Illustration: Lindsey Bailey/Axios
The global health implications of Trump administration moves to restructure or even dismantle the U.S. Agency for International Development are stoking growing pushback from congressional Democrats.
Why it matters: Through USAID, the U.S. provides humanitarian aid and a variety of programs that prevent and monitor diseases.
Catch up quick: On Monday night, Elon Musk told reporters and lawmakers during an X Space that he was "shutting down" USAID, and that President Trump had condoned the move.
- Congressional Democrats have decried the actions, asserting moves to fold the agency into the State Department as unconstitutional.
- Lawmakers also tried to enter the USAID building to talk to staff, but were stopped by police.
Threat level: USAID is essentially the program implementer for most U.S. global health programs around the world, Jen Kates, director of global health and HIV policy at KFF, told Axios.
- That includes efforts that address HIV/AIDS, tuberculosis, malaria, maternal and child health, nutrition, family planning, neglected tropical diseases and global health security.
- The State Department, on the other hand, isn't a program implementer, Kates said.
The question going forward is less about whether it's two agencies or one, but about what changes State makes to the way established USAID programs are organized and implemented.
- "This all has a huge impact on global health, depending on what gets decided," Kates said.
What they're saying: Democrats assert the actions around USAID are unconstitutional since Congress established the agency and approved funding for the international programs. They said that disbanding it would have dire consequences for global health.
- "Congress has appropriated foreign assistance to protect U.S. interests and global stability," Rep. Johnny Olszewski said Monday. "The Trump freeze on foreign assistance has halted vital humanitarian aid and medical deliveries that have already been paid for."
- "This is a constitutional crisis that we are in today. Let's call it what it is," said Sen. Chris Murphy. "The people get to decide how we defend the United States of America. The people get to decide how their taxpayer money is spent. Elon Musk does not get to decide."
- "I can tell you that there is an outbreak of Ebola in Uganda and Marburg virus in East Africa, and all of those programs are either completely shut down or hobbled to the point where people can't deliver aid," said Sen. Brian Schatz.
Reality check: Musk and some Republicans have said that overhauling the government will save money and root out biased programs.
- But U.S. foreign aid accounts for only 1% or less of the annual federal budget, and U.S. funding for global health accounts for an even smaller percentage.
