When Disaster Hits Home for a Global Aid Organization

Do you believe U.S.A.I.D. has fulfilled its mission under the Trump administration?

U.S.A.I.D. is the one agency that gets to make huge investments in lifting up the world’s most vulnerable people. For less than 1 percent of the federal budget, we put eight million girls in school in Afghanistan, we turned the lights on in Mogadishu after Al Qaeda was cleared out, so people could come out and restart society. We’ve helped 40 million people move out of poverty and hunger. It’s a vision of American leadership.

But during Covid, the act of turning the other way — of asking other nations to support America with protective equipment, with diagnostic supplies, with key necessary tools, and then of pulling out of the World Health Organization — has so dramatically undermined America’s role as the global health leader in the world, that the clear answer to your question is, “No.”

One thing I learned during my time in government was, like it or not, American leadership defines the degree to which the world can cooperate to tackle our toughest problems. When we exit that role, no one can take our place. We should embrace that role.

At what point did reports about the coronavirus set off all your alarm bells?

No one has that kind of perfect hindsight, but I first started to really believe this was going to be a very significant problem while I was having coffee with Tedros Adhanom Ghebreyesus, the director general of the W.H.O., at Davos. The next day, he had to go back to Geneva to host the big meeting on whether or not to declare this a public health emergency of international concern. We have worked together for many years, and it just became clear that we needed a big, strong, fast response. It also became clear that people didn’t have clarity around what was happening in China, much in the same way there was not clarity on what was happening in West Africa in the early summer of 2014. For Rockefeller, I went back home and we basically restructured our health work and quickly mobilized resources, hired a pandemics expert to join our team, mobilized what over time would be a $1 billion commitment to fighting the pandemic at home and around the world.

Do you believe there was ever a chance that this did not become a pandemic? Or, given the nature of this virus, was it inevitable?

It was not at all inevitable. I think history will record that the failure to get testing right in America, and in many other places, turned what could have a manageable health crisis into a global pandemic that has wiped out $28 trillion of economic value. It was avoidable had we had ubiquitous testing.

If you look at the countries that learned from SARS, they all got it right. China, after some stumbles, put in place massive testing and effectively got it right. It’s not like it doesn’t exist, but it’s not debilitating. Kids are in school, hunger hasn’t skyrocketed, and their economies have recovered and are growing even through second and third waves.