Former acting assistant administrator for global health Nicholas Enrich published an account titled "Into the Wood Chipper" last week, describing the pause and dissolution of the US Agency for International Development under the Trump administration. The title was taken from a comment by Elon Musk on Doge cuts at the agency.

Within days of taking office in January last year, Donald Trump issued a temporary pause on USAID funding. Two months later, a formal dissolution of the agency was announced, and by July last year, with over 80% of USAID programs canceled, it was officially merged into the State Department.

The State Department sent a cable memo to US embassies urging host nations to sign a declaration rejecting the US's role as the top provider of humanitarian assistance in favor of business relationships that create opportunities for US companies.

"The 5200 contracts that are now cancelled spent tens of billions of dollars in ways that did not serve, (and in some cases even harmed), the core national interests of the United States," US Secretary of State Marco Rubio wrote on X in March last year. He wrote that "The remaining 1,000 or so contracts would then be administered by the state department."

Oxfam estimated that "The effect of these cuts on people is dire: at least 23 million children stand to lose access to education, and as many as 95 million people would lose access to basic healthcare, potentially leading to more than 3 million preventable deaths per year." Enrich, an expert in drug-resistant tuberculosis, issued a memo in March 2025 outlining the risks of freezing foreign aid, concluding the freeze would have severe domestic and global consequences. He was put on administrative leave fewer than 30 minutes after the memo was published.

Addressing concerns voiced by Trump appointees that USAID was providing abortions, Enrich said: "I didn't know whether to laugh or cry. USAID didn't provide abortions to anyone. In fact, we had strict legal prohibitions on that."

Enrich said administration officials lied about operations inside the agency, citing Musk falsely claiming that Ebola activities had been restarted on the same day that contracts were canceled. He also described early-warning disease systems being dismantled.

"Outbreaks that start abroad do not respect international borders, and USAID had invested hundreds of millions of dollars in early-warning systems to detect potential outbreaks of diseases in countries where they originate and to deal with them before they are able to spread. But that was immediately torn down, leaving us blind to what might be developing," he said.

USAID was established in 1961 by John F. Kennedy. During the COVID-19 pandemic, the agency sent over $10bn in emergency funding to more than 120 countries.