Elon Musk is unrepentant. Starting in January 2025, in his brief stint as Donald Trump’s cost-slasher-in-chief, SpaceX’s boss helped the president dismantle the world’s biggest foreign-aid agency. Eighteen months on, he insists the end of USAID has not cost any human lives: “Zero point zero,” he says. Aid bureaucrats disagree. Bill Gates has accused Mr Musk of killing the world’s poorest children. Researchers started back-of-the-envelope calculations of the human cost of cuts soon after they began. The most influential, published in the Lancet in July 2025, estimates that by 2030 14m people will die as a result of USAID’s demise.
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