Elon Musk is set to become the world's first trillionaire as SpaceX's massive initial public offering takes off. But for many global health experts, this milestone is stained by accusations that his destruction of the US Agency for International Development (USAID) led to the deaths of hundreds of thousands of people. Critics say Musk's DOGE operation effectively 'murdered' an agency that saved millions of lives, and new public health models support that claim.

DOGE and USAID

In early 2025, President Donald Trump created the Department of Government Efficiency (DOGE) and placed Elon Musk at its helm. With unprecedented access to federal payment systems and personnel data, DOGE moved rapidly to slash government spending. Its first major target was USAID, an independent federal agency established in 1961 to provide humanitarian and development assistance overseas. For six decades, USAID funded vaccination drives, clean water projects, malaria prevention, and HIV treatment across Africa and Asia. It also led the US response to the Ebola crisis in West Africa in 2014.

Musk publicly called USAID a 'criminal organization' and said he spent a weekend 'feeding USAID into the wood chipper.' The remark was widely interpreted as a threat, and it was not idle. Within months, the agency's programs were halted, thousands of employees were laid off or placed on leave, and billions of dollars in lifesaving aid were frozen. The US government's own internal projection, reported by multiple outlets, was that the cuts would cause hundreds of thousands of deaths.

The death toll

The most cited projection comes from a tracker co-created by Brooke Nichols, a professor at Boston University. The tracker estimated that the cancellation of USAID programs could lead to over 780,000 deaths—mostly children and infants—from malaria, tuberculosis, HIV, and maternal health conditions. The researchers emphasized that these deaths were not an accident. They were the inevitable result of removing proven public health interventions in some of the poorest countries on Earth.

Other studies published in scientific journals were equally dire. A research letter in Nature predicted that the cuts would result in an additional 163,500 child deaths per year. An analysis in The Lancet went further, warning that the full toll could exceed one million if assistance was not restored quickly. In both cases, the authors stressed that these were preventable deaths. The medicine, the expertise, and the delivery systems already existed. What was lost was the political will to use them.

Musk's 'accident'

At a televised White House cabinet meeting in the spring of 2025, Musk, wearing a MAGA hat signed by the president, dismissed concerns about the cuts. He said he had 'accidentally' canceled a program to prevent Ebola and promised it would be fixed. But according to testimony from USAID whistleblower Nicholas Enrich, a career foreign service officer, the fix never came. Testifying before Congress, Enrich described an agency in chaos, with senior officials unsure who was authorized to respond to a brewing Ebola outbreak in Central Africa. The result, Enrich warned, was that Africa was facing 'the worst Ebola outbreak in recorded history.'

Musk's behavior during the cabinet meeting was widely criticized. Video of the event shows him grinning and appearing to suppress laughter as he described the cancellation. The image of a billionaire secretly glad to have cut a disease prevention program has become a symbol of what critics call his psychopathic disregard for human life.

Race and rage

The USAID affair did not exist in a vacuum. Throughout 2024 and 2025, Musk used his X platform to spread hateful rhetoric. He amplified antisemitic conspiracy theories and white supremacist talking points. He repeatedly claimed that white people were being subjected to 'genocide' in South Africa, a country with a brutal history of colonial and apartheid-era violence. He also encouraged race riots in the United Kingdom, saying that immigrant communities were eroding 'British identity.'

These beliefs are relevant because USAID's largest programs were dedicated to helping Black and Brown people in sub-Saharan Africa and South Asia. Experts note that Musk's focus on cutting USAID rather than other government agencies, and his public dismissal of the lives of those affected, align with his stated worldview. In interviews, public health officials have said they were not surprised that Musk targeted USAID specifically. It was, after all, saving lives of the people he had spent years dehumanizing.

White House insiders alarmed

Even within the Trump administration, Musk's actions were viewed as dangerously erratic. White House chief of staff Susie Wiles told Vanity Fair that Musk was a 'complete solo actor.' She said he 'probably knew' that his conduct would be 'horrifying to others' but did it anyway. She also admitted that she had been 'initially aghast' at his behavior. Wiles's statement, unusually frank for an administration where loyalty is paramount, suggests that even some of Musk's ideological allies were disturbed by his gleeful cruelty.

The 'solo actor' description is telling. It undermines the administration's official narrative that Musk was only doing what the president wanted. It also highlights a deeper problem: a private citizen with extraordinary wealth and influence was allowed to dismantle a federal agency with no apparent oversight, no expertise, and no accountability. That Musk did so with a smile is a matter of public record.

A waste — even by its own logic

The most striking irony is that DOGE's mission to make government more efficient failed. In October 2025, the libertarian Cato Institute released a review of DOGE's impact. The review found that DOGE had reduced federal employment by 9 percent over ten months, but total spending had continued to rise. The savings from cancelling USAID contracts were minuscule compared to the cost of the collapse in global health security. In other words, Musk had inflicted one of the greatest humanitarian catastrophes in modern history for no measurable fiscal gain.

What was lost, precisely, cannot be captured in a spreadsheet. USAID's institutional knowledge, its relationships with local health ministries, its ability to track emerging pathogens, its expertise in drug distribution—all of it was destroyed or scattered. The agency had a 60-year record of preventing epidemics, stabilizing regions, and keeping American ideals alive around the globe. Without it, the world is simply less safe.

The future

Musk's focus today has moved on. He is back to being a tech CEO, pushing SpaceX to Mars and launching consumer products. But he still has an outsized influence over public policy, and he continues to profit from federal contracts. According to public filings, SpaceX received billions in NASA and Pentagon funding even as its founder was dismantling USAID. There is no indication that Musk has any interest in funding global health initiatives himself. His charity, the Musk Foundation, has focused on sustainability research and science education, not on disease prevention in sub-Saharan Africa.

On SpaceX's IPO day, Musk told employees that 'there are always problems on Earth' and that the future lies among the stars. For the families of the nearly 800,000 people projected to have died because of USAID cuts, the future has already arrived. It is one where a single man's political whims could decide life or death for millions. As the world prepares to celebrate a trillionaire, more and more voices are asking a simple question: by what moral standard is this man allowed to hold so much power?

Source:The Verge News