The decision to dismantle the U.S. Agency for International Development (USAID) — a move that Elon Musk boasted about feeding “into the wood chipper” — is projected to result in an additional 14 million deaths by 2030, according to a sobering new analysis published in The Lancet. That staggering toll includes an estimated 4.5 million children under the age of 5, a humanitarian cost that experts say will ripple across the globe for decades.

The numbers come from a retrospective impact evaluation and forecasting analysis that examined two decades of USAID interventions. The study, titled “Evaluating the impact of two decades of USAID interventions and projecting the effects of defunding on mortality up to 2030,” was actually published in 2025, though its findings have gained renewed attention as the agency’s closure accelerates. The correction to an earlier version of the news report noted that the estimates were not new, but the implications remain as urgent as ever.

The scale of the projected loss

Researchers modeled what would happen if USAID’s health programs, famine relief, clean water initiatives, and maternal-child health services were permanently halted. Their conclusion: 14 million excess deaths through 2030, with the youngest and most vulnerable bearing the heaviest burden. The 4.5 million projected child deaths under age 5 represent a regression to mortality rates not seen in more than a generation.

To put that in perspective, the total exceeds the population of many countries. It is roughly equivalent to the entire population of Greece or Somalia. And it reflects only the direct mortality effects—the indirect consequences of collapsed health systems, resurgent infectious diseases, and widespread malnutrition could push the true number even higher.

USAID’s role in global health

USAID has long been the world’s largest bilateral donor for health and humanitarian assistance. Its programs have targeted HIV/AIDS, malaria, tuberculosis, polio, and neglected tropical diseases. It has funded vaccination campaigns, trained community health workers, and provided emergency food aid during famines. The agency also supported education, economic development, and governance programs that helped stabilize fragile states.

Since its founding in 1961, USAID has been credited with saving millions of lives. The President’s Emergency Plan for AIDS Relief (PEPFAR), which USAID helped implement, is widely acknowledged as one of the most successful global health initiatives in history, preventing more than 20 million HIV infections and enabling millions to access antiretroviral therapy.

The abrupt defunding of these programs is not merely a budget cut; it is a dismantling of the infrastructure that delivers life-saving aid. When the agency was shuttered, clinics closed, supply chains broke down, and local partners lost their funding overnight. In many regions, health workers fled or went unpaid, and patients were left without medication or follow-up care.

Musk and the Department of Government Efficiency

Elon Musk, tasked by the Trump administration to lead the Department of Government Efficiency (DOGE), made USAID a primary target. In public statements and on his social media platform X, he described the agency as a “criminal organization” and a “radical-left political machine” that needed to be eliminated. His team moved swiftly to shutter USAID’s headquarters, place staff on administrative leave, and terminate contracts and grants around the world.

The phrase “fed into the wood chipper” was Musk’s own vivid description of the agency’s fate, a metaphor that alarmed aid workers and diplomats alike. Critics argued that the unilateral dismantling of USAID without congressional approval was unconstitutional, and multiple lawsuits were filed. But the administration pressed forward, and by mid-2026, the agency had effectively ceased to exist as an independent entity.

Musk’s broader campaign to slash government spending has been marked by similar tactics: rapid, sweeping cuts justified as necessary to reduce the federal deficit and eliminate waste. Yet the human cost of those cuts, as the Lancet study makes clear, is measured in lives lost—not merely dollars saved.

The Lancet study’s methodology

The research team used decades of USAID program data, health statistics from 120 low- and middle-income countries, and advanced forecasting models to estimate the impact of defunding. They controlled for factors such as economic growth, conflict, and other donors’ contributions. The model assumed that USAID’s absence would lead to a complete cessation of its health and nutrition programs, with no equivalent replacement from other sources.

Under that scenario, the mortality projections are stark. Sub-Saharan Africa would bear the greatest burden, accounting for more than half of the additional deaths. South Asia and Southeast Asia would also see significant increases. The study emphasized that the most cost-effective interventions—childhood immunizations, oral rehydration therapy, insecticide-treated bed nets, and access to family planning—are precisely the ones that would be lost.

Reactions and warnings

Global health experts have reacted with alarm. The dean of a prominent school of public health called the projections “catastrophic but entirely avoidable.” A former USAID director noted that the agency’s work had bipartisan support for decades and that its dismantling would undermine U.S. soft power and national security. Medical charities and NGOs struggled to fill the void, but most lacked the funding and scale to replace USAID’s operations.

Some conservative commentators defended the cuts, arguing that foreign aid is wasteful and that other countries should step up. But the Lancet study’s authors pointed out that other donors collectively provide only a fraction of USAID’s health spending, and there is no evidence they would increase contributions to offset the gap. In fact, some European governments have also reduced their foreign aid budgets in recent years.

Musk’s other ventures and the SpaceX connection

Elon Musk’s attention, meanwhile, has been divided among his many companies. SpaceX, his rocket company, has continued to thrive. As of this writing, SpaceX shares are trading at $141.10, above their IPO price of $135. The company has launched thousands of satellites for its Starlink internet constellation, won major defense contracts, and been a key partner for NASA. The financial markets have largely ignored the humanitarian fallout from Musk’s government role, focusing instead on his companies’ valuations.

The juxtaposition is striking: while Musk’s wealth and influence grow through ventures like SpaceX and Tesla, the Lancet study suggests that his actions in government will contribute to the deaths of millions. That contrast has not gone unnoticed by Democrats and progressive advocacy groups, who have called on Musk to be held accountable.

A moral and political reckoning

The estimate of 14 million deaths is a forecast, not a certainty. The study’s authors stress that if USAID’s functions are transferred to other agencies or if alternative funding emerges, the toll could be reduced. But so far, there is little sign of such a rescue. The administration has shown no willingness to reverse course, and Congress has been unable or unwilling to intervene.

The broader question is one of values: what does a nation owe to the world’s poorest and sickest people? USAID represented a tiny fraction of the federal budget—less than 1%—yet its impact on global health was outsized. The decision to eliminate it was made quickly, with no public hearings, no impact assessment, and no debate. The Lancet study provides the impact assessment after the fact, and its conclusion is grim.

As the world grapples with the consequences, the numbers will inevitably translate into individual tragedies: a mother who cannot get treatment for her child, a farmer whose crops fail without irrigation support, a community devastated by a disease outbreak that could have been prevented. The 14 million figure is a statistical abstraction, but each digit represents a human life.

For now, the projections stand as a stark warning. The full death toll will depend on actions taken in the coming months and years. But the trajectory is clear, and the time to act is running out.

Source: The Verge News