In his first 100 days, Donald Trump has done so many horrific things that it can be difficult to keep track of them all. He has waged war on consumer financial protections, is cutting food safety inspections, has frozen police reform efforts and taken down a database of police misconduct, deported people illegally, cut the miner safety protection agency, revoked international students’ visas over their political speech, is suing media outlets and extorting law firms who oppose him, planned to end free online tax filing, cut science funding including public health research, and plotted the full ethnic cleansing of Gaza as Israel commits new atrocities with impunity.

With so much chaos in Washington, we have to work hard to keep focused on what matters most and avoid getting distracted by “palace drama” (such as the beef between Elon Musk and Trump economic adviser Peter Navarro). We have to focus our outrage on the most consequential and deadly decisions. That’s why there needs to be far more protest against Trump’s shuttering of vital aid programs abroad, a decision that has already started killing people and will kill hundreds of thousands if not millions more in the coming years. This may be one of the most evil things a U.S. president has ever done, and that’s saying a lot. 

Trump has essentially shuttered the U.S. Agency for International Development (USAID). He is “canceling 83 percent of USAID programs and folding the rest under the Department of State” and reducing the agency of 10,000 people to 15 positions. Elon Musk called USAID a “criminal organization” and declared that it was “time for it to die," while Donald Trump said the agency was run by “radical left lunatics.” Musk boasted that he had fed the agency “into the wood chipper” and falsely claimed that it had killed millions of people by funding “bioweapon research” that created COVID-19. 

Neither Musk nor Trump seems to have cared about the horrifying human consequences of the blanket cancelation of aid programs. For instance, the New York Times recently reported that in Sudan, where a brutal civil war has been ongoing since 2023, 25 million people (more than half the country’s population) are “acutely hungry,” and “Famine is spreading rapidly, with some resorting to eating leaves and grass.” With Trump’s cuts, 300 soup kitchens that were critical to relieving this crisis were immediately forced to close. That’s “almost 80% of the emergency food kitchens set up to help people left destitute by Sudan's civil war,” according to the BBC. Children have already begun to die. The Times reporter describes seeing “visibly malnourished residents [pouring] onto the streets,” for whom “the soup kitchens had been their only sources of food for months.” They describe an 11-month old boy who “starved to death in the weeks after President Trump froze all U.S. foreign assistance,” with the soup kitchens unavailable to provide relief. Many more children are likely to die within months. And it’s not just the soup kitchens, it’s also the health clinics. In neighboring South Sudan, recently “at least five children and three adults with cholera died as they went in search of treatment” “after aid cuts by the Trump administration shuttered local health clinics during the country’s worst cholera outbreak in decades.”

The harm extends elsewhere. In Uganda and Zambia, trials for an experimental HIV vaccine were terminated because of the Trump administration’s funding cuts. And as Nature reports: 

In Nigeria, withdrawal of USAID Advancing Nutrition funding has meant that the charity Helen Keller International has had to stop a programme that provides nutrition services for 5.6 million children. [...] In Ethiopia, supplies of nutrient-rich foods used to treat around one million severely malnourished children annually will run out by May. And the global FEWS-NET network — a leading source of data on famine risks — sits idle, disrupting early-warning systems for humanitarian planning and emergency resource allocation.

The U.S. has been a major source of support for public health programs in the world’s poorest countries. Some poor governments have “been completely reliant on the U.S. to procure most of the lifesaving medications for endemic infections,” and the sudden loss of that funding means “devastating consequences on lives lost from Africans who will die of preventable infections.” In particular jeopardy is PEPFAR, the President’s Emergency Plan for AIDS Relief, which has successfully saved millions of lives. The worldwide AIDS crisis looked like it might have been successfully ended by 2030, but now, with Trump’s cuts, millions more will likely die of the disease unnecessarily. The Namibian reports on the stories of people who now live in fear of death and cannot have sex with their partners because of the increased risk. A massive crisis is brewing. With the elimination of treatment for conditions resulting from malnutrition, Nature reports that the “termination of US-funded programmes (worth $128 million in 2022) alone will keep one million children from accessing such treatments, causing an extra 163,500 child deaths yearly.” (The “pronatalist” crowd has thus far been remarkably silent on this.) Nature also notes that “the number of deaths might be an underestimate, because the aid cuts threaten a huge array of nutrition-supporting programmes, including health, agriculture, school feeding and water and sanitation. Soon we might see many more millions of children around the world developing wasting, stunted growth and micronutrient malnutrition.” (Importantly, these kinds of cuts aren’t just coming from the pathologically cruel billionaires who run the U.S. government. Other governments around the world are also cutting aid, which is making these threats even worse.)

Now, we’ve been plenty critical of USAID here before, showing how it has often prioritized U.S. business and geopolitical interests over providing help, and its motives are often not terribly altruistic. (You can even see that in many of the arguments made in defense of USAID against Trump. For example, the American Academy of Diplomacy argues that USAID is useful for our interests, in part because it reduces migration and diminishes China’s influence.) But in assessing the morality of both providing and cutting aid, the motives matter less than the consequences. The fact is that USAID programs have saved millions of children’s lives, and the solution to problems with U.S. foreign aid is not to destroy foreign aid altogether, but to ensure that it is actually philanthropic in nature. That’s the opposite of what the Trump administration is doing. It’s trying to make sure that no foreign aid is given for any altruistic motives, saying all projects are being “reviewed to see if they aligned with the national interest, and that funding would continue only for those that met this condition.” In other words, if saving millions of people in sub-Saharan Africa from dying of AIDS is in the U.S. “national interest,” we might continue to pursue it. If it is in the “national interest” to let them die, then we will unleash a plague on them. 

One of the reasons this story isn’t getting as much attention as it deserves is that the U.S. media simply does not treat African lives as being as important as American lives. So the possibility that an iPhone will cost more due to Trump’s trade war may get more press than the possibility that hundreds of thousands of Sudanese people will starve to death. As my colleague Alex Skopic has written (and documented quantitatively), there is a pervasive assumption in American media that people in Africa don’t “really matter,” which “may be direct racism on the part of editors and media executives, who simply don’t care about African people or their stories” or which “may be secondhand racism, with the editors pandering to an audience they believe doesn’t care.”

Another problem here, however, is that language is hopelessly inadequate for conveying the moral import of the problem. An aid worker calls the situation “catastrophic,” but so many things are catastrophic now that the word’s meaning has been dulled. Nature says there will be “dire consequences.” Scientific American says “The effects of these actions immediately ricocheted around the world, and they will continue to be felt for years to come.” True, and also wholly inadequate to describe the mass starvation of children, which is what we are actually talking about. 

Activists have started to draw attention to the human horror being wrought by Trump’s changes. (Although the “philanthropic sector has largely been silent about the momentous change in the landscape,” in part, apparently, because they are embarrassed by the fact that they do not intend to try to make up the funding shortfall and save people’s lives.) Recently a group of activists stacked coffins outside the State Department in protest of the cuts to AIDS relief. But this issue has not dominated the headlines to the same degree as the cases of American residents targeted for deportation like Mahmoud Khalil and Kilmar Abrego Garcia. Of course, these cases are critically important, because they show Trump subverting the Constitution and claiming the power to personally deprive people of basic due process rights. But with so much going on domestically, Africa is easier than ever to overlook. We can’t let that happen. The people who depend on lifesaving aid are at risk right now, and they will live or die based on what happens in this country politically in the next months and years. Every American has an obligation to to stand up and fight to save these people from being killed by venal billionaires to whom the global poor are considered worthless and disposable.