PROGRAMMING ALERT: Watch the author discuss this topic and more on “Jesse Watters Primetime” on Feb. 7 at 8 pm ET.
I’m a physician who was suddenly laid off from USAID last month after Elon Musk fed “USAID into the wood chipper.” I should be livid about what Musk is doing to my former employer. But I’m not; I’m a whistleblower who worked at USAID for eight years, and Musk is (mostly) right about USAID’s dysfunction.
As USAID’s fate to be shrunk and subsumed into the State Department seems all but sealed, once the Republican-led Congress passes a law to legitimize it, two predictable debate positions have emerged. Musk and the Republicans say “USAID is a criminal organization” full of “radical left lunatics” that wastes taxpayer dollars, while the Democrats and USAID staff say USAID nobly performs vital life-saving work. The truth, as usual, is somewhere in between, but nobody disputes the criticisms regarding waste.
Musk colorfully said of USAID, “It’s not an apple with a worm in it; we have actually just a ball of worms.” I suggest instead that USAID is better described as an apple that has become infested by worms. During my eight years at USAID, I worked with some wonderful colleagues and together we made real impacts, but we were too frequently undermined by a sclerotic and at times malevolent bureaucracy. USAID has many good apples, but also many bad ones who spoil the barrel, as I will detail below. In my opinion, the ratio of good to bad apples is approximately 1:1, so the decision to fire 97% of the workforce is overzealous.
HOW USAID WENT WOKE AND DESTROYED ITSELF
USAID saves babies, but it also wastes taxpayer dollars at an unacceptable rate. To borrow another common analogy, it would be fair to say that USAID is a baby suffering in filthy bathwater that hasn’t been cleaned for decades. Musk’s overhaul of USAID therefore is a potentially valuable act of creative destruction. However, Musk’s exaggerations and minimizing of USAID’s real impacts suggest that he might go too far, so all stakeholders must now ensure that this moment is a net positive, rather than let the baby be thrown out with the bathwater.
Contrary to Musk’s assertions, USAID undeniably produces valuable results, as its defenders are now trumpeting. For example, its HIV programs have helped saved more than 25 million lives since 2000, enabled 7.8 million babies to be born HIV-free to mothers living with HIV, and thus helped stanch the global HIV pandemic. Recent peer-reviewed studies, co-authored by me, show that USAID investments have helped partner countries reduce child and adult mortality faster than otherwise comparable countries. Saving babies’ lives helps America make lasting friendships, and development creates markets for American goods, while both are also nice things to do. Humanitarian assistance in places such as Ukraine, Gaza, Indonesia, and Venezuela epitomize America’s soft power.
Lesser known examples of USAID’s value abound, illustrated well by USAID’s partnership with a private foundation to restore Gorongosa National Park in Mozambique, decimated by civil war in the 1980s, which is now thriving and was used as a base for USAID’s 2019 humanitarian response to Cyclone Idai. Building on the Gorongosa model, in response to the 2018 Ebola outbreak in the Democratic Republic of the Congo, my colleagues and I built a $165 million program across twelve countries to leverage USAID funding with matching private investment to reduce pressure on biodiverse ecosystems to protect wildlife and also reduce the risk of emerging diseases, while benefiting the local people. All those programs are now paused and possibly moribund, and that is of grave concern.
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That said, everyone who works at USAID knows about the appalling waste and occasional malevolence that happens within the aid-industrial complex. Musk and the White House have been highlighting DEI examples, such as the promotion of nonbinary gender language by journalists in Sri Lanka, but there are myriad others. The billion-dollar global health supply chain contract, which delivers HIV medicines, was ordered to pay $3.1 million to resolve corruption allegations, yet somehow its next generation contracts have been as problematic as before. Many beltway bandit recipients charge an average absurd 30% overhead yet too often report meaningless results like the number of people trained.
My story, through which I became a reluctant whistleblower (Merit System Protection Board Case DC-1221-23-0102-W-1), epitomizes what Musk must rightly eliminate from the Agency. When I became the Global Health Bureau’s Acting Deputy Chief of Staff in 2020, I immediately observed the incompetence of career bureaucrats as they moved too slowly to advance a $34.5 million tranche of funding to fight COVID-19. After I fixed this and other instances of their gross mismanagement, instead of thanking me for cleaning up their mess, the bureaucrats retaliated against me by slow-walking and then blocking a promotion for me and attempting (but failing) to fire me.
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In 2021, emboldened by their successful retaliation against me, they again incompetently slow-walked hundreds of millions of dollars of COVID funding, and were caught flat-footed in April when the Delta wave exploded in India. For weeks, they scrambled to inefficiently send supplies there only after the wave of cases had peaked. Everyone involved at USAID was embarrassed and upset at their inefficiency, which was mainly the fault of the few same bureaucrats who retaliated against me. Distracted by South Asia, USAID failed to send any aid to Latin America until well after the deadly 2021 COVID waves had passed there, with tens of thousands of confirmed deaths, outside of a small one-off delivery to Colombia. For example, USAID funding was sent so late to Peru to combat their Lambda COVID-19 wave that funding was eventually returned Washington, as the wave of around 30,000 confirmed deaths had been completely missed. Although I sent these data to the Government Accountability Office auditors, their 2023 audit only generally called out USAID negative leadership behaviors.
One of the main villains in my story was demoted by USAID Administrator Samantha Power following the gross mismanagement of COVID-19 in 2021, but was later given the plum job of USAID Mission Director in Cambodia. Another villain left USAID for a leadership position at CDC, only after I sued USAID under the Whistleblower Protection Act. Throughout my ensuing three year legal battle, USAID’s lawyers employed despicable tactics, enabled by our ineffective whistleblower protection system, but they finally settled with me in 2024. This kind of malfeasance must be purged not only from USAID, but from all of the US government. When I was an active-duty Army soldier, the waste I observed in the Defense Department was no better or worse.
Despite these appalling realities, to paraphrase Gen. Jim Mattis, if USAID did not exist, we would need to create it. USAID helped win the Cold War, and has helped make the world healthier, safer, and more prosperous. But USAID can and should be so much more than it has been, and it epitomizes how unaccountable bureaucrats can abuse their power while failing to do their duty and deliver for American and global interests.
If Musk and Secretary of State Marco Rubio eliminate the hundreds or thousands of bad employees from USAID, so many deserving groups will be better off, including American taxpayers, aid beneficiaries, and the good employees within USAID. Economic history shows that creative destruction is usually a net positive, however painful it is for those who cannot compete. But as USAID goes through this metamorphosis, we must not throw the baby out with the wretched bathwater.
