitarian aid from 2024 to 2025."
"A researcher from Boston University estimated that these cuts resulted in over 750,000 lives lost globally in their first year."
"A recent study published in The Lancet... predicted that if current funding trends continue, the defunding could lead to 9.4 million deaths [by] 2030, including 2 million children under the age of five."
Kristof is right to sound the alarm. The dismantling of USAID was never going to be only a budgetary exercise. When vaccination programmes stall and food pipelines dry up, the consequences can be measured not only on spreadsheets but in graves. The crisis Krostoff describes reveals the cruelty of abrupt aid cuts; it also exposes an uncomfortable truth: the international aid industry has spent many decades constructing systems that are permanently dependent on aid.
ReplyDeleteThe paradox is hard to ignore. After more than half a century of development assistance, many countries remain so reliant on foreign donors that the withdrawal of one agency can trigger institutional collapse. Nutrition programmes stop, and public-health systems falter. Governments that have received billions in support are not capable of maintaining even basic services without foreign aid. That is not just a funding problem. It is a structural failure.
The aid world often speaks the language of sustainability, resilience and capacity-building. In practice, many programmes have been designed around the opposite principle: perpetual external management.
An uncomfortable question follows: What exactly is the exit strategy? Much of the aid sector operates as though permanence were proof of virtue. Entire bureaucracies now depend on the continuation of crises they were originally established to solve.
While Kristof is correct that sudden withdrawal of aid can be catastrophic. Recipient governments had adapted rationally to the aid system that existed. Why allocate scarce resources to drought preparedness if international agencies reliably arrive after every failed rainy season? Why invest heavily in public health when donors finance vaccines, clinics and supply chains? In many cases, aid has allowed governments to divert their own revenues elsewhere, often to security forces or prestige projects.
The incentives on the donor side are also distorted. Politicians in wealthy countries prefer programmes that generate visibility. Aid agencies, therefore, favour branded initiatives, quantifiable targets and photogenic interventions. Long, politically difficult work, such as building tax systems, strengthening civil services or fostering accountable institutions, attracts far less enthusiasm.
The result is an ecosystem adept at managing poverty but less successful at eliminating it.
Africa illustrates the dilemma most starkly. The continent has seen big improvements in life expectancy, education and child survival over recent decades, supported by foreign aid. Yet large parts of Africa remain aid-dependent, with some governments receiving substantial portions of their health and social-service budgets from external donors. This dependence creates fragility. A political shift in Washington can reverberate instantly through clinics in Uganda or refugee camps in Kenya.
That fragility is now fully exposed. The gutting of USAID demonstrates what happens when development systems have no durable domestic foundations. Humanitarian damage is immediate and real. But blaming only the politicians who wielded the axe risks missing the larger lesson. Systems that collapse overnight after decades of support were never sustainable in the first place.
A more serious development model should begin with a harsher metric of success: dependency reduced, not programmes expanded. Aid should increasingly function as a temporary catalyst rather than a permanent substitute for government responsibility. Recipient governments would need to assume genuine fiscal ownership of core services. And the aid industry itself would need to accept that its core objective is to become redundant as early as possible.
None of this will happen overnight. Cutting life-saving assistance recklessly is both indefensible and foolish. But restoring the old system unchanged would be a major mistake. Kristof’s warning should not only provoke outrage, but it should also provoke reflection on flaws in the entire aid system built up over decades.
The NY Times article can be read in full as a gift article here
ReplyDeleteKristof rightly vents its anger at Trump's policies, particularly the abrupt cuts to development aid. However, I don't agree with all the details of his argument. Aid organizations typically fund programs that sell well in their home countries, such as the purchase of vaccines. But that doesn't mean African governments wouldn't also buy vaccines if they weren't available for free. If $1 spent on vaccines saves 54% of healthcare costs (as Kristof argues), then every health minister will promote vaccination programs - or not? Therefore, I agree with Thomas that the current aid system has produced fragility, undermined the agency of recipient governments, and set the wrong incentives.
This may be the most consequential moment the aid industry has ever faced, yet the level of engagement remains limited. Only two comments. One would think people whose careers are and have been in development would have views about the dismantling of USAID and the broader retreat from aid now spreading among Western donors.
ReplyDeleteThe old assumptions underpinning aid are eroding rapidly. Western electorates are increasingly unwilling to finance open-ended external commitments while facing fiscal pressure, ageing populations and political fragmentation at home. Once the United States moves decisively in one direction, smaller donors tend to follow.
The Economist’s recent article “Aid for Asia Gutted” makes Kristof’s warning even more striking because it shows that this is no longer only an African story. Large parts of Asia, often portrayed as the great development success story, are now also discovering how deeply basic health systems and disease surveillance depend on external financing.
ReplyDeleteWhat is emerging is not simply a humanitarian crisis, but a stress test of the entire aid model built over the last half-century. This raises uncomfortable questions that the aid world has often avoided. Did aid gradually become a substitute for state capacity? Did donors weaken domestic accountability by allowing governments to rely on external financing for core responsibilities? And did aid agencies themselves develop institutional incentives that favoured programme expansion over successful exit?
The Economist article also hints at another issue: geopolitics. As Western aid retreats, other actors move into the vacuum. China, Gulf states and regional powers are unlikely to replicate the old Western aid model. Their priorities will likely be more transactional, commercial and strategic. More loans and fewer grants.
Kristof is surely right about the immediate human cost. Abrupt cuts are morally and practically disastrous. But the current crisis also exposes how fragile many aid systems have remained after decades of support. That should prompt serious self-examination within the aid industry.
What would a development model actually designed to eliminate dependency look like? And are donors, aid agencies and recipient governments genuinely willing to pursue it, even if it means shrinking the aid industry over time?
Tom, have you completely lost your mind? Have you ever, in all your many years at UNICEF, heard anyone propose an “exciting strategy” to make the organization obsolete? Come on. We’re talking about an institution that celebrated its 80th anniversary with a straight face, apparently without anyone asking the question of why an emergency postwar agency still exists generations later.
DeleteCan you imagine someone standing up in a meeting with the Executive Director and the rest of the senior leadership and suggesting that UNICEF’s highest goal should be to work itself out of a job? That idea would have gone up like a lead balloon. Security might have escorted the person out before the coffee break.
The funny thing is, your logic is almost offensively simple: if development succeeds, eventually you shouldn’t be needed anymore. But somehow that thought never really caught on among our strategic visionaries and intellectual heavyweights. Then again, they also seemed remarkably untroubled by the fact that many of the countries where we invested the most money, conferences, consultants, workshops, study tours, dashboards, and “capacity building” exercises did not exactly catch up with the rest of the world. In quite a few cases, they actually fell further behind.
But let’s be honest: you did not rise through the ranks at UNICEF by floating dangerous ideas like institutional redundancy. You advanced by mastering the ancient bureaucratic arts — praising leadership, detecting which way the wind was blowing, embracing the latest fashionable jargon, and radiating relentless optimism no matter what the data said. “Transformational,” “innovative,” and “game-changing” could carry you a very long way.
In that sense, UNICEF was not unique at all. It behaved as most large organizations behave. First and foremost, people protected the institution, and by extension, themselves. UNICEF was truly "our wonderful organization".
Now that change is being forced upon the aid world from the outside, everyone suddenly talks about crisis, betrayal, and catastrophe. Maybe a little self-reflection would be in order. But organizations like UNICEF are notoriously difficult to reform from within. The incentives are simply too strong, and the vested interests too deeply entrenched.
The truth may be that the aid industry became far better at sustaining itself than at making itself unnecessary.
Why intellectualise a simple issue? What stops these countries from diverting a tiny bit from the budget of the armed forces to buy their own vaccines?
ReplyDelete
ReplyDeleteDevelopment aid suffers from a peculiar measurement problem. In most professional areas, success reduces the need for further intervention. Yet in development aid, success often seems to produce the opposite result: larger budgets and broader mandates. Aid agencies are built to deliver projects, absorb funding, and demonstrate success and depend less on solving problems permanently than on proving continued relevance.
There is always another framework to launch or another strategy to implement; aid becomes a parallel system that acquires its own momentum.
One does not hear discussion of what a successful exit would actually look like. Which countries have “graduated” from the aid relationship? UNICEF is still present in South Korea.
Aid organisations are asked simultaneously to solve problems and to sustain themselves as organisations. Are those two goals not contradictory?