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Scott-featured global health philanthropist and activist John Green made a video about TB treatment and USAID. tl;dw, TB is the brick-shithouse of bacteria, so treatment takes 4-6 months, but the good news is that people mostly aren't contagious during treatment. Stopping treatment increases the risk of treatment-resistance, including the spread of newly-treatment-resistant strains, so interruptions in the supply chain are a major global health problem. Yes, it's bad that global health was overly reliant on the USA, but it requires government-level funding and logistics. (Unsaid, his family pledged $1m/year 2024-2027 for a USAID TB program in the Philippines, in addition to $6.5m for Partners in Health, so he's literally put his money where his mouth is.) His contacts in confirm that drug supplies are being interrupted.
Even if one wants to cut USAID, a stop-work order, rather than a phase-out, was likely a net-negative by most measures of utility.
The reason this is being done so crudely is because every less-crude attempt made in the past was stopped. If you let them slow you down they'll keep finding reasons to do it until the whole thing grinds to a halt.
There was a limited supply of veto power and it has been squandered on less important issues. Don't blame the bartender for cutting you off, blame yourself for drinking too much.
My thoughts throughout this Presidency (all three weeks of it) has been a mix of:
Damn, Trump is reckless, unprofessional, and vain.
How the fuck does he have so much ammo?
There's a plane crash? Air Traffic Controllers were hired under a racist system. Foreign aid? Transgender operas in Colombia. Funding basic science? >60% "administrative overhead" tacked on. Threaten Canada with tariffs? Suddenly our border security is a valid issue. Random whatever? $20M in subscriptions to the Associated Press, and another $1.6M to the NYT.
It feels like a weird mirror to the Texas Sharpshooter fallacy: He gives every indication of shooting blindly, but there has actually been a bullseye where he hits all along. That could be luck or good spin, but the most compelling story is that everywhere is that bad.
(Related joke: There has been a shooting at a peaceful protest! A child molester, a sexual assaulter, and a convicted felon illegally carrying a gun are the only people injured.)
I still don't think he's doing a good job, but damn does he have a strong narrative.
"Indirect costs" are overhead, and 60% is too high (much higher than average in the US right now), but it's not all administrative overhead. Everything from lab equipment and computers to the lights and air conditioning in the research buildings is being paid for by that indirect take. You could make grant recipients itemize instead, but then you either have administrators (more administrative overhead!) do the itemizing, or you have often-highly-paid researchers wasting time on figuring out what fraction of their PC upgrade needs to come out of grant A vs grant B.
This feels like the ivory tower version of "What do you mean the plumber is charging $200! He worked for an hour to replace a $50 part!" You might want to look for a cheaper plumber next time (and in this analogy, I do think it's a problem that spending other people's money doesn't give grant committees so much incentive to price shop), but if you can't find any cheaper plumbers then it might just be possible that you're not considering his whole cost accounting.
I just don’t have much belief in price discovery where the main buyer is price indifferent
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