Is Elon Musk – with the help of Donald Trump – going to kill millions?

The claim that Elon Musk might be “killing millions” sounds like hyperbolic rhetoric, but it is an entirely predictable mathematical projection of his policy choices. Peer-reviewed global health modeling showed that the systematic dismantling of USAID—spearheaded by Musk’s Department of Government Efficiency (DOGE)—will result in over 14 million preventable deaths by 2030, millions of whom are children. By freeze-framing and terminating programs that provide life-saving vaccines, malaria bed nets, and HIV therapeutics, these actions have directly triggered the resurgence of entirely controllable diseases.

Hard to believe?

See for yourself; here is the abstract of the paper published in the Lancet:

Background: Official development assistance (ODA) accounts for the majority of humanitarian and development assistance in the world’s most vulnerable countries and has played a pivotal role in advancing global health. We aimed to comprehensively evaluate the impact of ODA funding on mortality across the past two decades, and to project the potential consequences of current defunding trends.

Methods: We conducted an integrated retrospective evaluation and forecasting analysis using longitudinal panel data from 93 low-income and middle-income countries (LMICs). First, we estimated the association between ODA per-capita funding and mortality outcomes from 2002 to 2021 using a two-ways fixed-effects multivariable Poisson regression model with robust standard errors, adjusted for all relevant demographic, socioeconomic, and health-system covariates. We then assessed age-specific and cause-specific effects, performing extensive sensitivity and triangulation analyses to test the robustness and causal interpretation of results. Finally, we integrated the retrospective impact estimates into validated country-level microsimulation models to forecast mortality under three defunding scenarios up to 2030: a business-as-usual trajectory, a severe defunding scenario, and a mild defunding scenario.

Findings: Higher ODA funding levels were associated with a 23% reduction in age-standardised all-cause mortality (rate ratio [RR] 0·77; 95% CI 0·70-0·85) and a 39% reduction in under-5 mortality (0·61; 0·49-0·75). ODA funding was associated with large mortality declines in major communicable diseases: 70% for HIV/AIDS (RR 0·30; 95% CI 0·24-0·39), 56% for malaria (0·44; 0·35-0·56), 56% for nutritional deficiencies (0·44; 0·30-0·65), and 54% for neglected tropical diseases (0·46; 0·36-0·59). Significant reductions were also observed in mortality from tuberculosis, diarrhoeal diseases, lower respiratory infections, and maternal and perinatal causes. Forecasting analyses projected that ongoing reductions in ODA funding could, under a severe defunding scenario, result in 22·6 million (95% uncertainty interval [UI] 16·3-29·3) additional deaths across all ages by 2030, including 5·4 million (4·1-6·8) among children younger than 5 years. Under a mild defunding scenario-defined as a continuation of current downward trends-the projected excess deaths would be 9·4 million (95% UI 6·2-12·6) overall and 2·5 million (1·8-3·2) among children younger than 5 years.

Interpretation: ODA funding has played a decisive role in reducing preventable mortality across LMICs over the past two decades, and the abrupt withdrawal of this support threatens to cause millions of avoidable deaths, reversing decades of progress in global health.

Funding: RF Catalytic Capital and the Spanish Ministry of Science and Innovation.

Attempting to shield Musk from the moral indictment of these deaths by hiding behind bureaucratic complexity is a cop-out. Musk is not a passive advisor suggesting minor budgetary trims; he has aggressively engineered and celebrated the destruction of these aid mechanisms on his public platform, explicitly branding the defunding of life-saving infrastructure as “clipping waste.” When an individual wields unchecked power to eliminate interventions with legally and medically proven survival rates, the line between “efficiency” and institutional negligence disappears. He is fully aware of the survival benefits of these programs, making the choice to dismantle them a calculated acceptance of mass mortality.

While defenders argue that epidemiological models deal in macro-statistics rather than localized causality, this defense elides the nature of modern accountability. Musk cannot hand-select which specific child dies of malaria, but he did hand-select the budget line that funded their treatment. Pretending this is just a structural or collective government failure sanitizes the reality: a single billionaire used his leverage to treat global survival infrastructure like an unprofitable corporate acquisition, making him materially and morally responsible for the human body count that follows.

In March 2025, a federal judge ruled that DOGE’s effort to dismantle USAID likely violated the Constitution and ordered restoration of access to key systems, saying USAID had been effectively eliminated. That matters because it weakens any claim that the dismantling was merely speculative or rhetorical: courts have already treated the shutdown effort as legally serious.

For a deeper look into the systemic impact of these specific health program suspensions and the firsthand accounts of how these funding disruptions unfolded on the ground, you can watch this France 24 Interview with a USAID Whistleblower.