Stephanie Nolen
Appearances
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
I think this gets to another point because these countries that have received all of this assistance, we imagine them becoming global actors who are also American allies. And the U.S. is not the only country capable of providing this kind of assistance. When I go to Zambia these days, I actually see a bigger presence from China than I do the U.S. And so not only is the U.S.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
attempting to buy some goodwill, but they're occupying space that otherwise might be taken up by other people. So it's also sort of a deliberate foreign policy play in that way.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
I will say that... Everyone I have ever spoken to who works for USAID has said that they wished that things about the organization were done differently and more efficiently and often in a way that would probably save money.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
I don't think I've ever met anyone who worked there who would not have said that there was room for significant improvement and lots of ways that things could have been done better. But I don't think any of those people would have said that even badly needed reform would look like what we've seen in the last few days.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
Yeah, it's the complete eradication of this agency with this 60-year history in hours, basically. I mean, I feel like I watched it dissolve in real time.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
Well, let me give you one example. I spoke to a scientist named Leila Mansour in South Africa at an HIV research project where I've spent a lot of time. And she was running a clinical trial to test new ways of trying to prevent HIV. And so she had a new experimental ring. It's a vaginal ring that women would wear to prevent both pregnancy and infection with HIV. And it's an early stage trial.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
So they're just testing these rings to see if they're comfortable, if they fit, that kind of thing.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
It's funded by USAID. And so this researcher, Dr. Leila, she gets up one day and she's got this stop work order from Washington. It's an order that she do no activities using U.S. funds. So that's her USAID grant money that's paying for this clinical trial.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
So she's, in fact, not supposed to have any further communication with these women from the community who are now wearing this experimental ring. She's not even supposed to tell them that she's no longer allowed to take care of them.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
Yeah. So Dr. Layla told me that she couldn't accept that as a doctor, as an ethical scientist. And she arranged with her team to bring all of these women immediately into the clinic and to have them remove the rings and collect them and make sure that everybody was okay and just try to explain to them that the U.S. had suddenly withdrawn its funding and the trial was over. Wow.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
And I really wondered, listening to her, what that felt like for those women. This is a community that I know pretty well, where literally generations of people have volunteered their bodies for science. Some of the best HIV treatments and prevention mechanisms we have have been tested on these communities.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
So as you can imagine, there's a real relationship of trust between these people who volunteer and these scientists. And so I asked Dr. Leila to connect me with someone who'd been in her clinical trial. And I spoke to a young woman named Azanda Zondi. And she told me about how bizarre it was to just get this phone call that said, come in right away tomorrow morning.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
We're going to take out the ring. The trial is over. And she told me how, you know, she and the other women in the trial were talking to each other saying, like, what do you think has happened? And of course, the explanation they've been given is like kind of a non-explanation, right? Which leaves you wondering, like, and she said, you know, really fearful.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
And are you being told the whole truth and what's really happening? Right. And listening to Dr. Leila, like you could see how this relationship of trust that is foundational to the kind of scientific research the U.S. has wanted to do around the world for, you know, years and years is just shattered instantly.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
You know, I think in that one relationship in South Africa, you see a kind of overnight switch from appreciation to mistrust and fear. And I think like writ large, that's what I've seen really in every conversation. And, you know, I've had 30 or 40 of them a day for the
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
people have gone from deeply, deeply valuing this relationship that has either made their work possible or kept their kids alive or kept them alive to a response that just feels extraordinarily capricious and cruel and profoundly isolating. And so, you know, I guess the thing that really stands out for me is that you could cut the amount the US spends on foreign aid.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
You could dramatically change the way the US spends money on foreign aid. But it would be very hard to overstate the degree of damage that has been done to those relationships with individuals and with governments around the world by the events of the last few days.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
So it's roughly a third. If you think about USAID having a budget of about $40 billion, about $12.5 billion of that was spent on healthcare.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
I would have to think for a long time to think of a trip when I have not come across either U.S.-funded research or medications or humanitarian assistance.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
And one of the big ones is the HIV program, which was started at the height of, you know, if you think back 20 years to when there were almost 30 million people living with HIV in sub-Saharan Africa and no treatment, and people were dying in just these extraordinary numbers.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
And at that point, President George W. Bush created this emergency AIDS response program, and it has brought life-saving HIV medication to millions and millions of people. Today, there's about 21 million people who rely on that program for that medication.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
It's been responsible for getting drugs to hundreds of thousands of women with HIV who were giving birth to make sure that their babies weren't infected. Wow. Less well-known, but I would argue about as important, is something called the President's Malaria Initiative. And it does malaria control programs across the countries that have the highest burden of malaria.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
And they do an extraordinary range of things from helping people put the chemicals in water supply to control mosquitoes, giving out bed nets. giving out malarial treatments, supporting the research that finds new drugs to control the parasites.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
They've played, I would say, like an essential role in the fact that deaths from malaria were cut in half over the last 15 years that the program was operating.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
I think one really basic but important thing is that it really directly touches people's lives, right? You're getting help and it's made clear to you where that help is coming from. So the medications you get, emergency supplies, Tents, food aid, it all comes branded with the words, a gift of the people of the United States, right? And it's a message from the U.S.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
government saying, we are here for you in this difficult moment, in your moment of need. We are a compassionate and benevolent actor. We are good guys who care about you. We're on your team. And that's like viewed as laying a kind of cornerstone for a positive foreign policy relationship.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
Exactly. You're taking your baby in to get TB medication and the little counter that they're sitting your kid up on to weigh and examine them has a little American flag in the corner. This is not a nefarious actor, right? This is a country that's here to help. And then I think, you know, it's also important to recognize that this, of course, is not only about goodwill. There are
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
is economic value in a lot of this for America and American companies.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
You know, as I look back over kind of 25 years of covering the response to the AIDS epidemic, keeping those people alive was the right thing to do, you know, in human terms. It also had economic payoff, right? Like, I used to go to Zambia, for example, and report when close to a third of people people who would be your productive workforce, like people between the ages of about 18 and 45.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
A third of those people had untreated HIV. So now, today, 20 years later, thanks in large part to this U.S.-funded program, almost all of those people with HIV are on treatment. They're back to work. They don't even think about it. And... That's obviously incredibly valuable for them, for their families, but it also had an economic impact on the country, right?
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
Like it became a much more economically stable country when it was not being crippled by HIV. And is it kind of grim to think about it in these terms? Sure, but if you're looking for a justification for the investment of American taxpayer dollars, well, Zambia has a very busy mining sector. The U.S. has a lot of mining interests there, including agreements for electric vehicle supply chains.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
So I think it's pretty clear that this was the right thing to do in human terms. It also had direct economic benefit to the United States.
The Daily
The Demise of U.S.A.I.D. — and American Soft Power
That's exactly right. And every year or every couple of years, a USAID partner country kind of graduates from the roles of foreign assistance and stops being a country that's getting USAID and becomes just a trading partner. Like there is ultimately long-term economic payoff in something like helping a community get bed nets and malaria treatment in all of their rural clinics. Yeah.