Gawande: Federal cuts could mean loss of life, harm to U.S. science enterprise
Physician, writer, and public health researcher Atul Gawande has been speaking out about the ramifications of cuts to federal health agencies including the U.S. Agency for International Development (USAID) and the Department of Health and Human Services (HHS).
Gawande, a distinguished professor in residence at Ariadne Labs, served as assistant administrator for USAID’s Bureau of Global Health during the Biden administration. As a guest on two podcasts that aired in mid-April, he spoke about how cuts that essentially dismantled USAID are expected to result in massive loss of life around the world, and how HHS cuts could harm health in the U.S. as well as seriously damage the nation’s science and research enterprise.
Speaking about his work at USAID on “The Al Franken Podcast” on April 13, Gawande said, “We reached hundreds of millions of people and saved lives by the millions.” For example, USAID sought to ensure that 20 million people with HIV got life-saving medications, worked to stop the spread of infectious diseases such as malaria and tuberculosis, tried to eradicate polio, and boosted vaccination programs, he said.
“This is an agency constituted in law by Congress and [the defunding] is going through the court processes, but it’s already dismantled to the point where it’s not going back to the way it was before,” he told Franken. With the loss of USAID, he added, “There are hundreds of thousands of deaths that we are projected to be facing in the course of the next year.”
On an April 11 “Pod Save America” podcast, Gawande discussed the U.S. measles outbreak, which has so far led to the deaths of two children who were unvaccinated and has spread to 25 states and to Mexico and Canada. He said that, in previous administrations, experts from a host of agencies such as the National Security Council, the Centers for Disease Control and Prevention, the Food and Drug Administration, and USAID would have been working together weekly to discuss the crisis. “We don’t see any of this happening,” Gawande said.
In addition, Gawande noted, HHS Secretary Robert F. Kennedy Jr.’s mixed messages about the measles vaccine, and his vaccine skepticism in general, could undo lifesaving gains made over decades. “We have reduced child deaths in the last 50 years by 75%; 40% of that reduction in child deaths has come from vaccines and 60% of the vaccine death reduction has come from the measles vaccine alone,” he said.
Gawande also noted that cuts to the National Institutes of Health “are hitting every part of the health and science infrastructure that have made the U.S. the leaders in this space for a century.”
Gawande addressed the ramifications of research funding cuts at Harvard, as well as other universities, in an April 21 New Yorker article. On April 11, the Trump administration, as part of its review of alleged antisemitism on campus, presented Harvard with an extensive list of demands that, if not agreed to, would put in jeopardy $9 billion in multiyear federal funding to the University and its affiliated hospitals. On April 14, Harvard rejected the demands—such as sharing with the government all hiring and admissions data through 2028, and agreeing to government audits of numerous departments, including at Harvard Chan School, for alleged antisemitism. Later that day, the Trump administration moved to freeze $2.2 billion in grants and $60 million in contracts to Harvard—the $60 million representing a seven-year contract for groundbreaking tuberculosis research by Harvard Chan School’s Sarah Fortune. On April 21, Harvard filed a lawsuit against the Trump administration, arguing that the research funding freeze is unconstitutional.
Most of the funds in question support life sciences research in a wide range of areas. Citing the University’s updated home page, which focuses on its research accomplishments, Gawande wrote, “If you or someone you love has cancer, cardiovascular disease, dementia, Parkinson’s disease, or diabetes, the website points out, you have likely benefitted from federally funded discoveries in care and treatment.” The Trump administration, he said, “was seeking to do to the university what it had done to USAID and other federal agencies: defund vital programs, purge and traumatize the staff, and place political reins on what remained.”
Listen to the Pod Save America podcast: Trump’s Art of the Fold
Listen to the AlFranken.com podcast: Atul Gawande on Musk’s Destruction of USAID
Read the New Yorker article: The Cost of Defunding Harvard
Gawande will speak on “Global health after USAID” at an April 28 Studio event. Register here to attend in person.
Editor’s note: This article was updated on April 22.
