The Trump Administration has killed America’s lifeline to the world

The Trump administration delivered a devastating blow to America's global leadership: the official dismantling of the U.S. Agency for International Development. USAID—our country's flagship development and humanitarian agency—has been absorbed into the State Department, with over 80 percent of its programs slashed.

Let's call this what it is: a cruel, short-sighted, and dangerous decision.

For more than six decades, USAID was the backbone of America's global development efforts. It was instrumental in implementing bipartisan initiatives like PEPFAR, the U.S. program to fight HIV. I worked with President George W. Bush to help create PEPFAR, and together with a bipartisan coalition in Congress, the course of the global HIV response was changed for good. More than 20 million people received treatment. Over 26 million lives were saved.

But PEPFAR was just one example. Across Africa, Asia, and the Caribbean, I saw USAID's impact with my own eyes: children in classrooms, clean water in villages, HIV clinics delivering lifesaving medicine, and mothers giving birth safely. When development works, it saves lives, and USAID delivered.

The numbers speak volumes. A new study in the Lancet medical journal estimates USAID has helped save 91 million lives over the past two decades, including 30 million children under five. These gains are now at risk. Public health experts warn that the cuts could lead to 14 million preventable deaths by 2030.

It costs a mere 37 cents to save the life of an African child with diarrhea through oral rehydration therapy. The notion that the wealthiest, most powerful country on earth can't afford such a paltry expenditure is both preposterous and outrageous.

Across Africa, America has not only shown its generosity but also catalyzed extraordinary local commitment and innovation. Countries like Botswana and Eswatini have massively reduced the level of HIV circulating in their populations by achieving near-universal HIV treatment coverage. Communities across Africa have devised innovative ways to deliver HIV prevention and treatment services to people who cannot afford to travel to a clinic.

These innovations aren't only promising for Africa, but also help us here in the U.S. When I declared a state of emergency for HIV in Alameda County in 1998, Black communities in my district were experiencing infection rates comparable to the hardest-hit countries. Decades later, the disparities persist: Black Americans make up nearly 40 percent of new HIV cases, despite being just 12 percent of the population. The fight to end HIV abroad is deeply connected to the battle to finish the job here at home. We cannot separate the two. Progress in Africa is proof that we have as much to learn from the Global South as we do to offer. That equity must guide our fight everywhere, including in our own backyard.

We must stand united if we hope to have a world that is healthy, safe, and secure. We must reject the politicization of science. And we must reject the Trump administration's cruel cuts, especially as they hand out tax breaks to billionaires and corporate donors. This is a moment for moral clarity. Congress must act now to stop further cuts, restore our country's moral leadership, and affirm that America's commitment to saving lives does not have an expiration date.

Dismantling USAID doesn't make us stronger. It weakens our alliances, undermines decades of bipartisan progress, and sends a dangerous message to the world: that we've turned our back on humanity.

I've spent my career fighting for health equity, from Oakland to the halls of Congress to the United Nations. I won't stop now. We owe it to the millions whose lives hang in the balance: to act boldly, to speak truth, and to protect the promise of a better world. Let's not let cruelty become policy. Let's not let cruelty become the face of America to the world. Let's lead with justice and with humanity.

To the thousands of USAID professionals, thank you. Your work mattered. Americans are proud of your service and the lives saved because of it. You showed the world the best of who we are.

I still believe in the power of what's possible. Together, we must recommit to global solidarity, shared responsibility, and the unfinished fight to end AIDS and improve health everywhere.

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