The recent New Yorker documentary “Rovina’s Choice” opens with scenes of hot blowing sand and drone footage of the Kakuma Refugee Camp in northern Kenya, home to about 300,000 people. Many of the residents here have fled the civil war in South Sudan, only to encounter a new challenge: the erosion of international aid that residents rely on to survive.
Rovina Naboi, the mother of nine at the center of the film, recounts a harrowing experience traveling 12 kilometers to the nearest clinic to treat her youngest, Jane Sunday. Malnutrition had wracked the child’s body, causing her to develop a terrible illness that eventually killed her. Ravina had to abruptly leave the understaffed clinic to find food for her other children. But as the film’s narrator and executive producer, Atul Gawande, explains, this death — and so many others like it — was entirely preventable.
“Malnutrition deaths, we’ve shown that they don’t need to happen,” Gawande said. “We’ve found the formula and we’ve delivered it and then we took it away. Then there is the blast radius still to come like declines in vaccination and loss of control of HIV and TB [tuberculosis] that are going to be harder to see and affect hundreds of thousands to millions more.”
In other words, shutting off the valve of international aid is going to cause widespread death and illness on a scale even greater than we’re already seeing. The “choice” Rovina faced was between providing care for her daughter and providing for her other kids. But the choice wealthy Western nations face is whether to allow this needless loss of life in the first place.
Terminating billions in funding for the U.S. Agency for International Development was one of the very first acts in Donald Trump’s second administration. With the help of Elon Musk and DOGE, the largest funding agency for humanitarian and development aid worldwide was eviscerated. Now we’re witnessing the fatal consequences. According to an online impact tracker operated by Dr. Brooke Nichols, a Boston University epidemiologist and mathematical modeler, more than 600,000 deaths can be linked to the shuttering of USAID, averaging about 88 deaths per hour. It includes deaths from malaria, tuberculosis, HIV, malnutrition, diarrhea and more. Two-thirds of these deaths are children.
In May, Trump called his own cuts what they are: destructive.
“It’s devastating, and hopefully a lot of people are going to start spending a lot of money,” Trump said. “I’ve talked to other nations. We want them to chip in and spend money too, and we’ve spent a lot. And it’s a big — it’s a tremendous problem going on in many countries. A lot of problems going on. The United States always gets the request for money. Nobody else helps.”
“The current steep funding cuts — coupled with the potential dissolution of the agency — could lead to more than 14 million additional deaths by 2030.”
It’s not just the U.S. cutting off aid, but also France, Germany and the U.K., to name a few. And sure, shame on the international community for not stepping in to fill the void — but the U.S. remains by far the wealthiest nation on Earth and we set the tone for other countries to follow. Regardless, by 2030, the death toll from these and other cuts could rise to 22 million people, according to a new study by the Barcelona Institute for Global Health published Tuesday. By looking at data from 93 low- and middle-income countries, the researchers found that humanitarian aid was responsible for massive declines in death since 2002: 70% for HIV/AIDS, 56% for malaria and 54% for neglected tropical diseases like dengue. Now we’re set to undo almost all of that progress. Even under a “mild defunding scenario,” the projected excess deaths would be 9.4 million people, including 2.5 million involving children under five.
“These results reveal the enormous contribution of international aid to global health over the past two decades,” Davide Rasella, the study’s coordinator and ICREA Research Professor at ISGlobal, said in a statement. “The abrupt contraction of ODA [official development assistance] funding could have severe repercussions, leading to substantial increases in preventable adult and child deaths in the coming years.”
We need your help to stay independent
These findings are echoed in a study published in July in The Lancet that found “USAID-supported efforts have helped to prevent more than 91 million deaths across all age groups, including 30 million deaths among children.”
“According to the forecasting models, the current steep funding cuts — coupled with the potential dissolution of the agency — could lead to more than 14 million additional deaths by 2030, averaging more than 2.4 million deaths per year,” the researchers conclude. “These deaths include 4.5 million among children younger than 5 years, or more than 700,000 deaths annually.”
This backsliding flies in the face of how much progress has been made to stop people from dying needlessly. A 2000 working paper from the Institute of Development Studies estimated that 70 million people died from famine in the 20th century, highlighting the significant progress to end this problem thanks to international cooperation. Crop failures and overpopulation are no longer the main reasons for mass starvation — war and totalitarianism are far more responsible. Countries once regularly ravaged by famine, such as Russia, China and India, are no longer plagued as they had been. African nations also saw significant improvement in the modern era, with diminishing death tolls and improved public health, such as the Africa CDC.
“If this trend continues, the 20th century should go down as the last during which tens of millions of people died for lack of access to food,” the paper’s author Stephen Devereux reported. Indeed, there was much optimism at the turn of the century that famine could be made “history.”
But roughly two decades later, it would seem that we’re doing everything possible to keep famine alive. The United Nations recognized two famines this year: one in Sudan and the other in Gaza, both affecting hundreds of thousands of people. Experts are predicting that world hunger is poised to get worse. This growing crisis is manufactured, so why are we abandoning such successful programs that nearly defeated such crises?
Some argue that international aid is ineffective or doesn’t help nations in the long term. It may foster corruption, dependency and stunt economic development. This, of course, comes down to the level of aid being offered and how it is directed.
Start your day with essential news from Salon.
Sign up for our free morning newsletter, Crash Course.
Others insist that we have a moral responsibility to help those who are less fortunate, especially given the innumerable ways that rich nations exploit the Global South. By some estimates, $152 trillion has been siphoned from poor nations since 1960. We have more than enough wealth to go around, especially with the understanding that climate change is going to make famine more likely. Rich nations are disproportionately responsible for greenhouse emissions that accelerate the heating of our planet and the disasters that follow.
By turning our backs on effective policy that prevents people from dying needlessly, we are complicit in a serious crime. Given the hundreds of thousands already dead, with millions projected to join their fate, Trump’s attacks on USAID are, in effect, tantamount to genocide, one of the greatest atrocities of his administration.
People are understandably nervous about using the G-word to describe situations like this, but what other term is more appropriate? Intentionally starving nations would fit the definition of genocide under international law, specifically the part defined as “Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part.”
The Trump administration is likely guilty of many crimes, from ignoring court orders to illegally assassinating people in boats near Venezuela. All of this is dwarfed by the outsized war on poor people that is steadily killing hundreds of thousands, potentially sending millions to an early grave. While Trump’s greatest legacy may be climate inaction or his alleged involvement in the Epstein files, the devastation unleashed on the world’s most vulnerable should certainly rank up there with the most villainous acts in recent history.
