Friends,
Thank you for circulating this.
Having read the proposal and the accompanying comments, I find myself unconvinced on moral, legal, and practical grounds.
First, the moral question.
The central purpose of global health programs is to prevent disease, disability, and death. Programs such as PEPFAR earned bipartisan support over many years precisely because they achieved measurable results at extraordinary scale. When funding interruptions lead to treatment disruptions, vaccine shortages, or reduced disease prevention, the costs are not theoretical. They are borne by real people, often among the most vulnerable populations on Earth.
One can debate the structure of aid. One can debate oversight mechanisms. What should not be debatable is whether preventable suffering is preferable to promoting health care. A policy that reduces human survival in order to improve negotiating leverage strikes me as a strange definition of success.
Second, the legal question.
Congress appropriates foreign-aid funds for public purposes established in law. The traditional justification for these programs has been humanitarian assistance, public health, diplomacy, development, and national security. The proposal appears to replace those purposes with an explicitly transactional model in which assistance is conditioned on economic concessions or geopolitical alignment.
That is not merely a different administrative model. It is a different conception of what the aid is for.
If the objective is obtaining mineral rights, market access, or other economic consideration, we should be honest enough to call that a bargain rather than a gift.
Third, the practical question.
The proposal assumes that America's greatest comparative advantage is its ability to extract concessions. I would argue the opposite.
The United States became influential not merely because it was wealthy or powerful, but because other nations generally believed American commitments were connected to larger ideals and institutions. We gained influence by helping others, not by presenting every interaction as a property transaction.
The authors seem to imagine that replacing multilateral cooperation with dozens of bilateral agreements will somehow reduce bureaucracy. This is a fascinating theory. Most people who have ever tried to manage contracts would assume that one agreement is simpler than thirty-five agreements. Apparently the laws of administrative complexity have now been repealed alongside USAID.
Likewise, the suggestion that bilateral deals are inherently easier to audit than large established programs deserves some scrutiny. Creating a separate negotiation, compliance, reporting, and enforcement structure for each country is not obviously a recipe for simplicity. It sounds more like a recipe for additional paperwork, just distributed into smaller piles.
I am also skeptical of the claim that aid becomes more effective when recipients know assistance can be suspended for political reasons. Hospitals, vaccination campaigns, and HIV treatment programs tend to function best when they can plan more than one election cycle ahead.
Most importantly, this proposal misunderstands what made programs like PEPFAR valuable. Their purpose was not merely charity. They were instruments of soft power. They advanced humanitarian goals while simultaneously increasing American influence, goodwill, stability, and security.
To abandon a demonstrably successful soft-power strategy in favor of a system that resembles conditional commercial bargaining is an odd choice. It is rather like selling your house to finance the purchase of a lawnmower. At the end you will possess an excellent lawnmower and no house.
You have written that "only time will tell."
That is certainly true.
Time will tell whether countries prefer long-term partnerships or short-term transactions.
Time will tell whether influence is built through trust or leverage.
Time will tell whether America's reputation is strengthened by turning health assistance into a negotiation over benefits owed to the United States.
My own expectation is that nations will sign such agreements when they have no alternative, but will not mistake compulsion for friendship. History suggests that genuine allies are created by reliability, not by conditionality.
In the meantime, I remain persuaded that the older approach, though imperfect, saved lives, advanced American interests, and reflected values worth defending.
Regards,
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