KJS Washington DC USA 💰

I’m at the World Bank fall meetings. Twenty three years after I started in humanitarian work. Eight years after I left, jaded and burned out.

Nothing has changed.

Except everything has.

Same Old Song

Twenty years ago it was The Lancet; then the Institute for Health Metrics (there were even global business coalitions back then). Today it’s the McKinsey Health Institute…here to make the investment case – again.

Every dollar in health nets 4x returns.

Yeah, yeah. We heard.

Health was never a cost center—it’s a multiplier.  

We wrote papers. We ran models. We proved the ROI.

That used to work.

We were able to convince donors that saving lives was smart economics, not just a moral imperative.

Today? It’s the very definition of falling on deaf ears. They don’t need convincing. Why not? They’re not listening, and don’t care.

They believe in the inverse: that poor black and brown people’s lives are not worth saving. The preferential treatment for white societies isn’t even hidden. It’s their policy.

Trump and DOGE turned US aid into direct payments to white military allies while cutting the programs that actually saved lives. The cuts aren’t about efficiency. It’s a different calculus for human life.

For the sake of this article I’m going to name these crimes against humanity, but genocide also works. It fits the actual definition: the deliberate and systematic killing or persecution of a large number of people from a particular national or ethnic group with the aim of destroying that group:

The Numbers

This administration terminated 92% of USAID programs. Cut $60 billion in foreign assistance. Fired 10,000 employees.

A study published in The Lancet found that USAID programs saved 91 million lives over two decades. The researchers estimate that if current cuts continue through 2030, 14 million people who might have otherwise lived will die.

Let say that differently: Trump’s aid cuts will kill 14 million people.

Children under five saw a 32% reduction in mortality where USAID operated. Now those programs are gone. Medicines to prevent mother-to-child HIV transmission for hundreds of thousands of newborns? Gone. Emergency food kitchens in famine-stricken Sudan? Closed. Cholera clinics in Congo? Shut down.

Five children died on a three-hour walk in 100-degree heat to the closest hospital after nearby clinics closed due to cuts.

The White House called these programs “woke,” “weaponized,” and “wasteful.” They eliminated $3.2 billion in development assistance because it funded “climate change, diversity, equity, and inclusion, LGBTQ activities… that are of no value to American taxpayers.”

Translation: We don’t care if Black people in Africa die. Their lives have no value to us.

The Moral Calculus

Compare Trump’s algorithm for the value of a non-American poor person’s life to, say, George Bush 2, who created PEPFAR out of his Christian values and saved millions of lives.

What’s the Trump First calculus?

From where I sit, it’s explicit:

White American lives matter. Everyone else can starve.

The administration preserved aid to Ukraine. They’re negotiating with wealthy white countries making deals that benefit American military interests. But an African girl born into poverty? She doesn’t register. Her life has zero value in their equation.

Real Republicans, wake up — look at the damage, the economic and spiritual reckoning you are causing.

What the Aid Industry Won’t Say

So here we are at an unrecognizable version of the World Bank, listening to presentations about “pressure on health budgets,” “debt distress,” “aligned incentives,” “blended finance,” “value for money.” 

What money?

Convincing them that one dollar creates four will only make them say “great, let’s save that money.”

They explicitly cut programs that saved lives and called them wasteful.

That moral foundation doesn’t exist right now in American foreign policy. 

The ‘bankers’ in the marble conference rooms, writing loans to countries, they will just calculate new ‘debt-to-GDP’ ratios.

They host meetings to have conversations to appear relevant – not to change the poverty equation. 

The advocacy message should be about the lack of humanity. The lack of moral leadership. The threat of the US driving xyz forces in other countries.

But the aid industry can’t say that. They’re trying to stay alive. Make the economic case. Prove ROI. Show value for money.

Don’t blame them—what choice do they have? But let’s be honest about what’s happening.

What’s Changed

Back in 2016, I wrote on Devex about speeding up procurement to save time, costs, and lives. Then, we were working on the UN Millennium Development Goals. We were scaling. The conversation was about efficiency, accountability, innovation.

For those who seek to save lives of the poorest people on the planet because it’s the right thing to do—it’s different now. There are few jobs to continue the work. Your work has likely been short changed or stopped. Your emotion and values consume you so you’ve lost track of the years of progress – stunted, thwarted and you’re the one looking to feed your family now. 

The whole field — all its success, science and implementation, community trust; a body of work the whole planet has taken on for decades; and all its workers, paid and volunteer, who have worked tirelessly and hopefully to change the trajectory of poverty and human rights — it is vanishing.  

Thanks to Trump and his movement of inhumane cultists we are witnessing a genocide we can’t talk about. It is such an intentional destruction of hope and show of hate that it will define Trump’s legacy.

Test for Our Species

These are people who honestly believe their life is worth as much as a poor newly born African girl with a disability. Who actually believe that we are all worth the same and some of us got lucky.

Those who feel that equity at large is the issue we’re supposed to be solving. Fairness for others will make all things better. Not survival of the fittest.

Survival of the fittest is what regular animals care about.

We are not regular animals. We are human animals.

Compassion and love are not ideological positions. They are universal values.

That’s what separates us from beasts. The capacity to care. To do it for someone you’ll never meet. To spend resources keeping alive someone who won’t benefit you. To value a life in Sudan as much as a life in South Carolina.

Now that’s prosperity and civilization. 

What This Reveals

The MAGA base supports this because they’ve been told these programs are “woke handouts” to people who don’t matter. The propaganda works because it aligns with existing hierarchies: white lives matter more, American lives matter most, everyone else is negotiable.

It’s not subtle. The cuts explicitly preserved programs in white countries and strategic allies while eliminating programs in the poorest, Blackest, most vulnerable places on Earth.

American foreign policy is anti-American, anti Christian and anti-Humane.

What I Can’t Accept

I spent fifteen years trying to raise more money, avert more deaths, save health budgets through smart investments and accountability and revenue generation.

I’m watching an American administration actively choose to let 14 million people die because they don’t value those lives.

Not because we can’t afford it.

We have proof it saved 91 million lives.

Because those lives don’t matter to them. Because the people dying are poor and Black and brown.

I can’t accept that. I won’t accept that. And neither should anyone who claims to value human life.

Either we believe all human life has value, or we don’t.

This is evil. And we should be ashamed.

This is what we should be saying and planning against at these meetings.

Otherwise, we’re helping to make the investment case for genocide.