Kristof: Rubio dead wrong that end of USAID hasn’t cost lives

By Nicholas Kristof / The New York Times

I see Secretary of State Marco Rubio as a good man doing bad things, but perhaps he thinks even worse of me: He recently suggested that I was a liar.

While testifying before Congress, Rubio claimed that the Trump administration’s dismantling of the U.S. Agency for International Development had not cost any lives.

“No children are dying on my watch,” he asserted. At another point in the hearing, he broadened his statement to include adults as well: “No one has died because of USAID.”

This is ludicrous: The only debate is whether to measure the dead in the thousands, tens of thousands or hundreds of thousands. So Rep. Brad Sherman, D-Calif., challenged Rubio, citing reporting overseas by me and by Reuters of individuals who died as a result of the shutdown of American humanitarian aid.

“That’s a lie,” Rubio said. “False.”

So, let me help Rubio with the truth. Meet Evan Anzoo, a 5-year-old boy who was born with HIV in South Sudan.

I mentioned Evan in a column in March from South Sudan. This was a child as precious as yours or mine. Evan’s life was in our hands, and for five years, America kept him alive with antiretroviral medicines costing less than 12 cents a day, through the President’s Emergency Plan for AIDS Relief, or PEPFAR. This was a program started by President George W. Bush that has saved more than 26 million lives so far, and it turned the tide of AIDS around the world and built enormous goodwill toward the United States.

Then along came President Trump and his freeze on most humanitarian aid in January. How could a 5-year-old orphan possibly obtain medicine on his own? Evan weakened and soon died of an opportunistic infection.

If Rubio needs further reminder of the human toll, there was a little girl named Achol Deng, 8, who likewise died when she lost access to antiretrovirals because of the USAID freeze.

I share these stories of Evan and Achol because it strikes me as doubly offensive not only to cause unnecessary deaths of such children but to deny these deaths and call them lies. The denials erase these children and dodge all responsibility.

It was Elon Musk who first insisted that “no one has died.” Now, Rubio has doubled down.

Rubio is smarter than this and better than this; over the years he has shown himself knowledgeable about foreign affairs and has demonstrated compassion. I was relieved when he became secretary of state, for I want smart, experienced people around Trump.

When I reached out to Rubio to ask about the “lies” comment and the suggestion that no one had died, he declined to be interviewed. But he seemed to back off and presented a more sensible response; albeit a complete evasion.

“America is the most generous nation in the world, and we urge other nations to dramatically increase their humanitarian efforts,” a senior State Department official said in a statement.

It is true that the United States has donated more in total humanitarian aid than any other country, although some European nations donate several times as much per capita. However, by slashing aid, the United States set an example that Britain and France promptly followed, compounding the suffering.

Trump is right that USAID needed reform. But U.S. aid overall still saved about one life every 10 seconds, based on estimates by the Center for Global Development.

The transfer of USAID into the State Department wouldn’t necessarily be a bad idea if it were done carefully. But simply shuttering the agency with no transition has been catastrophic. An “impact counter” developed by an economist estimates that about 300,000 people have died so far from the reductions in U.S. assistance, two-thirds of them children. The death toll is said to be rising at a rate of 103 per hour.

I’m not sure it’s actually that high, partly because I’ve seen some laid-off health workers continue to work without pay and some health ministries step up to pick up the slack. And it takes time for children to weaken and die. Yet, although nobody knows the true number — partly because the cancellation of programs means that no one is counting the dead — the flat denial of any deaths at all is preposterous.

Rubio chooses not to make the argument that I believe is Trump’s true position: We want tax cuts (disproportionately benefiting the rich), so we need to cut funds in the budget from people who are so marginalized that they can’t complain.

So, Evan and Achol died.

To deny the reality of dying children not only insults the memory of children starving to death in Sudan and Yemen and Afghanistan; it also insults the intelligence of Americans.

Contact Nicholas Kristof at Facebook.com/Kristof, X.com/NickKristof or by mail at The New York Times, 620 Eighth Ave., New York, NY 10018. This article originally appeared in The New York Times, c.2025.