6 ms·

> As for the article, this is modelling, not data (both the retrospective and the predictive). There is no direct causation being shown. You simply cannot make

> As for the article, this is modelling, not data (both the retrospective and the predictive). There is no direct causation being shown. You simply cannot make a claim like "X million people will die because USAID was terminated" based on this sort of evidence. It's not factual. It's not logical. Just emotionally driven claims intended to manipulate public opinion. How would one (ethically nor not) perform a randomised trial of this kind of intervention? Like, the Lancet definitely hop on far too many bandwagons for my taste, but it's almost certain that the withdrawal of USAID will cause ~millions of otherwise avoidable deaths. And ultimately, it's the choice of the US government and people whether or not to fund these programmes. Personally, I think that they are worthwhile, but others may disagree. But really, you're holding the evidence required here to a very high standard, one that many things you believe would probably not meet.

dekhn 8d ago
Thanks, this is more thoughtful than most of the replies I've seen. I don't think anybody proposed or considered running a randomized trial. I feel like the evidence standard has to be extremely high if you're claiming that tens of millions of people are going to die in the next few years with the goal of blocking a program from being defunded. Otherwise it's just emotional manipulation- "fight the change by making up numbers that sound bad".
- disgruntledphd2 7d ago
  > I feel like the evidence standard has to be extremely high if you're claiming that tens of millions of people are going to die in the next few years with the goal of blocking a program from being defunded. I mean, this is basically the evidence standard that we use for flu/respiratory illness deaths, along with lots of other hard to measure interventions. Personally, even if there were no deaths due to USAID being removed, it would still have been a strategically bad thing for the US government to do, in terms of soft power. Additionally, the US are noted in development circles for circular aid, in that they gave a lot, but then required it all to be spent on US goods, so it was more of a subsidy for domestic producers. I do agree that lots of people just jump on these numbers uncritically, because of prior beliefs about Musk/Trump/DOGE, but it would be very very surprising if there weren't lots of avoidable deaths due to the cutting off of aid. Like, the same thing could have been accomplished in a much better way by tapering off the aid as programmes expired.

dekhn 8d ago

Thanks, this is more thoughtful than most of the replies I've seen. I don't think anybody proposed or considered running a randomized trial. I feel like the evidence standard has to be extremely high if you're claiming that tens of millions of people are going to die in the next few years with the goal of blocking a program from being defunded. Otherwise it's just emotional manipulation- "fight the change by making up numbers that sound bad".

disgruntledphd2 7d ago
> I feel like the evidence standard has to be extremely high if you're claiming that tens of millions of people are going to die in the next few years with the goal of blocking a program from being defunded. I mean, this is basically the evidence standard that we use for flu/respiratory illness deaths, along with lots of other hard to measure interventions. Personally, even if there were no deaths due to USAID being removed, it would still have been a strategically bad thing for the US government to do, in terms of soft power. Additionally, the US are noted in development circles for circular aid, in that they gave a lot, but then required it all to be spent on US goods, so it was more of a subsidy for domestic producers. I do agree that lots of people just jump on these numbers uncritically, because of prior beliefs about Musk/Trump/DOGE, but it would be very very surprising if there weren't lots of avoidable deaths due to the cutting off of aid. Like, the same thing could have been accomplished in a much better way by tapering off the aid as programmes expired.