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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.
Seventy years pro-life activists have called their opponents baby-killers and it did not swerve their opposition's resolve by one inch.
Conservatives, particularly MAGA conservatives, must harden their hearts as such. In the coming months and years, there will be no end to the wailing. They will beg you in the name that all that is decent and humane to give them the one exception and save many lives. The rationalist crowd will come to you with spreadsheets and lives per dollar and give logical arguments to save lives. You will be constantly bombarded with propaganda designed to psyop you to support the return of the old status quo.
Put on your biggest smile and say no. That's your cross to bear. Resist the temptation to give in, and to be seen as 'one of the good ones'. Mercy and compassion are the luxuries of the victor, and you have not won yet. This is but the first of many battles in a long war. If your opponents say that your proposals will cost millions of lives, say to them: "Billions." And do what you intended to do, and do it so throughly and completely that it does not have to be done again. Embrace the virtue of Lycurgus and destroy what you must to save what you can.
I see this somewhat regularly and I really dislike this style of comment, written like a Roman general giving a speech to the senate.
On a surface level, get a grip! You aren’t fighting a war. Most anybody here engages with politics to is to squabble on the internet and maybe vote.
On a deeper level, I think it really reflects a polarized view. The battle-lines are drawn, and you’re rallying for a cause. But in reality these issues are often not as polarized in the public as you might think. There is room between ‘change nothing’ and ‘blow it all up’.
You flatter me. I have a sophist's love of rhetoric: but if politics is serious - if it is about human life - then it should be taken seriously. I find it less moral to equivocate, to pretend that there is a difference between 'save some lives' and 'save all'. Removing the room for argument is the only way to reduce the size of government otherwise you are merely a ratchet on Leviathan's appetite.
‘Removing the room for argument’
That’s already been done. I don’t know all the details, but Trump seems to have direct authority over USAID. In theory, he/DOGE could take even a cursory look at what programs they fund and make some decisions from a rational basis. But it doesn’t seem like they have a real methodology, it’s just ‘XYZ is corrupted by the woke left, burn it all down’.
I’m fine with making things more efficient, when it comes to aid programs, grants, and regulations, I want people to be arguing over the merits. What I don’t want is for it to be all-or-nothing situation. It doesn’t have to be that way, it would be better if it wasn’t, and I simply don’t agree with your framing.
The other side of that is that leaving room for arguments just leads to the deed never actually getting done.
Imagine a situation where a patient is morbidly obese. He weighs 500 lbs. if he doesn’t lose weight, he dies. Do you start by “negotiating” about how many cheat days he gets? How many sugary drinks he’s allowed to have? How many times he gets to eat dessert? Or do you hand him a strict diet plan that tells him that if he wants to see 2035, he needs to drink only water, not eat more than 2200 calories a day, and he can’t go over. When you start from the position that the cure is negotiable, you end up coming up with excuses to continue the behaviors or in this case the spending habits because if there are loopholes, then you’ll tend to find ways to squeeze more and more programs into the loopholes and not end up doing any actual cutting. If things that are national defense are okay, everything becomes national defense. Just like if you start allowing people to declare cheat days, every day will eventually meet the criteria for a cheat day.
I take this point, and it’s certainly true that this kind of decisive action can be gummed up, but I’m not sure it applies here. It seems like the administration has free rein on program approval, they don’t have to negotiate with anybody.
To extend your metaphor, it’s like if the doctor, instead of establishing a strict calorie limit and diet plan, simply said ‘Stop eating!’. You don’t have to be that harsh, you can take a second to come up with a plan that makes sense to you, and enforce it with an iron hand.
Except that “doing it on a rational basis” means getting information about the programs, having public criteria, and sitting down with the heads of the various programs. Word of mouth will quickly out what kinds of programs (say defense) that Trump won’t cut. Then suddenly for no reason at all, everything in USAID is defense related. If you cut than later perhaps restore, there’s a good chance of most of the cuts sticking because you didn’t start out negotiating, you started by laying down the law.
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