Here the cost is literal human lives.
In the aftermath of Elon Musk's dismantling of USAID, an Ebola outbreak spreads through the Democratic Republic of the Congo — a crisis experts say surveillance programs, now eliminated, might have caught before it began. The human cost of severing global health infrastructure is no longer theoretical: deaths are already occurring, and a Lancet study projects millions more, including 4.5 million children, if the cuts hold. History has long taught that the systems we dismantle in moments of ideological certainty are rarely rebuilt before the suffering they were meant to prevent arrives.
- An Ebola outbreak is spreading unchecked through the DRC because the early-detection programs that would have caught it were eliminated — Musk himself admitted to 'accidentally' cutting them.
- Experts are no longer speaking in projections alone: 'People are absolutely dying. They're dying in significant numbers in some places,' says the former head of USAID's Ebola response.
- A Lancet study estimating 14 million deaths from USAID's abolition prompted Musk to threaten a lawsuit rather than engage with the science, while the study's authors stood firmly behind their methodology.
- The corporate logic Musk applied — cut until people scream, then restore — collides catastrophically with public health reality, where the cost of cutting too far is measured not in market share but in lives.
- Congress retains the legal authority to restore USAID, but experts warn the window is narrowing fast, and the cascading failures across health, nutrition, and education programs are already compounding.
Elon Musk has spent recent days on X defending his role in dismantling USAID, dismissing journalists who named people — including children — who died as a result of the cuts. He has claimed, without evidence, that US tax dollars funded militants, and insisted his critics cannot name a single person who died because of the agency's elimination. They can.
An Ebola outbreak is now spreading through the Democratic Republic of the Congo, and experts say it would have been detected far earlier — possibly stopped before becoming an outbreak at all — had the surveillance programs Musk's efficiency department eliminated still been in place. Jeremy Konyndyk, who led USAID's 2014–2015 Ebola response and now heads Refugees International, is direct: 'If global health programs hadn't been slashed in the DRC and elsewhere, the Ebola outbreak would have been detected much earlier. I'm very confident about that.' Musk himself acknowledged last year that Ebola detection and response programs had been 'accidentally' cut.
The projected scale of harm reaches far beyond the current outbreak. A Lancet study estimates that full abolition of USAID could cause 14 million deaths over coming years, including 4.5 million children. When a congressman cited the research, Musk threatened to sue. One of the study's authors, Davide Rasella of Barcelona's Institute for Global Health, defended the methodology: 'We use the same statistical mathematical tools that we use to launch rockets into space.' He acknowledged uncertainty in the precise figure but not in its magnitude. 'There will probably be millions of deaths over the next several years. This is really unquestionable.'
Konyndyk describes the deeper problem as a category error in governance. The corporate model Musk imported — cut until people scream, then restore — functions where failure is measured in revenue. 'That's not how public funding works,' he said. 'Here the cost is literal human lives.' Without Musk's direct access to the White House, USAID would likely have survived in diminished form. Instead, funding has been choked, and the agency's legal mandate to exist has not translated into its survival in practice.
A narrow window remains. Congress could act to restore funding before the worst consequences compound. But Rasella offers a starker frame: 'This is just the beginning.' After a pandemic that killed roughly 20 million people worldwide, dismantling the systems built to prevent the next one, he said, was 'absurd.' The question is whether that window closes before the full weight of the decision becomes undeniable.
Elon Musk has spent the past week posting on X about the US Agency for International Development, the agency he helped dismantle last year. His companies are struggling—SpaceX stock fell sharply after going public, Tesla faces mounting lawsuits—yet he remains fixated on defending the demolition of USAID, which he described as feeding it into a woodchipper. When critics presented him with the names of people who died as a result of the cuts, including children, Musk called the journalist reporting the story "an utter piece of shit and a liar" and "utterly evil." He has insisted, without evidence, that US tax dollars were going to arm militants and corrupt politicians. He has also claimed his critics "cannot cite a single name of someone who died."
They can. And the timing of his recent posts has drawn renewed attention to what those cuts have already cost. An Ebola outbreak is spreading through the Democratic Republic of the Congo, and experts say the disease would have been detected far earlier—possibly prevented from becoming an outbreak at all—if the surveillance and preparedness programs that Musk's efficiency department eliminated had remained in place. Musk himself admitted last year to "accidentally" cutting Ebola detection and response programs. Jeremy Konyndyk, who led USAID's response to the 2014-2015 Ebola crisis and now heads Refugees International, is unambiguous about the connection. "If global health programs hadn't been slashed in the DRC and elsewhere, the Ebola outbreak would have been detected much earlier," he said. "I'm very confident about that."
The scale of potential harm extends far beyond the current outbreak. A study published in The Lancet estimated that if USAID were abolished entirely, 14 million people would die over the coming years, including 4.5 million children. When Democratic congressman Ro Khanna cited this research, Musk threatened to sue. Davide Rasella, one of the study's authors and a research professor at Spain's Barcelona Institute for Global Health, stood by the numbers. "When we speak about public health and global health, we use the same statistical mathematical tools that we use to launch rockets into space," Rasella said, responding to Musk's suggestion that the science was flawed. Rasella acknowledged that pinpointing an exact death toll is difficult, but emphasized the scale is what matters. "There will probably be millions of deaths over the next several years," he said. "This is really unquestionable."
Some of those deaths are already happening. "People are absolutely dying. They're dying in significant numbers in some places," Konyndyk said. The cuts have rippled across global health, nutrition, and education programs worldwide. What makes this different from typical budget reductions is the philosophy behind it. Konyndyk described the approach Musk brought from his companies: "cut until people scream, and then when people scream, you've cut too far, and then you restore." That model works in a corporate setting where the cost is measured in market share or shareholder value. "That's not how public funding works," Konyndyk said. "Here the cost is literal human lives."
Musk's personal investment in dismantling USAID gave the project reach all the way to the White House, Konyndyk noted. Without him and administrators like Pete Marocco, the agency would have faced "some huge hits" but likely would have survived in diminished form, like other health and science agencies. Congress could still act to restore the agency—USAID is required to exist by law—but funding has been choked by slow releases from the State Department. Konyndyk sees a narrow window remaining. "We have a window here to try and bring some of this back before the worst of the harms set in," he said. Rasella framed it differently: "This is just the beginning." After a pandemic that killed roughly 20 million people globally, he said, cutting programs designed to prevent and prepare for the next one was "absurd." The damage compounds when a single piece of the aid infrastructure is disrupted. The question now is whether that window closes before the full consequences materialize.
Citas Notables
If global health programs hadn't been slashed in the DRC and elsewhere, the Ebola outbreak would have been detected much earlier. I'm very confident about that.— Jeremy Konyndyk, president of Refugees International and former USAID Ebola response leader
People are absolutely dying. They're dying in significant numbers in some places.— Jeremy Konyndyk
La Conversación del Hearth Otra perspectiva de la historia
Why is Musk so focused on defending USAID cuts right now, when his companies are in trouble?
It seems like he's trying to rewrite the history of what happened. Konyndyk thinks Musk knows this is going to define his legacy, and he's scrambling to get ahead of it.
But he says no one can name a specific person who died. Isn't that technically true?
No. When journalists gave him names—including children—he attacked them personally rather than engage with the evidence. That's a different kind of answer.
How certain are experts that the Ebola outbreak would have been caught earlier?
Konyndyk, who ran the 2014-2015 response, says he's "very confident" it would have been detected sooner. The surveillance systems that could have caught it were in the programs Musk cut.
The Lancet study says 14 million deaths. Is that number solid?
It's an estimate based on the same statistical tools used for other large-scale projections. Rasella, one of the authors, stands by it. But he's careful to say the exact number is hard to pin down. What matters is the scale—millions, not thousands.
Could Congress actually bring USAID back?
Yes. It's required to exist by law. But funding is being strangled by slow releases from the State Department. There's a window to act, but it's closing.
What's the difference between cutting a company and cutting foreign aid?
In a company, you cut until people complain, then you restore what you cut too much of. The feedback loop works. With aid, the feedback is death. By the time you hear the screaming, people are already gone.