Atul Gawande on Elon Musk’s “Surgery with a Chainsaw”

Two weeks after the Inauguration of Donald Trump, Elon Musk tweeted, “We spent the weekend feeding USAID into a wood chipper.” Musk was referring to the Agency for International Development, an agency which supports global health and economic development, and which has saved millions of lives around the world. “A viper’s nest of radical-left lunatics,” Musk called it. U.S.A.I.D.’s funding is authorized by Congress, and its work is a crucial element of American soft power. DOGE has decimated the agency with cuts so sudden and precipitous that federal workers stationed in conflict zones were stranded without safe passage home, as their own government publicly maligned them for alleged fraud and corruption. Courts have blocked aspects of the federal purge of U.S.A.I.D., but it’s not clear if workers can be rehired and contracts restarted, or whether the damage is done.

In January, 2022, Atul Gawande, a surgeon and leading public health expert who has written for The New Yorker since 1998, was sworn in as assistant administrator for global health at U.S.A.I.D. He resigned as the new administration came to power, and is watching in shock as Trump and Musk make U.S.A.I.D. a guinea pig for the government-wide purge now under way. U.S.A.I.D. was, he admits, a soft target for MAGA—helping people in faraway countries. Gawande calls U.S.A.I.D. “America at its best.” But with Trump and Musk, “there’s a different world view at play here,” he says. “Power is what matters, not impact.”