>> OF ALL THE SWEEPING GOVERNMENT CUTS PERHAPS NONE IS BEING FELT SO QUICKLY AS USAID.

THE HUMANITARIAN DEVELOPMENT AGENT SEE HAS BEEN LARGELY DISMANTLED IN THE NAME OF GOVERNMENT EFFICIENCY AND ROOTING OUT SUPPOSES CORRUPTION.

THE CONSEQUENCES ARE REAL, EVEN FATAL.

A PHYSICIAN AND FORMER HEAD OF GLOBAL HEALTH RECENTLY VISITED KENYA TO SEE THE CONSEQUENCES FIRSTHAND.

HE JOINED HARI SREENIVASAN TO DESCRIBE WHAT HE SAW.

>> THANK YOU SO MUCH FOR JOINING US.

YOU ARE ONE OF THE ADMINISTRATORS OF USAID.

PRESIDENT TRUMP AND ELON MUSK HAVE PRETTY MUCH DISMANTLED THE PROGRAMS.

IT IS PRIMARILY AN ORGANIZATION ADMINISTERING AID TO DEVELOPING COUNTRIES.

YOU CAME BACK FROM A TRIP TO KENYA WHERE FUNDING IS CRUCIAL FROM PROVIDING EVERYTHING FROM HIV-AIDS CARE TO MALNUTRITION.

WHAT TYPE OF IMPACT DID YOU SEE ON THE GROUND?

>> FIRST OF ALL, IT'S NOT JUST CUTTING PROGRAMS.

IT'S THE DISMANTLING OF THE ENTIRE AGENCY.

THE REMOVAL OF EVERY PART OF THE WORKFORCE.

86% OF THE AWARDS BEING TERMINATED.

IT IS A MASSIVE IMPACT ON THE PROGRAM.

THE QUESTION, WHAT IS HAPPENING ON THE GROUND.

I WENT TO KENYA OVER THE LAST COUPLE OF WEEKS, EVERYTHING FROM A NATIONAL AID CENTER HOSPITAL FOR ADVANCED CASES TO PRIMARY HEALTH FACILITIES TO A REFUGEE CAMP.

EVERYWHERE YOU LOOK THERE IS A DEVASTATING IMPACT.

IT IS PUBLIC HEALTH BEING DISMANTLED IN SIGNIFICANT WAYS EVERYWHERE.

I CAN POINT TO SOME NUMBERS, CREDIBLE ESTIMATES INDICATE THAT THIS IS ALREADY COSTING MORE THAN 300,000 LIVES, MOST OF THEM CHILDREN.

MALNUTRITION THEFTS, FOR EXAMPLE, ARE OVER 60,000 SO FAR.

ANOTHER HUNDRED AND 20,000 DEATHS OF CHILDREN FROM TREATABLE PNEUMONIA AND DIARRHEAL DISEASE SO THIS IS DEVASTATING.

>> ONE OF THE PUSH BACKS RECEIVED FROM THE FOR THE RIGHT CORNERS IS HOW CAN THOSE ESTIMATES BE ACCURATE?

WHAT IS THE DATA, IT IS THE TRACKING ABILITY.

>> WE HAVE DATA FROM WHAT HAPPENED WHEN COUNTRIES HAVE BEEN CUT OFF FROM AID FOR PERIODS OF TIME BEFORE.

THERE ARE ALSO LONG-STANDING TRACKING OF PROGRAMS.

I LED GLOBAL HEALTH AT USAID.

WE COULD SEE IN 2023 THERE WERE 93 MILLION CHILDREN AND PREGNANT WOMEN WHO WERE REACHED.

WE COULD SEE THE IMPROVEMENTS IN LIFE EXPECTANCY THAT CAME FROM THAT.

WE HAVE DOCUMENTED THAT THERE IS AN ADDED SIX YEARS OF LONGER LIFE BECAUSE OF THE PROGRAMS.

THOSE PROGRAMS HAVE BEEN CUT MORE THAN 90%.

THIS IS NOT THEORETICAL.

THE REASON I WENT TO KENYA WAS TO SEE THE REALITY.

FOR EXAMPLE, AT A REFUGEE CAMP ON THE BORDER OF SOUTH SUDAN, THE WORLD FOOD PROGRAM HAS BEEN CUT TO ZERO FUNDING.

THEY SUPPLY THE FOOD TO THE PEOPLE IN THE CAMP WITH DONATIONS FROM OTHER COUNTRIES THEY'VE BEEN ONLY ABLE TO SUPPLY 29% OF THE DAILY CALORIC NEEDS OF FAMILIES.

I SAW DEATHS ON A DAILY BASIS THERE FROM COMPLICATIONS OF SEVERE, ACUTE MALNUTRITION.

IT IS REAL.

>> HERE YOU ARE.

WE'VE ALSO HAD A CONVERSATION, KRISTOF AFTER A TOOK -- TRIP HE TOOK TO AFRICA AS WELL.

YOU ARE DESCRIBING SPECIFIC INCIDENTS YOU HAVE SEEN FIRSTHAND HOW THE CHANGES AND DISMANTLING IN WASHINGTON, D. C. HAVE THE IMPACT ON LIVES AND DEATHS IN OTHER COUNTRIES.

YOU HAVE SECRETARY OF STATE MARCO RUBIO TELLING CONGRESS DIRECTLY, NO ONE HAS DIED BECAUSE OF USAID.

NO CHILDREN ARE DYING ON MY WATCH.

HOW DO YOU RESPOND?

>> IT IS SIMPLY UNTRUE.

WE HAVE AMPLE DOCUMENTATION.

THEY CLAIM TO BE SPENDING MONEY THAT IS NOT SPENT.

THEY CLAIM TO HAVE THE ABILITY TO DISTRIBUTE PROGRAMS THAT DON'T HAVE PEOPLE ON THE GROUND AND IT IS SIMPLY NOT HAPPENING.

IT IS EASIER WHEN THESE PEOPLE ARE LIVING ABROAD AND IT IS OUT OF SIGHT.

WE ARE SEEING THE SUPPLIED NOT JUST TO PUBLIC HEALTH HAPPENING ABROAD.

WE ARE SEEING IT APPLIED AT HOME.

IT IS MILLIONS AFFECTED ABROAD AND NOW IT IS MILLIONS AT HOME.

WE CAN SEE THE CONSEQUENCES RIGHT HERE.

>> ONE THING THAT SEEMS TO HAVE BEEN A BIPARTISAN EFFORT IS THE PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF.

THE LARGEST COMMITMENT BY ANY NATION TO ERADICATE A SINGLE DISEASE AND IS RESPONSIBLE FOR PROVIDING HID --HIV CARE IN THE WORLD.

SECRETARY RUBIO SAID TO CONGRESS THAT 85% OF THE ORGANIZATION REMAINS ACTIVE EVEN AT THE ADMINISTRATION MADE THE CUTS.

IS THAT TRUE?

>> IT IS NOT.

NUMBER ONE, LET'S JUST TAKE THIS IN CONTEXT.

THERE ARE 20 MILLION PEOPLE PLUS ON HIV TREATMENT BECAUSE OF THE COMPASSION AND CONTRIBUTION OF THE UNITED STATES.

THERE'S NO PLAN FOR WHAT HAPPENS IF YOU WILL CUT 15% OF PEOPLE OFF.

FURTHERMORE, THERE'S NOWHERE NEAR 85% FUNDING MOVING FORWARD.

THEY'VE BEEN ASKED FOR DOCUMENTATION AND HAVE NOT PROVIDED IT.

ONE OF THE POLICIES IS THAT NO PREVENTION FOR HIV BEYOND THE TRANSMISSION FROM MOTHER TO CHILD IS NOW ALLOWED TO BE DONE.

THAT HAS TAKEN MILLIONS OF PEOPLE OFF OF HIV PREVENTION TREATMENT.

I BRIEFED THE SENATE FOREIGN RELATIONS COMMITTEE BEFORE I LEFT OFFICE IN THE LAST ADMINISTRATION ABOUT A BREAKTHROUGH PREVENTION.

A SINGLE SHOT REMEDY CALLED THEN A U WHICH CAN STOP IT FOR UP TO A YEAR.

WE WERE READY TO DEPLOY THAT BY THE MILLIONS BECAUSE IT IS LIKE A FLU SHOT THAT CAN STOP HIV.

IT HAS BEEN DISMANTLED.

WE ARE TRYING TO DOMESTICALLY ALSO DRIVE THAT PREVENTION PROGRAM FOR HIV BUT THAT HAS ALSO BEEN PURGED WITH THE SEVERE.

THIS IS HAPPENING AT HOME AND ABROAD.

>> ANOTHER LINE OF THINKING ABOUT THIS IS THAT, USAID NEEDED TO BE DISMANTLED BECAUSE THERE WAS MAJOR AS THEY LIKE TO SAY FRAUD, WASTE, AND ABUSE IN THE SYSTEM.

IS THERE ANY VALIDITY TO THAT CLAIM?

IS THERE ANY KIND OF STRESS TESTING WERE A VERY NEAR TIME YOU HAVE FOUND THERE ARE PLACES WHERE IT COULD BE MORE EFFICIENT?

>> ABSOLUTELY SAW PLACES WHERE WE COULD BE MORE EFFICIENT.

BUT THAT IS NOT A CASE TO DISMANTLE IT ENTIRELY.

I GOT TO LEAD 2500 PEOPLE ACROSS 65 COUNTRIES.

WE HAVE THE BUDGET OF HALF OF WHAT THE HOSPITAL SYSTEM AT HOME IN BOSTON HAS.

IT WAS ABOUT $24 PER PERSON PER YEAR PER AMERICAN TAXPAYER PER YEAR FOR HEALTH.

IT REACHED HUNDREDS OF MILLIONS OF PEOPLE AND SAVE THE LIVES BY THE MILLIONS.

IT WAS INCREDIBLY EFFICIENT IN COMPARISON WITH OUR OWN HEALTH SYSTEM.

WE SAW WAYS THAT CLEARLY THERE WERE IMPROVEMENTS TO BE MADE.

WE DROVE A NUMBER OF IMPROVEMENTS TO DOCUMENT WAYS THAT WE WERE GETTING MORE LIVES SAVED PER DOLLAR AND THERE WERE MORE OPPORTUNITIES LIKE THE HIV ONE THAT I GAVE.

THE NOTION THAT IT WAS A CRIMINAL ENTERPRISE OR MONEY LAUNDERING OPERATION FRAUD THAT CLAIMED 90% OF DOLLARS THAT BEFORE THEY GOT TWO PEOPLE ON THE FRONT LINE, THOSE ARE SIMPLY NOT TRUE.

>> CAN YOU TELL ME THE DIFFERENCE BETWEEN TRUMP 1.

0 AND TRUMP TO POINT OUT BECAUSE THERE WERE SOME THINGS YOU INHERITED WHEN YOU CAME IN WITH THE BIDEN ADMINISTRATION THAT THE PRESIDENT AT THE TIME SEEMED TO BE IN FAVOR OF.

>> THERE WERE REALLY IMPORTANT GOALS THAT THE TRUMP ADMINISTRATION PASSED THAT I BUILT TON TO CARRY FORWARD.

THE HIV COMMITMENT TO ERADICATE THE PANDEMIC OF HIV BY 2030 WAS ONE OF THEM.

IT WAS IN THE UNITED STATES AS WELL AS ABROAD.

THAT WAS WHY THE BREAKTHROUGH SINGLE SHOT LONG ACT IN TREATMENT IS SO IMPORTANT.

ANOTHER AREA THAT TRUMP 1.

0 PUSHED VERY HARD WAS TO INVEST MORE IN LOCAL ORGANIZATIONS RATHER THAN LARGE MULTINATIONAL ORGANIZATIONS THAT WERE SWOOPING IN.

IT PUT PEOPLE AND COUNTRIES ON A SWIFTER PATH TO SELF- RELIANCE.

I THOUGHT THAT WAS EXACTLY RIGHT AND GREW FROM ONLY 10% OF FUNDS GETTING TO LOCAL ORGANIZATIONS ABROAD TO OVER 30% GETTING TO THAT POINT.

ALL OF THAT HAS BEEN DISMANTLED AND DESTROYED.

WE ARE FAR FROM BUILDING MORE OF THAT CAPACITY.

WE ARE UNDERMINING IT.

>> I ALSO WANT TO TALK MORE ABOUT HEALTH IN THE CONTEXT OF RESEARCH AND UNIVERSITIES.

HARVARD SEEMS TO BE ONE OF THE TARGETS.

THE PRESIDENT HAS NOT ONLY DISMANTLED USAID BUT FROZEN ABOUT $2 BILLION IN GRANTS AND $60 MILLION IN CONTRACTS TO HARVARD.

GIVE ME AN IDEA OF HOW HEALTH RESEARCH WORKS AND IF THERE ARE LONGER AFFECTS WE SHOULD BE LOOKING FOR.

>> MY HOME BASE WHERE THEY CAME FROM AFTER BEING A PROFESSOR WAS A SURGEON AND PUBLIC HEALTH RESEARCHER AT HARVARD SCHOOL OF PUBLIC HEALTH, HARVARD MEDICAL SCHOOL AND THE WOMEN'S HOSPITAL.

I RETURNED THERE, WHAT YOU ARE SEEING NOW IS THE MASSIVE DISMANTLING THAT HAD OCCURRED TO A PLACE LIKE USAID NOW BEING BROUGHT HOME TO OUR SYSTEMS FOR SCIENCE, FOR HEALTH DISCOVERIES, AND FOR UNIVERSITIES AT HOME.

HARVARD IS UP TO ALMOST $3 BILLION HAS BEEN CUT OFF.

THAT INCLUDES MY OWN RESEARCH CENTER ON REDUCING MORTALITY OF SURGERY.

WE HAD MORE THAN 20 YEARS WHERE WE CUT THE DEATH RATE FOR SURGERY ACROSS THE UNITED STATES AND NOW ACROSS THE WORLD BY MORE THAN A THIRD.

THAT SAME WORK THAT WAS CREATING THE NEXT SET OF ADVANCES WAS DEFUNDED LAST WEEK ALONG WITH ALL THE OTHER PUBLIC FUNDING AT HARVARD.

WHAT IMPACT DOES THAT HAVE.

IT RANGES FROM DISMANTLING PROGRAMS THAT WERE SHOWING THE WAY TO MANAGE PEDIATRIC HEART CONDITIONS TO ALZHEIMER'S DISEASE, HIV, ALMOST EVERY AMERICAN BENEFITS FROM WORK THAT HAS BEEN UTTERLY FUNDED AT HARVARD AND OTHER INSTITUTIONS ASSOCIATED WITH IT.

THE IMPACT IS GOING TO BE FELT FOR YEARS TO COME.

THE PLAYBOOK FROM USAID HAS BEEN APPLIED BROADLY.

IT'S IMPORTANT NOT TO JUST SEPARATE INTO INDIVIDUAL FIGHTS.

YOU ARE TALKING ABOUT IN THE NEW TAX AND SPENDING BILL THE ADMINISTRATION IS MOVING THROUGH CONGRESS, IT'S A MORE THAN 40% CUT IN THE NATIONAL INSTITUTE OF HEALTH.

A SIMILAR MASSIVE CUT IN THE CDC AND ITS PUBLIC HEALTH RESEARCH CAPABILITIES.

ALSO, NASA AND THE NATIONAL SCIENCE FOUNDATION.

THE U. S. HAS BEEN THE LEADER FOR THE WORLD IN ADVANCING LIFE EXPECTANCY AND HEALTH THROUGH INNOVATIONS AS WELL AS IN ENGINEERING AND A VARIETY OF OTHER AREAS.

THAT IS NOW BEING SACRIFICED.

WE ARE SACRIFICING OUR ABILITY TO WIN THE FUTURE.

YOU SEE THAT IN WHAT IS HAPPENING AT UNIVERSITIES AND OUR INSTITUTIONS OF SCIENCE AND PUBLIC HEALTH.

>> GIVE ME AN EXAMPLE.

I TALKED ABOUT HARVARD THERE'S ABOUT $16 BILLION WITH THE FUNDING ACROSS THE COUNTRY IN PLACES THAT HAS NOT BEEN CANCELED SO FAR.

DOES THAT MEAN THE PHD'S THAT ARE THERE ARE DEFUNDED AND LOOKING AROUND TO FIGURE OUT WHERE THEY SHOULD CONTINUE THEIR WORK OR ONES THAT WOULD HAVE COME TO THIS UNIVERSITY OR COLLEGES OR INSTITUTIONS ARE NOT COMING?

HOW DOES THIS TRANSLATE TO THE IDEA OF RESEARCH LOST LEAD LOST?

>> THIS IS SO IMPORTANT.

IT'S A TERRIBLE TIME FOR A YOUNG PERSON WHO IS INTERESTED IN SCIENCE.

THE REASON WHY IS BECAUSE ONE OF THE BIGGEST AREAS OF CUT ARE THE TRAINING GRANTS THAT SUPPORT PHD STUDENTS ACROSS THE COUNTRY.

THE RESULTS OF THAT IS YOU HAVE UNIVERSE NOT ACCEPTING ANY MORE PHD STUDENTS AT THE MOMENT.

THEY ARE RESENDING OFFERS INCLUDING FOR SOME AT HARVARD.

RESENDING ACCEPTANCES THAT PHD STUDENTS HAD.

THEN YOU HAVE THE PROFESSORS AND RESEARCHERS THEMSELVES WHO ARE DOING WORK CUT OFF, HAVING LABS SHUT DOWN.

IT IS A DEVASTATING IMPACT THAT WILL BE FELT FOR YEARS TO COME.

>> YOU MENTIONED THE NIH.

THERE WAS RECENTLY A LETTER PUBLISHED KNOWN AS THE BETHESDA DECLARATION.

THIS WAS SENT TO THE DIRECTOR OF THE NIH ACCUSING THE LEADERSHIP OF PRIORITIZING POLITICAL MOMENTUM OVER HUMAN SAFETY AND FAITHFUL STEWARDSHIP OF PUBLIC RESOURCES.

WHAT DO YOU MAKE OF THAT LETTER?

>> WHAT IS REMARKABLE ABOUT THAT IS IT COMES FROM THE SCIENTISTS WITHIN THE NATIONAL INSTITUTES OF HEALTH WHO ARE REPORTING THEY ARE UNABLE TO DO THEIR WORK AND UNABLE TO SUPPORT OTHER PROGRAMS ACROSS THE COUNTRY THAT WERE CREATING REAL BREAKTHROUGHS, REAL ADVANCEMENTS AND NOW ARE UNDER OFTEN IDEOLOGICAL ATTACK.

OFTEN NOT GROUNDED IN SCIENCE AND MAKING IT INCREDIBLY DIFFICULT FOR THEM TO DO THE JOB THEY ARE LEGALLY SUPPOSED TO DO.

>> WHEN YOU LOOK AT THIS PICTURE I'M WONDERING, IS THIS SOMETHING THAT CAN BE RESTORED IF THERE IS A DIFFERENT PARTY, DIFFERENT ADMINISTRATION THAT COMES IN IN A COUPLE YEARS, DOES IT GET TURNED BACK ON?

DOES IT TAKE YEARS TO UNDO THIS?

>> THIS IS SUCH AN IMPORTANT QUESTION.

THERE ARE SEVERAL LAYERS OF DESTRUCTION AND THEY ARE ON DIFFERENT TIMELINES.

ONE IS THE CAPACITY ABROAD HAS BEEN SHUT DOWN.

WE ARE TALKING ABOUT TENS OF THOUSANDS OF PEOPLE THAT ARE DEPLOYED AROUND THE WORLD TO DO EVERYTHING FROM SUPPORT THE UKRAINE HEALTH SYSTEM TO KEEP GOING AND ALSO THE ENERGY SYSTEM TO KEEP GOING TO SOME OF THE POOREST PLACES IN THE WORLD IN CONFLICT ZONES.

THAT SOFT POWER CAPACITY THAT U. S. HAS HAD TO DO GOOD AND WORK ON AREAS OF MUTUAL BENEFIT SUCH AS CONTROLLING HIV.

THAT IS DISMANTLED.

THAT IS GONE.

IT TOOK DECADES TO BUILD UP INCLUDING RELATIONSHIPS AND CAPACITIES.

THAT IS NOT COMING BACK ANYTIME SOON.

EVEN AS MUCH MONEY AS HARVARD HAS THEY CAN'T KEEP LINEAR ACCELERATORS FOR MAJOR PHYSICS PROGRAMS RUNNING.

THEY CANNOT KEEP GENOME PROGRAMS RUNNING THAT HAVE MASSIVE INFRASTRUCTURE CAPACITY.

OVER THE NEXT FEW MONTHS ESPECIALLY IF THE NEXT BUDGET CUTS THE NIH BY 40% YOU WILL SEE THAT DISMANTLED AND DISAPPEAR.

WE HAVE STOPPED WELCOMING THE BEST AND THE BRIGHTEST TO COME FROM ABROAD.

WE DO NOT HAVE ENOUGH ENGINEERS.

WE DON'T HAVE ENOUGH BIOTECHNOLOGY RESEARCHERS.

WE WANT TO BE THE PLACE THAT ATTRACT THE GREATEST TALENT IN THE WORLD.

THAT IS ALREADY SHUT DOWN AND THE TRUST THAT IT WILL COME BACK IS HARMED FOR YEARS TO COME.

ALL OF IT IS HAPPENING AT ONCE.

THAT IS THE REALLY DAMAGING THING.

>> THE FORMER ADMINISTRATOR FOR GLOBAL HEALTH AT USAID, THANK YOU FOR YOUR TIME.

>> THANK YOU