In the Trump Administration’s war against the administrative state, led by Elon Musk’s Department of Government Efficiency (DOGE), one of the first things on the chopping block was the US Agency for International Development (USAID).
The agency, which distributes foreign aid worldwide, dates back to the Kennedy Administration and has traditionally been used by the US to project soft power around the world.
Musk, however, has attempted to paint USAID as a hotbed of fraud and abuse, to shut it down altogether. However, whether a non-elected appointee has the power to do that remains unknown.
Lawsuits have been filed, including from the unions that represent USAID workers, and a judge last week agreed to halt the agency’s shutdown, at least temporarily. Similar challenges have been filed against the Trump Administration’s Day One executive order to freeze all foreign aid.
However, it isn’t only employees who are affected by the shutdown. Even more, those who have depended on aid from the agency for life-saving medicine are hurt even more.
The View From South Africa
Sky News reported over the weekend from South Africa, which happens to be Elon Musk’s birthplace. In that country, 8.5 million people live with HIV/AIDS. Still, a USAID-funded sexual health clinic in Johannesburg has been shuttered, leaving people without life-saving medicine, health screenings, and Pre-Exposure Prophylaxis (PrEP), which can prevent the spread of the disease.
Two decades ago, South Africa suffered a terrible AIDS outbreak at a time when South Africa’s government believed in and propagated AIDS denialism. However, it was a USAID-administered program under a previous Republican US president that helped keep people in that country and elsewhere in Africa.
Enter PEPFAR
PEPFAR (United States President’s Emergency Plan For AIDS Relief) was an initiative by President George W. Bush that was first launched in 2003, which allocated billions of dollars to combat HIV/AIDS around the world, especially in Africa. The AIDS epidemic in the United States had been significantly curtailed by the late 1990s thanks to successful new drugs. Still, little progress had been made in the third world.
According to HIV.gov, PEPFAR had saved “over 25 million lives” as of the end of 2024, including by preventing the disease from being passed on from mothers to their children.
PEPFAR was among the unmitigated successes of the Bush presidency. Since it was instituted, the program was continued by administrations of both parties, including Trump during his first term in office. The Brookings Institution has described the program as “possibly the single most successful policy to date in U.S.-Africa relations [and] also one of the most successful foreign policy programs in U.S. history.”
“PEPFAR shows the power of what is possible through compassionate, cost-effective, accountable, and transparent American foreign assistance,” the HIV.gov website says.
Pro-Lifers for PEPFAR
Last week, four people associated with the anti-abortion movement, Leah Libresco Sargeant, Matthew Loftus, Kristin M. Collier, and Kathryn Jean Lopez, authored a New York Times op-ed addressed to the Secretary of State, Marco Rubio, with the headline “As Fellow Pro-Lifers, We Are Begging Marco Rubio to Save Foreign Aid.”
Rubio, the longtime US senator and now secretary of state, has frequently praised the work of USAID until now.
By Gage Skidmore: U.S. Senator Marco Rubio speaking with attendees at the 2015 Iowa Growth & Opportunity Party at the Varied Industries Building at the Iowa State Fairgrounds in Des Moines, Iowa.
“As pro-life writers, doctors and activists, we ask Mr. Rubio and other pro-life officials and lawmakers to fully restore PEPFAR and protect babies, both born and unborn,” the authors write.
What Will Become of PEPFAR?
There is a chance that courts could intervene and declare that the executive branch does not have the unilateral power to shutter government agencies, throwing the entire question to Congress. However, it remains to be seen how safe foreign aid programs are in an environment in which Trump and Congressional Republicans will be looking for cuts everywhere.
About the Author: Stephen Silver
Stephen Silver is an award-winning journalist, essayist and film critic, and contributor to the Philadelphia Inquirer, the Jewish Telegraphic Agency, Broad Street Review and Splice Today. The co-founder of the Philadelphia Film Critics Circle, Stephen lives in suburban Philadelphia with his wife and two sons. For over a decade, Stephen has authored thousands of articles that focus on politics, technology, and the economy. Follow him on X (formerly Twitter) at @StephenSilver, and subscribe to his Substack newsletter,
