Sep 2, 2026 · 21 min · 10 segments
After the dismantling of USAID, and with millions of lives at stake, what does the future of global health look like now? And what compelled a USAID civil servant of over a decade to risk his job by…
Sandro GaleaHost
So what's going on? Leaving aside, for a second, we'll come back to it, sort of a narrow ideology.
Where's this push to dismantle global health institutions come from? To what extent does it reflect features that are really unique and particular to this moment? And to what extent does it reflect more longstanding critiques of foreign assistance?
Well, I think I would first remind everyone that USA was not dismantled due to any particular critique of foreign assistance.
or because it was wasteful or not aligned with the administration's priorities or something.
It was destroyed by a small group of tech bros who really had no idea what the agency even did.
But I think it's important to start there because that's what actually happened.
When we attempt to find a strategic justification for what happened, I find it often to be misguided because remember, there really was no plan.
But that said, I do think that USAID and foreign assistance and global health aid in general was uniquely vulnerable to sort of the political argument that I think was easier for people to recognize that, look, we have problems here in the United States.
Why would we be spending money overseas to help people there when we have our own problems here? And I think it reflects that we at USAID and in the global health and foreign assistance community in general just didn't do a good enough job of explaining how foreign assistance actually helps Americans.
And To me, I think we need to do a better job of explaining how when you're improving global health overseas, that actually makes Americans safer here at home.
And it makes the world safer and stabler in ways that has been a huge benefit to Americans over the past few generations.
So what's going on? Leaving aside, for a second, we'll come back to it, sort of a narrow ideology.
Where's this push to dismantle global health institutions come from? To what extent does it reflect features that are really unique and particular to this moment? And to what extent does it reflect more longstanding critiques of foreign assistance?
Well, I think I would first remind everyone that USA was not dismantled due to any particular critique of foreign assistance.
or because it was wasteful or not aligned with the administration's priorities or something.
It was destroyed by a small group of tech bros who really had no idea what the agency even did.
But I think it's important to start there because that's what actually happened.
When we attempt to find a strategic justification for what happened, I find it often to be misguided because remember, there really was no plan.
But that said, I do think that USAID and foreign assistance and global health aid in general was uniquely vulnerable to sort of the political argument that I think was easier for people to recognize that, look, we have problems here in the United States.
Why would we be spending money overseas to help people there when we have our own problems here? And I think it reflects that we at USAID and in the global health and foreign assistance community in general just didn't do a good enough job of explaining how foreign assistance actually helps Americans.
And To me, I think we need to do a better job of explaining how when you're improving global health overseas, that actually makes Americans safer here at home.
And it makes the world safer and stabler in ways that has been a huge benefit to Americans over the past few generations.
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