Boston—Atul Gawande, the renowned surgeon and former USAID global health chief, didn’t mince words on April 28 at Harvard’s Chan School of Public Health. Speaking to a packed room of students and faculty, he laid bare the wreckage left by the Trump administration’s gutting of the U.S. Agency for International Development. The agency, once a linchpin in global health, has been slashed to the bone, with nearly all staff axed and over 85 percent of its programs shuttered. The fallout, Gawande warned, is catastrophic—not just for millions abroad but for America’s standing as a health leader.
Gawande, who stepped down from his USAID role three months ago, painted a grim picture. He described a 50-country network, built on a budget dwarfed by a single Boston hospital, that once tracked killers like Ebola and bird flu with unprecedented speed. That network? Dismantled. Programs saving lives from HIV, TB, malaria, and maternal hemorrhaging? Gone or crippled. The White House’s moves, including a 90-day stop-work order issued in January, have choked off aid, leaving 21 serious disease outbreaks unaddressed. Gawande called the cuts “insane and cruel,” a blow that hands adversaries a gift while endangering the world.
Yet, even as he detailed the devastation, Gawande’s message wasn’t despair. He urged the crowd to dig in, to cling to the work of science and medicine. Federal funding freezes have hit hard—his own Ariadne Labs, a Harvard-affiliated research center he founded in 2012, is among the casualties. Still, he insisted it’s not too late to salvage the nation’s health infrastructure and talent. “USAID can’t be what it was,” he said, “but we can save what’s left.”
The numbers are stark. USAID’s budget, already lean, was slashed further, with grants canceled en masse. Hundreds of thousands of lives are at risk, Gawande noted, unless the administration reverses course. His words echoed earlier warnings, like those in a February statement to a major news outlet, where he decried the purge as a betrayal of global health progress.
Gawande’s talk wasn’t just a lament. It was a call to action, raw and urgent, from a man who’s seen the stakes up close. The crowd left sobered but challenged—to fight for medicine’s mission, no matter the odds.