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Killing PEPFAR means killing millions of people

8 5
08.03.2025
Demonstrators, some of them former PEPFAR and USAID employees, protest to demand that Congress stand up to President Donald Trump and Elon Musk’s “Department of Government Efficiency” and reinstate lifesaving programs in the Cannon House Office Building on Capitol Hill on February 26, 2025, in Washington, DC.

A lot has happened in the last six weeks, to put it mildly, and it can be hard to see through the dust and tell what’s actually ongoing.

The government threatened tariffs, backed off, then did the tariffs, and then started carving out tariff exceptions for connected-enough constituencies.

We did showy military deportation flights then stopped because they’re incredibly expensive. Trump’s flurry of executive orders tried to end birthright citizenship (a judge put that on hold), and froze the issuing of passports to transgender Americans (this is being slowly resolved as people individually appeal to their representatives or the media for help). Elon Musk’s Department of Government Efficiency, or DOGE, team slashed the federal workforce, then sent emails hiring many people back.

One result has been that it is very hard to communicate as a journalist — or to learn as an interested member of the public — which of the harmful things that the government is doing are actually ongoing and actually worth pushing back on.

But here is an enormously high-stakes problem that is clear and still ongoing: the cancellation of our best-performing overseas programs to treat infectious disease.

My colleague Dylan Matthews has written for a decade

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