Seriously? As mentioned, it’s 5 dollars for the average tax payer and 0.08% of the U.S. federal budget. It’s a small prize to pay for millions of lives.
”It didn't address concerns about American tax dollars going outside of America“
But epidemics and global instability affect everyone? Even if we're just talking about infectious diseases - treating them in other countries prevents them from getting to the US - that makes sense, right?
It didn't really address the objections or look at the other side. It didn't mention the harms of taxation or the huge debt crisis looming. It didn't address concerns about American tax dollars going outside of America. Also the tone created very negative associations with this viewpoint and people who hold it.
I think this fails to address the most common objections to PEPFAR: "I Don't Know How To Explain To You That You Should Not Give The Tiniest Flying Fuck About Other People And You Are A Gay Libtard If You Do", and "I am extremely racist and I love it when people in Africa die"
So yeah, all the dead babies, but also for a minuscule portion of our budget we get to wield enormous leverage over nations that provide us with goods and resources? Leverage which will now fall to Russia/China/Iran/Whatever country you're afraid of? Why are we giving up a valuable foreign policy tool that costs us a tiny portion of our tax dollars and probably provides economic benefits far in excess of that? Even if you're a genuinely evil person and don't care that we get to save millions of lives at extremely low cost, maybe you aren't stupid?
You really think these other countries care that much about a relatively small amount of funding for HIV prevention? These are third world countries, corrupt, repressive, and religious. I'm sure it would be more effective to bribe the leaders directly, if that's what you're actually trying to do.
There's some sleight-of-hand here - this type of soft power isn't why anyone is doing the program, and if that type of soft power is really the goal, then we should focus on that and find the best and most efficient way to do that, rather than just conjecturing that something you're arguing for on separate grounds might help with it.
It strikes me as very unlikely that HIV prevention is the most effective way of currying favor with corrupt leaders. Corrupt leaders care about their own interests, not a stigmatized disease that affects hoi polloi.
This is the one good argument in favor of ending PEPFAR, but ending the non-effective parts of USAID seem more effective at achieving that goal and has less accompanying harms.
Ah, see, as a fan of American power, this is one of the strongest arguments for *keeping* PEPFAR. (Ozy might find it interesting how we come to the same conclusion having opposed value structures.)
Because we're a global superpower and we often have reasons to fuck around in other countries doing things they don't approve of, and those countries will be more willing to swallow that if they're friendly with us and they associate that friendship with lifesaving AIDS treatment.
E.g., if we're sending some special forces/CIA types to go hunt terrorists or suppress communists or whatever, and they get caught, we want the reaction to be "we're friends so I'll pretend I didn't see that" instead of "how dare you, you imperialist dogs, we will kick out your diplomats and execute the spies."
And on the flip side, we don't want China or Russia to be able to form similar relationships, in case *they* want to fuck around in other countries doing things we don't approve of. Having these relationships is the cost of being a global superpower.
(Sure, you can say "why do we want to be a global superpower at all?" but I thought that was kinda implied by the "Make America Great Again" slogan.)
You really think they care that much about a relatively small amount of funding for HIV prevention? These are third world countries, corrupt, repressive, and religious. I'm sure it would be more effective to bribe the leaders directly, if that's what you're actually trying to do.
There's some sleight-of-hand here - this type of soft power isn't why anyone is doing the program, and if that type of soft power is really the goal, then we should focus on that and find the best and most efficient way to do that, rather than just conjecturing that something you're arguing for on separate grounds might help with it.
It strikes me as very unlikely that HIV prevention is the most effective way of currying favor with corrupt leaders. Corrupt leaders care about their own interests, not a stigmatized disease that affects hoi polloi.
You asked how this program gives us leverage, so I answered that question. Don't get mad because I didn't answer an entirely different question about whether George Bush *really* intended it to serve as a source of soft power.
>I'm sure it would be more effective to bribe the leaders directly, if that's what you're actually trying to do.
I'm not sure that's true at all. If it's so easy, then why don't most countries have a "bribing foreign despots" fund instead of a "foreign aid" fund? After all, unlike the US, other countries aren't trying to maintain a reputation as a global force for democracy, so why not just go ahead and spend all their foreign aid money on bribes instead? Why is China funding its massive Belt and Road Initiative instead of just paying for whatever access it needs?
Even *Russia* has a foreign aid program. And not just financial or military assistance, they've also done classic things like sending people to Guinea to fight an Ebola outbreak. I'm not enough of a scholar to explain why this strategy is more effective than directly bribing people, but empirically, most of the world has concluded that helping poor people is a useful way to gain influence in other countries.
thanks for doing this. Much needed. It's an historic tragedy - maybe a crime - that the US is killing people by destroying our foreign assistance system. The US has never been especially generous in foreign aid, but due to our size, we've always been very important. It's a trivial amount of money for the US, but keeps millions alive. A good estimate of the human mortality of the 90-day aid freeze is 100,000 dead. https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.26431. This isn't quite right for several reasons, but gives you a sense of the order of magnitude.
Shouldn't that money go towards Americans? Why are the lives of non-Americans being considered in how American tax dollars are spent?
And also, what about the debt? We're hugely in debt and this is a crisis that, much like global warming, needs to be addressed right away before it causes a huge disaster.
Apply the reversal test - should we go a lot more in debt to save a lot more non-Americans, at the expense of future Americans?
1) American prosperity is largely due to America's presence at the center of an international system it built to benefit itself and its allies. The cost of goods in your local store is dependent on a network of trade agreements, the maintenance of the world's largest navy keeping waterways free of pirates, and numerous other soft-power flexes sometimes involving USAID. Asking this question is like asking why a business should spend money on the products of other companies instead of just dividing its bank account between its employees: any short-term gain experienced by the employees would be quickly outweighed by the loss of income owing to not having jobs.
Furthermore the lives of non-Americans are considered in American tax spending because a majority of Americans place non-zero value on the lives of foreigners and vote to spend money in ways that reflect this belief. As noted by the author, we all pay taxes for things that we don't like. This is how democracy works. If you believe that all taxes should be opt-out on an item-by-item basis, you are welcome to run for Congress and propose a bill to that effect.
2) You may not have noticed, but the Republican party is currently attempting to cut taxes such that net government revenue will be decreased by much more than the disassembly of USAID could ever increase it. If the deficit concerns you, I suggest that you write to your representatives asking them to cease attempting to cut taxes and raise them instead.
3) Recall that PEPFAR consists of 0.08% of the federal budget. Review point 1) above.
I thought this was about PEPFAR, not USAID. The grounds for dismantling USAID are that it generally does bad things.
I don't see what PEPFAR has to do with America's prosperity - that certainly was not discussed in Ozy's piece.
I did notice that the GOP is increasing the debt with tax cuts, yes. I think that's very bad policy. But the debt is a looming huge crisis, and raising taxes is not politically feasible, so we have to cut spending. Ideally we'd both massively cut spending and massively raise taxes, yes.
Honest question: Have you read the first thing about these topics you apparently care so deeply about? For example the first paragraph of the introduction of the detailed report this post links to in its own first paragraph? It would tell you that USAID implements such vital parts of PEPFAR as drug orders, a very important thing for a program that distributes antiretroviral therapy.
You see, agencies in the US government do multiple things. They help each other. When you delete one without accounting for all of its functions, apparently unrelated projects regarding numerous areas of concern are rendered inoperable. This is why it's very important to not do what Trump just did.
If you are truly concerned that some USAID activities destabilize foreign governments, I suggest isolating those programs and halting their operation in a controlled way instead of disbanding the whole agency.
As for what it has to do with American prosperity, a known behavior of diseases is that they spread. With the novel inventions of boats and airplanes, diseases have been known to spread between landmasses separated by water, such as Africa and North America. Indeed, this is how a disease native to Africa arrived in the United States to begin with! Thus, improving global health has significant knock-on effects for local health. You may feel confident that no extant virus will ever mutate into a more severe form that resists conventional treatment due to our allowing it to brew unchecked among billions of people, but I think most people will recall that this in fact happened just five years ago. It also did serious damage to the global economy and local prices, another point for defending American prosperity by not suffering diseases to spread.
Regarding the budget, going to go over this one more time, just to make sure you have seen all the numbers. As of FY 2023:
Do you perhaps see that cutting foreign aid to zero would make no difference to the deficit?
If you would object to raising taxes on political feasibility grounds, I invite you to consider the feasibility of cutting medicare, medicaid, and social security, which make up the vast majority of federal spending and would have to be severely cut to zero out the deficit without raising taxes. The Republicans' new spending bill details exactly this plan. They are trying to make this proposal palatable to the average voter through the rhetoric method known as 'lying'. This is because they know everyone hates that way more than they hate raising taxes. If anything, negative sentiment towards people in top income brackets is higher than at any point since the Great Depression. If you would like to explore serious solutions to reducing the deficit, I repeat what others have said and invite you to read the work of Jessica Riedl: https://xcancel.com/JessicaBRiedl
I agree the new GOP spending bill is very stupid, and that foreign aid alone will not make much of a dent in the deficit. My point was not that cutting foreign aid will solve all our problems, just that we have a huge crisis so spending needs to be justified.
Ok, just to track points you're not arguing here to see if we can mark anything as a settled issue because we keep roaming over a range of topics:
-Do you now see that dissolving major executive agencies has serious knock-on effects, particularly that PEPFAR is de-facto inactive if USAID is destroyed the way it has been?
-Do you agree now that PEPFAR and USAID are relevant to the prosperity of the United States, and that spending on them gives Americans significant benefits?
-Riedl's plan focuses entirely on modifications to medicare and social security spending as well as adopting European-style taxation. It mentions foreign aid only twice, both times dismissing the idea of cutting it to reduce the deficit because it is so vanishingly small that it has no relevance to the problem. Does this change your opinion at all?
Overall, you've asked for PEPFAR spending to be justified and people have given justifications to you in various terms across the comments. What more do you want exactly?
HIV is an *infectious* disease. If a bunch of people on another continent get HIV and then it acquires ART resistance - that will absolutely be our problem, sooner or later. Americans will die over it.
I'd happily take that reversal test! If I could double PEPFAR's lives saved I would spend 0.08% more of the federal budget.
If you're that concerned about the national debt, going after 0.08% of the federal budget is a waste of time.
Think about all the harm that program does, entrenching anti-sex-work attitudes in numerous organizations. Think about all the sex workers that will suffer.
Think about all the sex workers and other people who will suffer and die from AIDS without PEPFAR. It's better to be prejudiced against than to be dead.
I believe being born poor and/or in another country shouldn't be a death sentence. All lives have (equal) value. So, yes I think American tax dollars should be spent this way. Also it's a trivial expense in the scheme of the US federal budget or US economy. Cutting Pepfar and killing many hundreds of thousands of people will not meaningfully reduce the US deficit or debt.
Congress appropriated the fund, they were allocated, and service providers planned and expected them, quite reasonably. Services are in place and patients rely on them and the US has never filched this way before. The Trump regime is - probably illegally - cutting off funding with no advanced warning. Ethically, that's the equivalent of killing them.
If the Trump regime provided some notice and transition, expended existing funds, wrapped things up in an orderly way, I think there could be an ethical defense of it.
Another example is cutting us US support for maternal care - treating new mothers experiencing severe bleeding. The clinics were just shut down with no warning or replacement. I think the Trump regime killed the mothers who will die as a consequence and orphaned their kids.
I intended to connect “JC” to its most common meaning “Jesus Christ” and my interpretation of his gospel as it relates to charity and helping the least of these.
And he was clearly talking about voluntary contributions from individuals. I think it's an error to conflate government spending (bad) with charitable contributions (good).
Don't take it personally, he thinks that about almost everything. Saying "X is not about X, X is about signalling" is basically Robin Hanson's catchphrase.
Great post, I will likely link it and/or the Report directly next time I'm trying to defend USAID online (which will no doubt be in the next 10 minutes).
One thing, though- your link for 'quack science that puts innocent people in prison' is just to a book about forensic science. Is there a specific citation intended to support that assertion? What even is the assertion? Are you saying forensic science, in general, is quackery? Because that seems obviously wrong.
Most forensic science is quackery! DNA isn't, obviously, and some areas of forensic science like fingerprinting or ballistics have limited use. But mostly the entire field is pseudoscientific nonsense. I particularly recommend chapter 5 of the linked report, where the National Academy of Sciences exhaustively debunks numerous kinds of forensic science.
I think what people think of when they think of forensic science is mostly fingerprinting and DNA, though. And they do in actuality make up a significant portion of the practice of forensic science. So it seems at least very misleading, if not outright incorrect, to say that 'mostly the entire field is pseudoscience', when it largely comprises methods you agree are scientifically valid, and those valid methods are exactly what people take to mean by 'forensic science'.
Either way, when you link a whole book about forensic science as your citation for 'quack science', it gives the apparently misleading impression that that's your opinion of the field in its entirety, I think. Maybe the citation should specify chapter 5?
PEPFAR is just one part of the US' foreign aid. It's not hard to defend USAID at all, because they do lots of important and demonstrably effective things like PEPFAR.
Yes they do! PEPFAR is independent of control of USAID, not totally unrelated!
> On January 24, when the State Department announced a stop-work order on most foreign assistance, PEPFAR clinics shuttered. After two weeks of intense bipartisan lobbying, the State Department issued waivers intended to allow some PEPFAR programs to continue, but since PEPFAR contracts with USAID for drug orders and other functions, USAID closures have left PEPFAR services paused.
This is the second time I've personally explained this to you!
> That American tax dollars are taken from Americans and should be used for the benefit of Americans, not to save non-American lives.
I think most people expect that their tax gives *some* amount to charity (i.e. to people not in the tax base). How *much* is appropriate? Jesus recommended 100%. The apostles recommended 100% in theory for the original Christian community in Jerusalem, but in practice a lot of that was reinvested in the individual and a lot was reinvested in the same community. Many religious and secular communities recommend choosing 10-15% and treating that as appropriate in practice.
In practice, most people expect to give much less. Maybe a couple of percent. People are often confused about how much countries actually give. Typically they *assume* the figure is much higher, guess that it ought to be one or two percent, and it actually *is* distinctly less than 1 percent.
Ozy's article says PEPFAR is 0.08% of US tax revenue. 99% of people think that's appropriate in theory, but some people get outraged about some PEPFAR because they image money is wasted elsewhere or the % is much higher than it is. I think arguing for 0% foreign aid is a niche position, and as Ozy says, you just have to accept that most people want more than 0%.
I'm not convinced that's actually true. We did elect Trump.
> I think most people expect that their tax gives *some* amount to charity (i.e. to people not in the tax base).
A little off-topic, but why would you only consider it charity when it goes to people not in the tax base? The majority of our tax dollars go to help the disabled, elderly, veterans, and poor in this country - why isn't that charity?
First, while the cost of this program may be small, it's one of many. This same logic would apply to many, many other government programs. Accept it, and what are the grounds for rejecting other programs? Once you accept this, you're on the hook for hundreds of others.
Second, we're dealing with a huge looming disaster that we need to start addressing as soon as possible - the debt. This money that's being spent is money we don't have. It's one thing to debate how to spend money we have. It's quite another to be over our heads in debt, out of money, and debating how to spend more. Apply the reversal test - should we go more into debt and save more non-American lives, at the cost of impoverishing future Americans? American tax dollars should be used for Americans.
The debt is like global warming: no one wants to think about it, people hope we can somehow solve the problem through less painful means, but it will take painful cuts and reductions to prevent a disaster.
Finally, I just looked at the law authorizing this program ( https://www.congress.gov/bill/108th-congress/house-bill/1298/text ), and I'm incredibly disturbed. It says the government should be promoting abstinence and monogamy and should be opposing sex work, and no money can go to any organization unless it has an explicit policy against sex work! This is truly terrible. I do not want my money going to this and I don't understand how anyone pro-poly and pro-sex-work can support it.
I find it genuinely baffling why you wouldn't care about people thousands of miles away dying horrible preventable deaths, but would care about them being taught to be monogamous.
Many Americans care about people in other countries, and elected Congresspeople who passed a popular bipartisan law that saved 19.5 million lives. This IS for Americans! Specifically, the portion of Americans who want their money to be spent this way!
If you want to tackle the debt you need to tackle Social Security and the military! Jessica Riedel, a conservative commenter who has spent her entire career researching how to reduce the budget deficit, has come out in favor of PEPFAR: https://x.com/JessicaBRiedl/status/1895227195771232406 It is not that much money, and it saves an extraordinary number of lives. The U.S. government does almost no programs as good as PEPFAR.
> The U.S. government does almost no programs as good as PEPFAR.
If so, a reasonable compromise would be to allow the administration to stop all other foreign aid, like we want, but keep PEPFAR. If that's the price of stopping all other foreign aid, I'd accept it.
This is sort of a motte/bailey thing where PEPFAR is the motte and USAID and foreign aid in general is the bailey. "Look how great PEPFAR is! Now spend more money on all this antisemitic, anti-American stuff abroad."
Thanks for the Riedl link - I do agree we need to tackle social security and the military, massively cut spending in every category, massively increase taxes to the extent politically feasible, and look for other creative ways of generating revenue as well.
> I find it genuinely baffling why you wouldn't care about people thousands of miles away dying horrible preventable deaths, but would care about them being taught to be monogamous.
IIRC you are poly and pro-sex-work - it doesn't bother you that this is basically being used as an excuse to push truly odious views? Why do you think W signed it? The law is full of stuff about "faith-based" organizations.
People will always be dying of preventable deaths. We don't have an obligation to prevent that as a country (even if we do individually, that should be paid by individuals). But I'm much more upset about our tax dollars being used to push these horrible views on others, with saving lives being the excuse for doing so.
So the answer to your bafflement is that one is an act, one is an omission that doesn't really concern us.
I'm pretty skeptical about a lot of USAID's programs. I think USAID has historically had a very toxic culture that almost completely rejects evidence about whether its programs work or not. (There's a reason PEPFAR is independent from USAID.) I was really excited about Dean Karlan's work making USAID more effective. The current approach to USAID cuts is absurd (as Dean Karlan has said, while quitting the agency >.<) but I'm absolutely in favor of smarter spending there.
I am pro-PEPFAR because PEPFAR is really really good. I don't think this commits me to support all other foreign aid. I am like 70% an aid skeptic, but that's compatible with believing that PEPFAR is one of the best things America has ever done.
I think W signed PEPFAR because, for better or for worse, he *was* an idealist and he genuinely wanted to make the world a better place. Everything I've read about it implies that he actually just thought it was bad for people to die when we could fix it.
If somewhat suboptimal sex ed is the price I have to pay-- in a democratic society where I compromise with people of different viewpoints-- for getting antiretrovirals in the hands of sick people, I will gladly pay it.
So W is the only major-party candidate I've ever voted for, other than Trump... I voted Libertarian in 2008, '12, and '16.
And yes, he was a compassionate conservative. But he was also very Christian and pushed those values inappropriately, in combination with preventing deaths.
But I think you are severely underestimating the serious harm PEPFAR does! It's not just "somewhat suboptimal sex ed" - it forces large numbers of organizations to adopt anti-sex-work and pro-abstinence, pro-monogamy positions, which will affect hiring in those organizations and change attitudes and organizational policies for decades to come. That will cause serious harm to sex workers, penalizing and criminalizing them further, as well as to LGBTQ and poly people.
You have a very odd value system if you think compromising on some obligatory "abstinence only" seminars to get the conservatives on board is worse than failing to prevent of tens of millions of AIDS deaths.
I feel like even if you buy the act/omission distinction, abruptly stopping aid that people are relying on is more like an act: I may have no obligation to give you a ride, but if I kick you out of my car in the middle of nowhere, to make your own way home or die trying, I'm clearly harming you.
This could argue for not establishing PEPFAR in the first place, or for winding it down faster, but not for suddenly stopping it, leaving people without medicine after you've told them "come here every month to pick up this medicine, and take it every day, or you will die".
No, I see each individual continuation of PEPFAR as a separate act. Since none of it is obligatory in any way, just doing it for a few years can't make it obligatory. Obviously everyone has always known that we could always stop it - we did not and could not meaningfully commit to continuing the program for eternity.
It seems like a troubling precedent to say that paying once obligates us to continue (and if that were true, we definitely should never start any foreign aid programs, for fear of them becoming an obligation!)
The car ride analogy is not a good one because a car ride is a specific discrete unit promised in advance with a specific endpoint.
Okay, so would you at least agree that passing a bill guaranteeing PEPFAR funding through 2030 perhaps constitutes a promise to actually fund it through 2030 that we would be obligated to fulfill, only then winding down involvement and transferring control to other organizations? I think the car ride analogy fits perfectly given that we did in fact promise a discrete unit in advance with a specific endpoint.
No, everyone understands that Congress frequently changes its mind and reallocates funding or amends or repeals bills, and that Congress has the power to do that, so that no bill can guarantee anything. Congress doesn't have the power to lock itself in like that. So no one can reasonably rely on a bill many years into the future.
If there really were "hundreds of other" programs as effective as PEPFAR (there aren't), then the US could save a billion lives with 4% of it's budget. And you view this as a BAD thing?
If you sat down in a room and watched one person die every single second, it would take you 31 years to get through a billion people. Please imagine yourself sitting through those 31 years of constant death, and then afterwards being like "nah, a 4% cut in the deficit is more important than this".
I assume you think the debt crisis is a problem because it's bad for people. But how can the effect possibly worse than a death every second for 30 years?
I think the debt crisis is a problem because it's bad for AMERICANS.
If those billions of people are not Americans, it's simply not an issue for the US government to address with our tax dollars. Not everything needs to be done by the government. Let people's private donations handle that.
Ok but at least don't screw the organisations out of payment for services already rendered! My private donations aren't handling shit if you also sabotage them!
The grounds for accepting PEPFAR over other programs is that it has a greater impact than most of them. I don't see what's complicated about this. Run a cost-benefit analysis, set a standard for how much altruistic bang for our buck we want, and cut everything below that number. This is budgeting 101.
Seems like you're making the mistake of confusing effectiveness with justification. We have no obligation and no reason to spend money on even a really effective program, if that program doesn't help us.
And it'd make more sense to fix a dollar amount, rather than an efficiency threshold, otherwise we might exceed our available budget if there are many effective interventions available.
". We have no obligation and no reason to spend money on even a really effective program"
Do you think no one ever has even "reason" (never mind obligation for the moment) to spend money on charity, outside of weird cases where doing so directly promotes their self-interest?
If not, why can't a *collective* of people have non-zero reason to give to charity, if individuals can? Presumably if individuals can have some reason to give to charity that's because the fact that something would advance a valuable goal gives you (non-zero) reason to do it, even if it's not personally advantageous. Why would that apply to individuals but not collectives (of which nations are one example)? If you buy the logic at all, nothing about it obviously suits individual decision-making better than collective decision-making.
That hardly supports a no reason claim though, it just adds a balancing reason on the other side. It also applies exactly as much to US government attempts to improve the lives of US citizens as to PEPFAR or other attempts by the US government to help foreigners. But you seem to be trying to categorically rule out the former not the latter.
> First, while the cost of this program may be small, it's one of many. This same logic would apply to many, many other government programs. Accept it, and what are the grounds for rejecting other programs? Once you accept this, you're on the hook for hundreds of others.
I answered you.
> And it'd make more sense to fix a dollar amount, rather than an efficiency threshold, otherwise we might exceed our available budget if there are many effective interventions available.
I assure you, the United States government has never been in danger of driving itself off a budgetary cliff over foreign aid.
The concern is not that the government will drive itself off a cliff over foreign aid.
The concern is that your proposed methodology is not useful because there's generally a fixed budget for foreign aid interventions, and your proposed methodology wouldn't stick to the budget.
Honestly, the more important question is not whether PEPFAR or other foreign aid should be funded.
The question is who should decide.
The US is a democracy with the elected president in charge of the executive branch. So even if you or I disagree, protecting democracy is a lot more important, and it needs to be the president's decision.
It is, in fact, *Congress's* decision, not the president's. But also, that's just an entirely separate matter? This is straight out of "Arguments From My Opponent Believes Something" (https://slatestarcodex.com/2013/06/13/arguments-from-my-opponent-believes-something/). (Indeed, I thought this one was in the sequel, but I can't find that right now?) We can, in fact, argue both over the object level of the correct course of action and separately over the decision system for the government to use. Saying "we should do X instead of what the government is currently doing" means you think the people in charge of the government should make different decisions -- not that you think you should overthrow the government!
Well, I don't think it is "in fact" Congress's decision - Congress *could* certainly legislate specifically on this, but has not.
I agree, both are valid questions. I'm saying the political one is much more important. And often people conflate the two.
As to your last point, a lot of people seem to think it means that it shouldn't be the president's decision. Tell that to all the people filing litigation on things like this.
> Well, I don't think it is "in fact" Congress's decision - Congress *could* certainly legislate specifically on this, but has not.
Is this not, in fact, the purpose of the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003? Like, what, you think George W. Bush just authorized PEPFAR on his own? He cannot in fact do that! The money has to come from a Congressional spending bill!
> As to your last point, a lot of people seem to think it means that it shouldn't be the president's decision. Tell that to all the people filing litigation on things like this.
Yeah, because it's Congress's! The President does not, in fact, have the authority to unilaterally impound funds! They're saying it *factually is not* the president's decision -- not making the argument you seem to be imputing to them, that because the president is getting it wrong it isn't his decision!
> I agree, both are valid questions. I'm saying the political one is much more important.
Yes, it does appropriate money for various purposes, including antiretroviral treatment. Interestingly, it also says:
"the President is authorized to furnish assistance, **on such terms and conditions as the President may determine**, for HIV/AIDS" (p. 18 of the pdf)
So it does seem that the president has some discretion. How much wiggle room does this give him? Unclear. The impoundment control act does prevent him from withholding funds, but it may be unconstitutional - we'll have to see what happens. Also, what if he doesn't withhold the funds, but once the funds are distributed to his Coordinator, he instructs the Coordinator to slow-walk them? Or what if he doesn't appoint a Coordinator, or appoints only people Congress rejects?
The law also provides for the president to make a determination, regarding money going to the Global Fund, that a country supports terrorism and can withhold money on that basis. (p.15)
> Thanks for the reference to the law! I just looked at the text.
I will reiterate here is that part of my point is that you can be reasonably certain that such a law must exist without having to find the particular law!
> Also, what if he doesn't withhold the funds, but once the funds are distributed to his Coordinator, he instructs the Coordinator to slow-walk them? Or what if he doesn't appoint a Coordinator, or appoints only people Congress rejects?
That is arguably within his authority! Without anything explicit to resolve such a conflict I'd call it an open question until the courts rule on it. But also, if you're in that position that they have to rule on it, you're basically already in something of a constitutional crisis. I would consider this one of the problems with the American system of having an independently-elected president. Given that the president's job is to execute on legislation, having him elected by the people instead of by the legislature allows these sorts of conflicts to occur. Things have largely worked so far due to presidents caring enough about doing their stated job (or just not causing constitutional crises, or not doing things that are unpopular), but now we may see what happens when that's not the case...
So yes, you can safely guess that Congress appropriated money somehow, but the relevant questions are how specific the appropriation was (anything for global health? Fighting HIV specifically? Distributing ARVs specifically?) and how much discretion the administration has.
> I'd call it an open question until the courts rule on it. But also, if you're in that position that they have to rule on it, you're basically already in something of a constitutional crisis.
Huh? No, that's not a constitutional crisis at all. That's the system working as intended. Conflicts arise and the courts perform their assigned function of ruling on the conflicts. How is that a crisis? That's exactly what's supposed to happen. Courts ruling on things is part of the system.
In the spirit of this FAQ, today I learned that there are currently two elective absolute monarchies in the world: Vatican City and the United States of America.
Nope, the president is not an absolute monarch. He's just in charge of the executive branch.
But please tell me, since I hear this from people (mostly on the left) quite a lot - what is causing this misunderstanding?
Do you genuinely not see a difference between being in charge of the executive branch and being an absolute monarch? Are you exaggerating for effect? Do you know that there's a difference but you're pretending there isn't for political purposes?
"exaggerating for effect, but with increasing concern"
Restated: I think that de facto wholesale destruction, by the executive, of agencies created by law is, at best, a clear abuse of executive power, as the executive has a constitutional duty to faithfully execute the law. I therefore believe that your view to the contrary reflects a dangerously expansive view of executive power. This is particularly so because you said not just that the president has a right to make the decision, but that "protecting democracy is a lot more important, it needs to be the president's decision", as if it's undemocratic for the president to be subordinate to democratically enacted law.
(I am of course assuming that Congress has appropriated money for this specific purpose, I haven't checked.)
No, of course the president has to follow properly enacted law, but that law is subordinate to the constitution, which puts the president in charge of the executive branch, and so there's a limit as to how much congress can limit executive power.
I was of course assuming that Congress hadn't passed a law specifically requiring this program to continue. Typically there's some discretion given to the executive.
The point of the executive branch is to *execute* policies passed by Congress. Congress has passed a bill funding PEPFAR. The President has refused to execute this policy. Either:
1) You agree that the power of the executive is limited to reasonable discretion in carrying out laws passed by Congress and outright refusing to carry out a law constitutes a breach of authority, in which case welcome to the Resistance.
2) You think that the President can just decide to do or not to do things as suits their mood, making the authority of Congress mostly hypothetical and the distance between the US government and an elected monarchy an increasingly theoretical question.
Yes, it does appropriate money for various purposes, including antiretroviral treatment. Interestingly, it also says:
"the President is authorized to furnish assistance, **on such terms and conditions as the President may determine**, for HIV/AIDS" (p. 18 of the pdf)
So it does seem that the president has some discretion. How much wiggle room does this give him? Unclear. The impoundment control act does prevent him from withholding funds, but it may be unconstitutional - we'll have to see what happens. Also, what if he doesn't withhold the funds, but once the funds are distributed to his Coordinator, he instructs the Coordinator to slow-walk them? Or what if he doesn't appoint a Coordinator, or appoints only people Congress rejects?
The law also provides for the president to make a determination, regarding money going to the Global Fund, that a country supports terrorism and can withhold money on that basis. (p.15)
I agree, protecting democracy is important. In fact, that's why we all went to Maidan when our president started abusing his powers and why he's still hiding from us in moscow with his dictator friends.
The Vox article you link to is very weird in that it seems to assume that there is no value to great works of art. Clearly there is - a great cathedral or painting is worth many, many people's lives.
"Clearly there is - a great cathedral or painting is worth many, many people's lives."
The word "clearly" is doing a lot of work in that sentence. What's your rationale for saying a painting (however great you like) is worth many, many lives?
Well, the alternative would seem to be the Repugnant Conclusion - that it's better to have a large number of impoverished lives lacking art or other good things in life, than to have a small number of lives full of flourishing.
The Repugnant Conclusion is self-evidently wrong, so the alternative is that there are some goods that are worth lives, and it should be clear that among the best of them would be art.
If you don't understand why art is valuable and important to humans, I'm not even sure where to start, but there have been many books written about it. A human life lacking in aesthetic value just seems worthless to me. We might as well be monkeys.
You could also look at revealed preference - people spend a lot of money on art, entertainment, their own hobbies, their own pleasures - rather than saving dying kids, so clearly these things are important to people.
You've moved the goalposts. Your last post wasn't about the value of whether or not art exists. You said that one painting is worth "many, many lives". Again: what's your rationale for that? How many people would you be willing to sacrifice per painting?
I don't think I moved the goalposts at all. I'm not sure what's missing here. For art to exist, or to thrive, or to exist in sufficient amounts or quality, money has to go towards it, right. That money could have gone to saving lives.
The context here was the vox article which said that money going to repair a cathedral could have gone to save some people's lives instead. Which is true for money going to any form of art.
So it's not that I'd shoot a bunch of people for the sake of art! It's just that any money used for anything could have gone to save lives. There's a difference between me personally killing people, versus allocating funding so that some of the funding goes to art rather than saving lives.
I think I explained the rationale - if art is important, some amount of money needs to go to it and should go to it, and that money could have been used to save lives.
$5 million for a great painting works out to about 1000 lives, so I guess at least that many, if not more.
Okay, while we don't disagree on the basic point (lives being more valuable if there's art and other things making them present, and therefore art being worth a non-zero amount of lives), I think 1,000 lives for a single painting is crazy. I mean, one painting? I can't think of a painting worth prioritizing over saving 1,000 lives, whether by Van Gogh or whoever.
Well we don’t usually think of money in terms of lives, that’s why it seems crazy. Spending a few million dollars on renovating a government building or something is also 1000 lives.
I'm aware population ethics is finickly, but I'm pretty sure you can avoid the repugnant conclusion without committing to killing taking away "many, many people's lives" to save an empty building.
I think you may have a very confused and nonstandrad version of the repugnant conclusion in mind, can you explicit what you think it is supposed to say?
No it doesn't? Where are you getting that from? The article actually explicitly calculates and compares the costs of the two, inviting the reader to compare their value, which you'll notice is basically the exact opposite of assuming one has none.
> It’s useful to imagine walking down Main Street, stopping at each table at the diner Lou’s, shaking hands with as many people as you can, and telling them, “I think you need to die to make a cathedral pretty.” And then going to the next town over and doing it again, and again, until you’ve told 47,500 people why they have to die.
> can I imagine going down Main Street and telling people they need to die for Notre Dame? Of course not.
> If I were to file effective altruism down to its more core, elemental truth, it’s this: “We should let children die to rebuild a cathedral” is not a principle anyone should be willing to accept. Every reasonable person should reject it.
Where in that is there discussion or even recognition of the value of art to humanity? It's trivialized down to "make a cathedral pretty" as though the Repugnant Conclusion were the only value.
Yeah, I think that quite clearly does *not* assume works of art have no value. In fact I think it assumes the opposite!
Clearly, the author does not think that the Notre Dame is worth fifty thousand human lives. But the whole passage wouldn't really make sense if she thought it had *zero* value. And beyond 'clearly less than 50 thousands human lives', she doesn't even make it clear what that value is! It could be quite large.
The point of the passage is to be an intuition pump, to make you realise how many people 47,500 is. The point is not to denigrate the importance of art, but to illustrate the scale of good that could be done with it instead. If you have a contrary intuition to the author's (and I suspect most readers'), and truly think you *would* kill tens of thousands of peopel to rebuild a cathedral, you're entitled to that view- but you've misinterpreted the passage if you think it "assumes there is no value to great works of art".
Well, we disagree on the interpretation of that passage, then. I think it takes it for granted that no reasonable person could value art as worth human lives, and says that explicitly. I think the passage makes no sense if the author does value art. It doesn't even seem that the author thinks discussing the value of art is worth considering.
It's hard for me to imagine most readers would agree with the author, as that's a pretty extreme EA viewpoint.
Also, no one is talking about "killing" anyone, just letting people die by not spending scarce resources on them, people who we have no duty towards.
> I think it takes it for granted that no reasonable person could value art as worth human lives, and says that explicitly.
Well it simply... doesn't. The passage does not say those words, nor anything semantically equivalent.
> I think the passage makes no sense if the author does value art.
Well, it does. I think everyone else understood it! It would make no sense if the author valued *this* work of art at more than 47,500 lives- but I don't think anyone sincerely does, as the thought experiment was meant to illustrate.
> It's hard for me to imagine most readers would agree with the author, as that's a pretty extreme EA viewpoint.
Agree with the author about what? The author doesn't really even express a view in the passage in question. She simply describes a thought experiment, that I don't think you've quite followed.
> Also, no one is talking about "killing" anyone, just letting people die by not spending scarce resources on them, people who we have no duty towards.
Well the thought experiment assumes there is no act/omission distinction, as I think is clearly correct. Killing someone and letting someone die if you could easily prevent it are morally equivalent; if you disagree, you're welcome to argue for a distinction, but no-one in the history of analytic philosophy has yet managed to do so convincingly:
> The passage does not say those words [no reasonable person could value art as worth human lives], nor anything semantically equivalent.
> Agree with the author about what? The author doesn't really even express a view in the passage in question.
Huh? The passage does clearly say exactly that. I already quoted it:
"If I were to file effective altruism down to its more core, elemental truth, it’s this: 'We should let children die to rebuild a cathedral' is not a principle anyone should be willing to accept. Every reasonable person should reject it."
> no-one in the history of analytic philosophy has yet managed to do so convincingly
Thanks for the SEP link. But it says the opposite of your last claim: for instance, Foot, Quinn, and Kamm are all cited in that SEP article as giving accounts of the distinction, and many other philosophers have done so as well.
This is of course a heavily debated question in moral philosophy with solid arguments on both sides. Most people - and most moral philosophers - generally think there is a difference though. I think it is clear that the government deliberately and cold-bloodedly killing a bunch of innocent people is much worse than making the budgeting decision to not spend money that we don't have in order to save a few more lives.
> It would make no sense if the author valued *this* work of art at more than 47,500 lives- but I don't think anyone sincerely does, as the thought experiment was meant to illustrate.
Hmm? Many people sincerely do. I certainly do. The flaw in the thought experiment / intuition pump is that it relies mostly on the emotional power of imagining telling someone you're condemning them to death and then making your reason sound as trivial as possible.
No, it really doesn't. It covers other topics but doesn't actually justify spending money to help people in other countries. It seems to adopt the effective altruist position that people are worth the same no matter what country they're in.
you are correct that the post is built on an assumption that it is good to help people. even if you must stipulate that some people are of more value than others many people would still agree that it is good to help them. this is a common assumption in our culture and you should focus on disagreeing with it (if that is how you feel) instead of pretending it isn't there.
I can kinda see it? You could see the US government as Americans forming a club to help each other (for coordination and redistribution), and putting money in a common pot for that purpose. It's a bit rude if George then waltzes in and demands to use the club's funds for some emergency rather than for club activities, even if the emergency is genuinely dire and the club is a tad frivolous.
I think I'd be pretty sympathetic to that argument in the context of paying down the national debt (rather than increasing the deficit by several trillion) and stopping programmes that don't help and indeed harm Americans (Ozy gives many examples).
Because they are paid by Americans. And not by choice, but because we have to. By threat of force.
The justification for that is that we're participating in this society and taxes are the price for that. So if taxes go to help the country, that's one thing, but when they are forcibly stolen from you and given to help another country, that's at least presumptively wrong.
You could make a case that some foreign aid is in the US's interest, but Ozy didn't do that, and that has to be balanced against the huge looming crisis facing our country: the debt. Just like global warming, the debt has to be dealt with using painful cuts to avoid disaster.
Worth the same in some abstract moral sense, sure.
We're talking about using American tax dollars to pay for this, though, and those should be used for Americans. This is not an "edgelord" position. I suspect it may be the majority view.
What do you mean an "abstract moral sense"? When you questioned the "effective altruist position that people are worth the same", what else did you think that was but a claim about morality?
In any case, I'm glad you now seem to have accepted that "effective altruist position".
It seems incoherent, though, to accept that and nonetheless think we should arbitrarily prioritise certain people. What's your reasoning for that?
I meant, people may have the same intrinsic worth, in some objective sense, but that doesn't dictate how we should allocate resources.
Like a friend or family member has the same worth as a stranger, but if you are personally choosing who to save, you'd presumably save the person you're close to.
I thought the EA position was a claim not just about moral worth, but about action. I don't agree with it.
I don't believe it's arbitrary in any way to prioritize Americans with American tax dollars. As I explained in another comment, that money was stolen from Americans based on the justification that it's the cost for living in American society. So that money should go to benefit American society.
Very few people truly believe that we should spend the same amount of money to help strangers as we do to help those of the same nationality. Indeed, we do not. However, most people agree that if somebody could get lifesaving medicine for an amount of money that is insignificant to your personal wellbeing, you should give them that money. Considering PEPFAR's cost per-person is approximately $4-5, it appears to pass this test. Further evidence for this claim is that it has been passed by a majority of the representatives of the American public, suggesting most people are in favor of it.
If you truly believe all tax spending should be completely self-contained, most of the people in the country appear to disagree with you.
He did not, in fact, do this. Project 2025 was written with the goal of gutting the federal government, but Trump repeatedly disavowed having anything to do with this idea. If anything, it's likely that about half of his voters were betting that we would have something like the impotent Trump 2016 who talked about crazy nonsense every week but accomplished nothing other than appointing two Supreme Court justices. Trump ran on "America First", whatever that means, but to most people it meant deporting undocumented immigrants and reducing legal immigration. That much I will gladly concede a majority of Americans are in favor of. As for USAID, I doubt most people knew it existed a month ago.
As for your second point, uh, yeah? There was not anybody running on the "no foreign aid" platform because people didn't want that? Do you think all those republicans kept voting to extend PEPFAR for kicks? Anybody could have formed the Zero Foreign Aid block of congressional representatives at any point without a change in presidential administration. Seriously, how are you having trouble with this concept?
I'm saying that if you divide PEPFAR's annual cost by the population of the United States, it costs each taxpayer about $4-5 per year. This is proportionate with giving a five dollar bill to a homeless person to buy lunch, something that I would guess most Americans do at least once a year. Given that the typical American is willing to make at least one trade per year at the cost/benefit ratio of $5/one meal, I think there is substantial evidence that they would be in favor of paying $5 to reduce global HIV by the amount shown in this post's graph.
> This is proportionate with giving a five dollar bill to a homeless person to buy lunch
"lunch" lol.
To address your actual point - I would be interested to see a survey on the question of asking Americans to pay $5 a year to reduce HIV in Africa. But there's a big difference between an individual choosing to pay that money, and the government stealing it from you at gunpoint and forcing you to do it. That's really the issue. Just because Americans might choose to pay $5 to Africa doesn't mean that our tax dollars should be used that way.
He spoke many times at his rallies about not sending money to other countries. This isn't something new or a surprise.
Did you really think Trump was a huge foreign aid fan? Did anyone think that?
> There was not anybody running on the "no foreign aid" platform because people didn't want that? Do you think all those republicans kept voting to extend PEPFAR for kicks? Anybody could have formed the Zero Foreign Aid block of congressional representatives at any point without a change in presidential administration. Seriously, how are you having trouble with this concept?
People did want that, but their elected representatives did not.
This is exactly how Trump rose to power. He observed that there was a significant gap between what Republican voters wanted and what Republican politicians said.
As you said, voters wanted to deport people who are legally deportable and reduce immigration, and almost no politicians wanted that, so he took advantage of that gap, said the things voters wanted, and got elected.
Same for foreign aid. There was a consensus in favor of foreign aid among the Republicrat elites. Basically no politician spoke out against it, despite the voters hating foreign aid. So Trump got elected, in part, by talking a lot about other countries taking advantage of us and us saving money by not sending it to other countries. This was a huge theme of all his rallies and speeches.
I think I speak for the entire choir when I say that this was some truly excellent preaching.
As someone not in the choir, it did not convince me at all - if anything, it made me more determined to stop all foreign aid and vote conservative.
Why?
“It didn't mention the harms of taxation“
Seriously? As mentioned, it’s 5 dollars for the average tax payer and 0.08% of the U.S. federal budget. It’s a small prize to pay for millions of lives.
”It didn't address concerns about American tax dollars going outside of America“
What exactly do you mean by that?
That American tax dollars are taken from Americans and should be used for the benefit of Americans, not to save non-American lives.
But epidemics and global instability affect everyone? Even if we're just talking about infectious diseases - treating them in other countries prevents them from getting to the US - that makes sense, right?
No. We can't treat the whole world. It's not our responsibility.
It didn't really address the objections or look at the other side. It didn't mention the harms of taxation or the huge debt crisis looming. It didn't address concerns about American tax dollars going outside of America. Also the tone created very negative associations with this viewpoint and people who hold it.
I think this fails to address the most common objections to PEPFAR: "I Don't Know How To Explain To You That You Should Not Give The Tiniest Flying Fuck About Other People And You Are A Gay Libtard If You Do", and "I am extremely racist and I love it when people in Africa die"
So yeah, all the dead babies, but also for a minuscule portion of our budget we get to wield enormous leverage over nations that provide us with goods and resources? Leverage which will now fall to Russia/China/Iran/Whatever country you're afraid of? Why are we giving up a valuable foreign policy tool that costs us a tiny portion of our tax dollars and probably provides economic benefits far in excess of that? Even if you're a genuinely evil person and don't care that we get to save millions of lives at extremely low cost, maybe you aren't stupid?
As I said to beleester:
You really think these other countries care that much about a relatively small amount of funding for HIV prevention? These are third world countries, corrupt, repressive, and religious. I'm sure it would be more effective to bribe the leaders directly, if that's what you're actually trying to do.
There's some sleight-of-hand here - this type of soft power isn't why anyone is doing the program, and if that type of soft power is really the goal, then we should focus on that and find the best and most efficient way to do that, rather than just conjecturing that something you're arguing for on separate grounds might help with it.
It strikes me as very unlikely that HIV prevention is the most effective way of currying favor with corrupt leaders. Corrupt leaders care about their own interests, not a stigmatized disease that affects hoi polloi.
This is the one good argument in favor of ending PEPFAR, but ending the non-effective parts of USAID seem more effective at achieving that goal and has less accompanying harms.
Ah, see, as a fan of American power, this is one of the strongest arguments for *keeping* PEPFAR. (Ozy might find it interesting how we come to the same conclusion having opposed value structures.)
Huh? How is that an argument for ending it?
I like countries in the global periphery being allowed to develop and dislike crimes against humanity.
Are you saying the US stops them from developing and commits crimes against humanity? Oh boy, now the Chomskyites are coming out of the woodwork...
Open a book.
By Chomsky no doubt
How do we wield enormous leverage? This is a case that needs to be explicitly made, and which Ozy should have addressed in his FAQ:
Q: How does this program actually benefit Americans?
A: ...
Because we're a global superpower and we often have reasons to fuck around in other countries doing things they don't approve of, and those countries will be more willing to swallow that if they're friendly with us and they associate that friendship with lifesaving AIDS treatment.
E.g., if we're sending some special forces/CIA types to go hunt terrorists or suppress communists or whatever, and they get caught, we want the reaction to be "we're friends so I'll pretend I didn't see that" instead of "how dare you, you imperialist dogs, we will kick out your diplomats and execute the spies."
And on the flip side, we don't want China or Russia to be able to form similar relationships, in case *they* want to fuck around in other countries doing things we don't approve of. Having these relationships is the cost of being a global superpower.
(Sure, you can say "why do we want to be a global superpower at all?" but I thought that was kinda implied by the "Make America Great Again" slogan.)
You really think they care that much about a relatively small amount of funding for HIV prevention? These are third world countries, corrupt, repressive, and religious. I'm sure it would be more effective to bribe the leaders directly, if that's what you're actually trying to do.
There's some sleight-of-hand here - this type of soft power isn't why anyone is doing the program, and if that type of soft power is really the goal, then we should focus on that and find the best and most efficient way to do that, rather than just conjecturing that something you're arguing for on separate grounds might help with it.
It strikes me as very unlikely that HIV prevention is the most effective way of currying favor with corrupt leaders. Corrupt leaders care about their own interests, not a stigmatized disease that affects hoi polloi.
You asked how this program gives us leverage, so I answered that question. Don't get mad because I didn't answer an entirely different question about whether George Bush *really* intended it to serve as a source of soft power.
>I'm sure it would be more effective to bribe the leaders directly, if that's what you're actually trying to do.
I'm not sure that's true at all. If it's so easy, then why don't most countries have a "bribing foreign despots" fund instead of a "foreign aid" fund? After all, unlike the US, other countries aren't trying to maintain a reputation as a global force for democracy, so why not just go ahead and spend all their foreign aid money on bribes instead? Why is China funding its massive Belt and Road Initiative instead of just paying for whatever access it needs?
Even *Russia* has a foreign aid program. And not just financial or military assistance, they've also done classic things like sending people to Guinea to fight an Ebola outbreak. I'm not enough of a scholar to explain why this strategy is more effective than directly bribing people, but empirically, most of the world has concluded that helping poor people is a useful way to gain influence in other countries.
thanks for doing this. Much needed. It's an historic tragedy - maybe a crime - that the US is killing people by destroying our foreign assistance system. The US has never been especially generous in foreign aid, but due to our size, we've always been very important. It's a trivial amount of money for the US, but keeps millions alive. A good estimate of the human mortality of the 90-day aid freeze is 100,000 dead. https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.26431. This isn't quite right for several reasons, but gives you a sense of the order of magnitude.
Shouldn't that money go towards Americans? Why are the lives of non-Americans being considered in how American tax dollars are spent?
And also, what about the debt? We're hugely in debt and this is a crisis that, much like global warming, needs to be addressed right away before it causes a huge disaster.
Apply the reversal test - should we go a lot more in debt to save a lot more non-Americans, at the expense of future Americans?
1) American prosperity is largely due to America's presence at the center of an international system it built to benefit itself and its allies. The cost of goods in your local store is dependent on a network of trade agreements, the maintenance of the world's largest navy keeping waterways free of pirates, and numerous other soft-power flexes sometimes involving USAID. Asking this question is like asking why a business should spend money on the products of other companies instead of just dividing its bank account between its employees: any short-term gain experienced by the employees would be quickly outweighed by the loss of income owing to not having jobs.
Furthermore the lives of non-Americans are considered in American tax spending because a majority of Americans place non-zero value on the lives of foreigners and vote to spend money in ways that reflect this belief. As noted by the author, we all pay taxes for things that we don't like. This is how democracy works. If you believe that all taxes should be opt-out on an item-by-item basis, you are welcome to run for Congress and propose a bill to that effect.
2) You may not have noticed, but the Republican party is currently attempting to cut taxes such that net government revenue will be decreased by much more than the disassembly of USAID could ever increase it. If the deficit concerns you, I suggest that you write to your representatives asking them to cease attempting to cut taxes and raise them instead.
3) Recall that PEPFAR consists of 0.08% of the federal budget. Review point 1) above.
I thought this was about PEPFAR, not USAID. The grounds for dismantling USAID are that it generally does bad things.
I don't see what PEPFAR has to do with America's prosperity - that certainly was not discussed in Ozy's piece.
I did notice that the GOP is increasing the debt with tax cuts, yes. I think that's very bad policy. But the debt is a looming huge crisis, and raising taxes is not politically feasible, so we have to cut spending. Ideally we'd both massively cut spending and massively raise taxes, yes.
Honest question: Have you read the first thing about these topics you apparently care so deeply about? For example the first paragraph of the introduction of the detailed report this post links to in its own first paragraph? It would tell you that USAID implements such vital parts of PEPFAR as drug orders, a very important thing for a program that distributes antiretroviral therapy.
You see, agencies in the US government do multiple things. They help each other. When you delete one without accounting for all of its functions, apparently unrelated projects regarding numerous areas of concern are rendered inoperable. This is why it's very important to not do what Trump just did.
If you are truly concerned that some USAID activities destabilize foreign governments, I suggest isolating those programs and halting their operation in a controlled way instead of disbanding the whole agency.
As for what it has to do with American prosperity, a known behavior of diseases is that they spread. With the novel inventions of boats and airplanes, diseases have been known to spread between landmasses separated by water, such as Africa and North America. Indeed, this is how a disease native to Africa arrived in the United States to begin with! Thus, improving global health has significant knock-on effects for local health. You may feel confident that no extant virus will ever mutate into a more severe form that resists conventional treatment due to our allowing it to brew unchecked among billions of people, but I think most people will recall that this in fact happened just five years ago. It also did serious damage to the global economy and local prices, another point for defending American prosperity by not suffering diseases to spread.
Regarding the budget, going to go over this one more time, just to make sure you have seen all the numbers. As of FY 2023:
-Spending on all foreign aid was $71.9 billion.
-Total Federal spending was $6.1 trillion.
-Total Federal revenue was $4.4 trillion.
https://www.pewresearch.org/short-reads/2025/02/06/what-the-data-says-about-us-foreign-aid/
Do you perhaps see that cutting foreign aid to zero would make no difference to the deficit?
If you would object to raising taxes on political feasibility grounds, I invite you to consider the feasibility of cutting medicare, medicaid, and social security, which make up the vast majority of federal spending and would have to be severely cut to zero out the deficit without raising taxes. The Republicans' new spending bill details exactly this plan. They are trying to make this proposal palatable to the average voter through the rhetoric method known as 'lying'. This is because they know everyone hates that way more than they hate raising taxes. If anything, negative sentiment towards people in top income brackets is higher than at any point since the Great Depression. If you would like to explore serious solutions to reducing the deficit, I repeat what others have said and invite you to read the work of Jessica Riedl: https://xcancel.com/JessicaBRiedl
Thanks for telling me about xcancel! Looks like her site is here: https://www.jessicariedl.blog/ and she's trans too!
looks like she writes some good stuff. And I approve of making fun of progressives haha.
https://manhattan.institute/article/the-progressives-empty-policy-agenda-utopian-promises-are-not-backed-up-with-serious-legislation
here's the actual plan - it looks like a good start, though I think more reductions are needed than just stabilizing the debt at 100%.
https://manhattan.institute/article/a-comprehensive-federal-budget-plan-to-avert-a-debt-crisis-2024
I agree the new GOP spending bill is very stupid, and that foreign aid alone will not make much of a dent in the deficit. My point was not that cutting foreign aid will solve all our problems, just that we have a huge crisis so spending needs to be justified.
Ok, just to track points you're not arguing here to see if we can mark anything as a settled issue because we keep roaming over a range of topics:
-Do you now see that dissolving major executive agencies has serious knock-on effects, particularly that PEPFAR is de-facto inactive if USAID is destroyed the way it has been?
-Do you agree now that PEPFAR and USAID are relevant to the prosperity of the United States, and that spending on them gives Americans significant benefits?
-Riedl's plan focuses entirely on modifications to medicare and social security spending as well as adopting European-style taxation. It mentions foreign aid only twice, both times dismissing the idea of cutting it to reduce the deficit because it is so vanishingly small that it has no relevance to the problem. Does this change your opinion at all?
Overall, you've asked for PEPFAR spending to be justified and people have given justifications to you in various terms across the comments. What more do you want exactly?
HIV is an *infectious* disease. If a bunch of people on another continent get HIV and then it acquires ART resistance - that will absolutely be our problem, sooner or later. Americans will die over it.
I'd happily take that reversal test! If I could double PEPFAR's lives saved I would spend 0.08% more of the federal budget.
If you're that concerned about the national debt, going after 0.08% of the federal budget is a waste of time.
How do you feel about the program pushing Christian anti-sex anti-poly anti-sex-work moral values? That doesn't concern you?
If that's what it takes to keep the program running, I can make my peace.
Think about all the harm that program does, entrenching anti-sex-work attitudes in numerous organizations. Think about all the sex workers that will suffer.
Think about all the sex workers and other people who will suffer and die from AIDS without PEPFAR. It's better to be prejudiced against than to be dead.
I believe being born poor and/or in another country shouldn't be a death sentence. All lives have (equal) value. So, yes I think American tax dollars should be spent this way. Also it's a trivial expense in the scheme of the US federal budget or US economy. Cutting Pepfar and killing many hundreds of thousands of people will not meaningfully reduce the US deficit or debt.
So we're not "killing" anyone. They're dying of AIDS. We're simply not allocating funds to help them.
Congress appropriated the fund, they were allocated, and service providers planned and expected them, quite reasonably. Services are in place and patients rely on them and the US has never filched this way before. The Trump regime is - probably illegally - cutting off funding with no advanced warning. Ethically, that's the equivalent of killing them.
If the Trump regime provided some notice and transition, expended existing funds, wrapped things up in an orderly way, I think there could be an ethical defense of it.
Another example is cutting us US support for maternal care - treating new mothers experiencing severe bleeding. The clinics were just shut down with no warning or replacement. I think the Trump regime killed the mothers who will die as a consequence and orphaned their kids.
Your username is deeply ironic
Why?
I regret making that drive by comment. Sorry.
I intended to connect “JC” to its most common meaning “Jesus Christ” and my interpretation of his gospel as it relates to charity and helping the least of these.
Those are my initials not his!
And he was clearly talking about voluntary contributions from individuals. I think it's an error to conflate government spending (bad) with charitable contributions (good).
The EU comission shall step in. Pelase, send a letter to President von der Leyen:
https://forum.effectivealtruism.org/posts/CCHwPXCTRNKdnyYbk/the-anti-aids-program-pepfar-the-european-union-must-replace
I’ve been so frustrated about this that I’ve been bothering to fight people on Twitter/X about it https://x.com/lydialaurenson/status/1893709188552909144
What are we even doing as a society anymore
ps however I gotta say I disagree that Christianity is about signaling, though I can also see why someone would think that
Don't take it personally, he thinks that about almost everything. Saying "X is not about X, X is about signalling" is basically Robin Hanson's catchphrase.
It depends on the Christian, of course. Jesus explicitly criticized the people who treat it as signaling.
This is extremely concentrated, weapons-grade sarcasm. I love it.
Do you think it was effective in persuading anyone? Or is that not a concern?
Great post, I will likely link it and/or the Report directly next time I'm trying to defend USAID online (which will no doubt be in the next 10 minutes).
One thing, though- your link for 'quack science that puts innocent people in prison' is just to a book about forensic science. Is there a specific citation intended to support that assertion? What even is the assertion? Are you saying forensic science, in general, is quackery? Because that seems obviously wrong.
Most forensic science is quackery! DNA isn't, obviously, and some areas of forensic science like fingerprinting or ballistics have limited use. But mostly the entire field is pseudoscientific nonsense. I particularly recommend chapter 5 of the linked report, where the National Academy of Sciences exhaustively debunks numerous kinds of forensic science.
I think what people think of when they think of forensic science is mostly fingerprinting and DNA, though. And they do in actuality make up a significant portion of the practice of forensic science. So it seems at least very misleading, if not outright incorrect, to say that 'mostly the entire field is pseudoscience', when it largely comprises methods you agree are scientifically valid, and those valid methods are exactly what people take to mean by 'forensic science'.
Either way, when you link a whole book about forensic science as your citation for 'quack science', it gives the apparently misleading impression that that's your opinion of the field in its entirety, I think. Maybe the citation should specify chapter 5?
Fingerprinting is also basically junk science
Yes. Even fingerprinting is basically junk science.
USAID? Or PEPFAR? Defending PEPFAR is one thing, but it's hard to defend USAID...
PEPFAR is just one part of the US' foreign aid. It's not hard to defend USAID at all, because they do lots of important and demonstrably effective things like PEPFAR.
They don't. They don't even do PEPFAR!
They spread anti-American and antisemitic attitudes.
Yes they do! PEPFAR is independent of control of USAID, not totally unrelated!
> On January 24, when the State Department announced a stop-work order on most foreign assistance, PEPFAR clinics shuttered. After two weeks of intense bipartisan lobbying, the State Department issued waivers intended to allow some PEPFAR programs to continue, but since PEPFAR contracts with USAID for drug orders and other functions, USAID closures have left PEPFAR services paused.
This is the second time I've personally explained this to you!
For people who are interested and want to help, some orgs have set up temporary bridging funds for USAID: https://forum.effectivealtruism.org/posts/FTTPCtkizkAQ9fkvM/unicode-wvyp
From another reply:
> That American tax dollars are taken from Americans and should be used for the benefit of Americans, not to save non-American lives.
I think most people expect that their tax gives *some* amount to charity (i.e. to people not in the tax base). How *much* is appropriate? Jesus recommended 100%. The apostles recommended 100% in theory for the original Christian community in Jerusalem, but in practice a lot of that was reinvested in the individual and a lot was reinvested in the same community. Many religious and secular communities recommend choosing 10-15% and treating that as appropriate in practice.
In practice, most people expect to give much less. Maybe a couple of percent. People are often confused about how much countries actually give. Typically they *assume* the figure is much higher, guess that it ought to be one or two percent, and it actually *is* distinctly less than 1 percent.
Ozy's article says PEPFAR is 0.08% of US tax revenue. 99% of people think that's appropriate in theory, but some people get outraged about some PEPFAR because they image money is wasted elsewhere or the % is much higher than it is. I think arguing for 0% foreign aid is a niche position, and as Ozy says, you just have to accept that most people want more than 0%.
I'm not convinced that's actually true. We did elect Trump.
> I think most people expect that their tax gives *some* amount to charity (i.e. to people not in the tax base).
A little off-topic, but why would you only consider it charity when it goes to people not in the tax base? The majority of our tax dollars go to help the disabled, elderly, veterans, and poor in this country - why isn't that charity?
Well done. Nothing is going to change for 2-4 years. But you have to try.
There are a couple things that you're missing:
First, while the cost of this program may be small, it's one of many. This same logic would apply to many, many other government programs. Accept it, and what are the grounds for rejecting other programs? Once you accept this, you're on the hook for hundreds of others.
Second, we're dealing with a huge looming disaster that we need to start addressing as soon as possible - the debt. This money that's being spent is money we don't have. It's one thing to debate how to spend money we have. It's quite another to be over our heads in debt, out of money, and debating how to spend more. Apply the reversal test - should we go more into debt and save more non-American lives, at the cost of impoverishing future Americans? American tax dollars should be used for Americans.
The debt is like global warming: no one wants to think about it, people hope we can somehow solve the problem through less painful means, but it will take painful cuts and reductions to prevent a disaster.
Finally, I just looked at the law authorizing this program ( https://www.congress.gov/bill/108th-congress/house-bill/1298/text ), and I'm incredibly disturbed. It says the government should be promoting abstinence and monogamy and should be opposing sex work, and no money can go to any organization unless it has an explicit policy against sex work! This is truly terrible. I do not want my money going to this and I don't understand how anyone pro-poly and pro-sex-work can support it.
I find it genuinely baffling why you wouldn't care about people thousands of miles away dying horrible preventable deaths, but would care about them being taught to be monogamous.
Many Americans care about people in other countries, and elected Congresspeople who passed a popular bipartisan law that saved 19.5 million lives. This IS for Americans! Specifically, the portion of Americans who want their money to be spent this way!
If you want to tackle the debt you need to tackle Social Security and the military! Jessica Riedel, a conservative commenter who has spent her entire career researching how to reduce the budget deficit, has come out in favor of PEPFAR: https://x.com/JessicaBRiedl/status/1895227195771232406 It is not that much money, and it saves an extraordinary number of lives. The U.S. government does almost no programs as good as PEPFAR.
> The U.S. government does almost no programs as good as PEPFAR.
If so, a reasonable compromise would be to allow the administration to stop all other foreign aid, like we want, but keep PEPFAR. If that's the price of stopping all other foreign aid, I'd accept it.
This is sort of a motte/bailey thing where PEPFAR is the motte and USAID and foreign aid in general is the bailey. "Look how great PEPFAR is! Now spend more money on all this antisemitic, anti-American stuff abroad."
Thanks for the Riedl link - I do agree we need to tackle social security and the military, massively cut spending in every category, massively increase taxes to the extent politically feasible, and look for other creative ways of generating revenue as well.
> I find it genuinely baffling why you wouldn't care about people thousands of miles away dying horrible preventable deaths, but would care about them being taught to be monogamous.
IIRC you are poly and pro-sex-work - it doesn't bother you that this is basically being used as an excuse to push truly odious views? Why do you think W signed it? The law is full of stuff about "faith-based" organizations.
People will always be dying of preventable deaths. We don't have an obligation to prevent that as a country (even if we do individually, that should be paid by individuals). But I'm much more upset about our tax dollars being used to push these horrible views on others, with saving lives being the excuse for doing so.
So the answer to your bafflement is that one is an act, one is an omission that doesn't really concern us.
I love your blog and your writing by the way!!!
I'm pretty skeptical about a lot of USAID's programs. I think USAID has historically had a very toxic culture that almost completely rejects evidence about whether its programs work or not. (There's a reason PEPFAR is independent from USAID.) I was really excited about Dean Karlan's work making USAID more effective. The current approach to USAID cuts is absurd (as Dean Karlan has said, while quitting the agency >.<) but I'm absolutely in favor of smarter spending there.
I am pro-PEPFAR because PEPFAR is really really good. I don't think this commits me to support all other foreign aid. I am like 70% an aid skeptic, but that's compatible with believing that PEPFAR is one of the best things America has ever done.
I think W signed PEPFAR because, for better or for worse, he *was* an idealist and he genuinely wanted to make the world a better place. Everything I've read about it implies that he actually just thought it was bad for people to die when we could fix it.
If somewhat suboptimal sex ed is the price I have to pay-- in a democratic society where I compromise with people of different viewpoints-- for getting antiretrovirals in the hands of sick people, I will gladly pay it.
So W is the only major-party candidate I've ever voted for, other than Trump... I voted Libertarian in 2008, '12, and '16.
And yes, he was a compassionate conservative. But he was also very Christian and pushed those values inappropriately, in combination with preventing deaths.
But I think you are severely underestimating the serious harm PEPFAR does! It's not just "somewhat suboptimal sex ed" - it forces large numbers of organizations to adopt anti-sex-work and pro-abstinence, pro-monogamy positions, which will affect hiring in those organizations and change attitudes and organizational policies for decades to come. That will cause serious harm to sex workers, penalizing and criminalizing them further, as well as to LGBTQ and poly people.
You have a very odd value system if you think compromising on some obligatory "abstinence only" seminars to get the conservatives on board is worse than failing to prevent of tens of millions of AIDS deaths.
It’s a lot more than just some seminars. Don’t underestimate the harm that pepfar does to sex workers, please.
I feel like even if you buy the act/omission distinction, abruptly stopping aid that people are relying on is more like an act: I may have no obligation to give you a ride, but if I kick you out of my car in the middle of nowhere, to make your own way home or die trying, I'm clearly harming you.
This could argue for not establishing PEPFAR in the first place, or for winding it down faster, but not for suddenly stopping it, leaving people without medicine after you've told them "come here every month to pick up this medicine, and take it every day, or you will die".
No, I see each individual continuation of PEPFAR as a separate act. Since none of it is obligatory in any way, just doing it for a few years can't make it obligatory. Obviously everyone has always known that we could always stop it - we did not and could not meaningfully commit to continuing the program for eternity.
It seems like a troubling precedent to say that paying once obligates us to continue (and if that were true, we definitely should never start any foreign aid programs, for fear of them becoming an obligation!)
The car ride analogy is not a good one because a car ride is a specific discrete unit promised in advance with a specific endpoint.
Okay, so would you at least agree that passing a bill guaranteeing PEPFAR funding through 2030 perhaps constitutes a promise to actually fund it through 2030 that we would be obligated to fulfill, only then winding down involvement and transferring control to other organizations? I think the car ride analogy fits perfectly given that we did in fact promise a discrete unit in advance with a specific endpoint.
That's a long car ride.
No, everyone understands that Congress frequently changes its mind and reallocates funding or amends or repeals bills, and that Congress has the power to do that, so that no bill can guarantee anything. Congress doesn't have the power to lock itself in like that. So no one can reasonably rely on a bill many years into the future.
If there really were "hundreds of other" programs as effective as PEPFAR (there aren't), then the US could save a billion lives with 4% of it's budget. And you view this as a BAD thing?
Yes, I don't think it's the government's job to save a billion lives of people thousands of miles away when we are facing a catastropic debt crisis.
Do you understand how many people a billion is?
If you sat down in a room and watched one person die every single second, it would take you 31 years to get through a billion people. Please imagine yourself sitting through those 31 years of constant death, and then afterwards being like "nah, a 4% cut in the deficit is more important than this".
I assume you think the debt crisis is a problem because it's bad for people. But how can the effect possibly worse than a death every second for 30 years?
I think the debt crisis is a problem because it's bad for AMERICANS.
If those billions of people are not Americans, it's simply not an issue for the US government to address with our tax dollars. Not everything needs to be done by the government. Let people's private donations handle that.
Ok but at least don't screw the organisations out of payment for services already rendered! My private donations aren't handling shit if you also sabotage them!
How does that sabotage them?
The grounds for accepting PEPFAR over other programs is that it has a greater impact than most of them. I don't see what's complicated about this. Run a cost-benefit analysis, set a standard for how much altruistic bang for our buck we want, and cut everything below that number. This is budgeting 101.
Seems like you're making the mistake of confusing effectiveness with justification. We have no obligation and no reason to spend money on even a really effective program, if that program doesn't help us.
And it'd make more sense to fix a dollar amount, rather than an efficiency threshold, otherwise we might exceed our available budget if there are many effective interventions available.
". We have no obligation and no reason to spend money on even a really effective program"
Do you think no one ever has even "reason" (never mind obligation for the moment) to spend money on charity, outside of weird cases where doing so directly promotes their self-interest?
If not, why can't a *collective* of people have non-zero reason to give to charity, if individuals can? Presumably if individuals can have some reason to give to charity that's because the fact that something would advance a valuable goal gives you (non-zero) reason to do it, even if it's not personally advantageous. Why would that apply to individuals but not collectives (of which nations are one example)? If you buy the logic at all, nothing about it obviously suits individual decision-making better than collective decision-making.
You have agent-principal problems with collective decisionmaking. That doesn't come up with individual decisionmaking.
That makes collective donations prone to abuse and mismanagement, because the person making the decision is playing with someone else's money.
That hardly supports a no reason claim though, it just adds a balancing reason on the other side. It also applies exactly as much to US government attempts to improve the lives of US citizens as to PEPFAR or other attempts by the US government to help foreigners. But you seem to be trying to categorically rule out the former not the latter.
It doesn't apply exactly as much, since money spent on US citizens is not presumptively bad the way money spent on foreigners is.
You said:
> First, while the cost of this program may be small, it's one of many. This same logic would apply to many, many other government programs. Accept it, and what are the grounds for rejecting other programs? Once you accept this, you're on the hook for hundreds of others.
I answered you.
> And it'd make more sense to fix a dollar amount, rather than an efficiency threshold, otherwise we might exceed our available budget if there are many effective interventions available.
I assure you, the United States government has never been in danger of driving itself off a budgetary cliff over foreign aid.
You misunderstood my objection.
The concern is not that the government will drive itself off a cliff over foreign aid.
The concern is that your proposed methodology is not useful because there's generally a fixed budget for foreign aid interventions, and your proposed methodology wouldn't stick to the budget.
Okay, since you need me to detail the concept of "spending limits":
1) decide on maximum acceptable spending on foreign aid
2) allocate budget to the highest-reward aid actions until the limit is hit
Are you now convinced that we can agree to fund PEPFAR without promising to reimburse everyone's dinner bill?
Honestly, the more important question is not whether PEPFAR or other foreign aid should be funded.
The question is who should decide.
The US is a democracy with the elected president in charge of the executive branch. So even if you or I disagree, protecting democracy is a lot more important, and it needs to be the president's decision.
It is, in fact, *Congress's* decision, not the president's. But also, that's just an entirely separate matter? This is straight out of "Arguments From My Opponent Believes Something" (https://slatestarcodex.com/2013/06/13/arguments-from-my-opponent-believes-something/). (Indeed, I thought this one was in the sequel, but I can't find that right now?) We can, in fact, argue both over the object level of the correct course of action and separately over the decision system for the government to use. Saying "we should do X instead of what the government is currently doing" means you think the people in charge of the government should make different decisions -- not that you think you should overthrow the government!
Well, I don't think it is "in fact" Congress's decision - Congress *could* certainly legislate specifically on this, but has not.
I agree, both are valid questions. I'm saying the political one is much more important. And often people conflate the two.
As to your last point, a lot of people seem to think it means that it shouldn't be the president's decision. Tell that to all the people filing litigation on things like this.
> Well, I don't think it is "in fact" Congress's decision - Congress *could* certainly legislate specifically on this, but has not.
Is this not, in fact, the purpose of the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003? Like, what, you think George W. Bush just authorized PEPFAR on his own? He cannot in fact do that! The money has to come from a Congressional spending bill!
> As to your last point, a lot of people seem to think it means that it shouldn't be the president's decision. Tell that to all the people filing litigation on things like this.
Yeah, because it's Congress's! The President does not, in fact, have the authority to unilaterally impound funds! They're saying it *factually is not* the president's decision -- not making the argument you seem to be imputing to them, that because the president is getting it wrong it isn't his decision!
> I agree, both are valid questions. I'm saying the political one is much more important.
Well it's not the question this post is about!
Thanks for the reference to the law! I just looked at the text.
https://www.congress.gov/bill/108th-congress/house-bill/1298/text
Yes, it does appropriate money for various purposes, including antiretroviral treatment. Interestingly, it also says:
"the President is authorized to furnish assistance, **on such terms and conditions as the President may determine**, for HIV/AIDS" (p. 18 of the pdf)
So it does seem that the president has some discretion. How much wiggle room does this give him? Unclear. The impoundment control act does prevent him from withholding funds, but it may be unconstitutional - we'll have to see what happens. Also, what if he doesn't withhold the funds, but once the funds are distributed to his Coordinator, he instructs the Coordinator to slow-walk them? Or what if he doesn't appoint a Coordinator, or appoints only people Congress rejects?
The law also provides for the president to make a determination, regarding money going to the Global Fund, that a country supports terrorism and can withhold money on that basis. (p.15)
> Thanks for the reference to the law! I just looked at the text.
I will reiterate here is that part of my point is that you can be reasonably certain that such a law must exist without having to find the particular law!
> Also, what if he doesn't withhold the funds, but once the funds are distributed to his Coordinator, he instructs the Coordinator to slow-walk them? Or what if he doesn't appoint a Coordinator, or appoints only people Congress rejects?
That is arguably within his authority! Without anything explicit to resolve such a conflict I'd call it an open question until the courts rule on it. But also, if you're in that position that they have to rule on it, you're basically already in something of a constitutional crisis. I would consider this one of the problems with the American system of having an independently-elected president. Given that the president's job is to execute on legislation, having him elected by the people instead of by the legislature allows these sorts of conflicts to occur. Things have largely worked so far due to presidents caring enough about doing their stated job (or just not causing constitutional crises, or not doing things that are unpopular), but now we may see what happens when that's not the case...
So yes, you can safely guess that Congress appropriated money somehow, but the relevant questions are how specific the appropriation was (anything for global health? Fighting HIV specifically? Distributing ARVs specifically?) and how much discretion the administration has.
> I'd call it an open question until the courts rule on it. But also, if you're in that position that they have to rule on it, you're basically already in something of a constitutional crisis.
Huh? No, that's not a constitutional crisis at all. That's the system working as intended. Conflicts arise and the courts perform their assigned function of ruling on the conflicts. How is that a crisis? That's exactly what's supposed to happen. Courts ruling on things is part of the system.
In the spirit of this FAQ, today I learned that there are currently two elective absolute monarchies in the world: Vatican City and the United States of America.
Nope, the president is not an absolute monarch. He's just in charge of the executive branch.
But please tell me, since I hear this from people (mostly on the left) quite a lot - what is causing this misunderstanding?
Do you genuinely not see a difference between being in charge of the executive branch and being an absolute monarch? Are you exaggerating for effect? Do you know that there's a difference but you're pretending there isn't for political purposes?
"exaggerating for effect, but with increasing concern"
Restated: I think that de facto wholesale destruction, by the executive, of agencies created by law is, at best, a clear abuse of executive power, as the executive has a constitutional duty to faithfully execute the law. I therefore believe that your view to the contrary reflects a dangerously expansive view of executive power. This is particularly so because you said not just that the president has a right to make the decision, but that "protecting democracy is a lot more important, it needs to be the president's decision", as if it's undemocratic for the president to be subordinate to democratically enacted law.
(I am of course assuming that Congress has appropriated money for this specific purpose, I haven't checked.)
No, of course the president has to follow properly enacted law, but that law is subordinate to the constitution, which puts the president in charge of the executive branch, and so there's a limit as to how much congress can limit executive power.
I was of course assuming that Congress hadn't passed a law specifically requiring this program to continue. Typically there's some discretion given to the executive.
The point of the executive branch is to *execute* policies passed by Congress. Congress has passed a bill funding PEPFAR. The President has refused to execute this policy. Either:
1) You agree that the power of the executive is limited to reasonable discretion in carrying out laws passed by Congress and outright refusing to carry out a law constitutes a breach of authority, in which case welcome to the Resistance.
2) You think that the President can just decide to do or not to do things as suits their mood, making the authority of Congress mostly hypothetical and the distance between the US government and an elected monarchy an increasingly theoretical question.
Congress has, in fact, passed a law specifically requiring this program to continue. It has done so on three separate occasions, in 2013 (https://www.congress.gov/bill/113th-congress/senate-bill/1545), 2018 https://www.congress.gov/bill/115th-congress/house-bill/6651), and 2024 (https://www.congress.gov/bill/118th-congress/house-bill/10457/text/ih), the last extension covering the program through 2030. I appreciate your keen attention to such critical details.
I'll repeat my earlier comment, above:
I just looked at the text.
https://www.congress.gov/bill/108th-congress/house-bill/1298/text
Yes, it does appropriate money for various purposes, including antiretroviral treatment. Interestingly, it also says:
"the President is authorized to furnish assistance, **on such terms and conditions as the President may determine**, for HIV/AIDS" (p. 18 of the pdf)
So it does seem that the president has some discretion. How much wiggle room does this give him? Unclear. The impoundment control act does prevent him from withholding funds, but it may be unconstitutional - we'll have to see what happens. Also, what if he doesn't withhold the funds, but once the funds are distributed to his Coordinator, he instructs the Coordinator to slow-walk them? Or what if he doesn't appoint a Coordinator, or appoints only people Congress rejects?
The law also provides for the president to make a determination, regarding money going to the Global Fund, that a country supports terrorism and can withhold money on that basis. (p.15)
I agree, protecting democracy is important. In fact, that's why we all went to Maidan when our president started abusing his powers and why he's still hiding from us in moscow with his dictator friends.
Who, Ukrainians?
Yes. I'm not a US citizen so I don't feel qualified to comment about the current US politics. All I can add is my experience from my own country.
The Vox article you link to is very weird in that it seems to assume that there is no value to great works of art. Clearly there is - a great cathedral or painting is worth many, many people's lives.
"Clearly there is - a great cathedral or painting is worth many, many people's lives."
The word "clearly" is doing a lot of work in that sentence. What's your rationale for saying a painting (however great you like) is worth many, many lives?
Well, the alternative would seem to be the Repugnant Conclusion - that it's better to have a large number of impoverished lives lacking art or other good things in life, than to have a small number of lives full of flourishing.
The Repugnant Conclusion is self-evidently wrong, so the alternative is that there are some goods that are worth lives, and it should be clear that among the best of them would be art.
If you don't understand why art is valuable and important to humans, I'm not even sure where to start, but there have been many books written about it. A human life lacking in aesthetic value just seems worthless to me. We might as well be monkeys.
You could also look at revealed preference - people spend a lot of money on art, entertainment, their own hobbies, their own pleasures - rather than saving dying kids, so clearly these things are important to people.
You've moved the goalposts. Your last post wasn't about the value of whether or not art exists. You said that one painting is worth "many, many lives". Again: what's your rationale for that? How many people would you be willing to sacrifice per painting?
I don't think I moved the goalposts at all. I'm not sure what's missing here. For art to exist, or to thrive, or to exist in sufficient amounts or quality, money has to go towards it, right. That money could have gone to saving lives.
The context here was the vox article which said that money going to repair a cathedral could have gone to save some people's lives instead. Which is true for money going to any form of art.
So it's not that I'd shoot a bunch of people for the sake of art! It's just that any money used for anything could have gone to save lives. There's a difference between me personally killing people, versus allocating funding so that some of the funding goes to art rather than saving lives.
I think I explained the rationale - if art is important, some amount of money needs to go to it and should go to it, and that money could have been used to save lives.
$5 million for a great painting works out to about 1000 lives, so I guess at least that many, if not more.
Okay, while we don't disagree on the basic point (lives being more valuable if there's art and other things making them present, and therefore art being worth a non-zero amount of lives), I think 1,000 lives for a single painting is crazy. I mean, one painting? I can't think of a painting worth prioritizing over saving 1,000 lives, whether by Van Gogh or whoever.
Well we don’t usually think of money in terms of lives, that’s why it seems crazy. Spending a few million dollars on renovating a government building or something is also 1000 lives.
I'm aware population ethics is finickly, but I'm pretty sure you can avoid the repugnant conclusion without committing to killing taking away "many, many people's lives" to save an empty building.
Well, it's not killing or taking away their lives, it's just allocating money to art and culture rather than saving lives. They're dying anyway.
I don't see how you avoid the repugnant conclusion without allocating money to art and culture - how can you?
Do you put all your money into saving lives personally? Do you think the government shouldn't be funding anything other than saving lives?
I think you may have a very confused and nonstandrad version of the repugnant conclusion in mind, can you explicit what you think it is supposed to say?
https://plato.stanford.edu/entries/repugnant-conclusion/
No it doesn't? Where are you getting that from? The article actually explicitly calculates and compares the costs of the two, inviting the reader to compare their value, which you'll notice is basically the exact opposite of assuming one has none.
From this:
> It’s useful to imagine walking down Main Street, stopping at each table at the diner Lou’s, shaking hands with as many people as you can, and telling them, “I think you need to die to make a cathedral pretty.” And then going to the next town over and doing it again, and again, until you’ve told 47,500 people why they have to die.
> can I imagine going down Main Street and telling people they need to die for Notre Dame? Of course not.
> If I were to file effective altruism down to its more core, elemental truth, it’s this: “We should let children die to rebuild a cathedral” is not a principle anyone should be willing to accept. Every reasonable person should reject it.
Where in that is there discussion or even recognition of the value of art to humanity? It's trivialized down to "make a cathedral pretty" as though the Repugnant Conclusion were the only value.
Yeah, I think that quite clearly does *not* assume works of art have no value. In fact I think it assumes the opposite!
Clearly, the author does not think that the Notre Dame is worth fifty thousand human lives. But the whole passage wouldn't really make sense if she thought it had *zero* value. And beyond 'clearly less than 50 thousands human lives', she doesn't even make it clear what that value is! It could be quite large.
The point of the passage is to be an intuition pump, to make you realise how many people 47,500 is. The point is not to denigrate the importance of art, but to illustrate the scale of good that could be done with it instead. If you have a contrary intuition to the author's (and I suspect most readers'), and truly think you *would* kill tens of thousands of peopel to rebuild a cathedral, you're entitled to that view- but you've misinterpreted the passage if you think it "assumes there is no value to great works of art".
Well, we disagree on the interpretation of that passage, then. I think it takes it for granted that no reasonable person could value art as worth human lives, and says that explicitly. I think the passage makes no sense if the author does value art. It doesn't even seem that the author thinks discussing the value of art is worth considering.
It's hard for me to imagine most readers would agree with the author, as that's a pretty extreme EA viewpoint.
Also, no one is talking about "killing" anyone, just letting people die by not spending scarce resources on them, people who we have no duty towards.
> I think it takes it for granted that no reasonable person could value art as worth human lives, and says that explicitly.
Well it simply... doesn't. The passage does not say those words, nor anything semantically equivalent.
> I think the passage makes no sense if the author does value art.
Well, it does. I think everyone else understood it! It would make no sense if the author valued *this* work of art at more than 47,500 lives- but I don't think anyone sincerely does, as the thought experiment was meant to illustrate.
> It's hard for me to imagine most readers would agree with the author, as that's a pretty extreme EA viewpoint.
Agree with the author about what? The author doesn't really even express a view in the passage in question. She simply describes a thought experiment, that I don't think you've quite followed.
> Also, no one is talking about "killing" anyone, just letting people die by not spending scarce resources on them, people who we have no duty towards.
Well the thought experiment assumes there is no act/omission distinction, as I think is clearly correct. Killing someone and letting someone die if you could easily prevent it are morally equivalent; if you disagree, you're welcome to argue for a distinction, but no-one in the history of analytic philosophy has yet managed to do so convincingly:
https://plato.stanford.edu/entries/doing-allowing/#Bib
> The passage does not say those words [no reasonable person could value art as worth human lives], nor anything semantically equivalent.
> Agree with the author about what? The author doesn't really even express a view in the passage in question.
Huh? The passage does clearly say exactly that. I already quoted it:
"If I were to file effective altruism down to its more core, elemental truth, it’s this: 'We should let children die to rebuild a cathedral' is not a principle anyone should be willing to accept. Every reasonable person should reject it."
> no-one in the history of analytic philosophy has yet managed to do so convincingly
Thanks for the SEP link. But it says the opposite of your last claim: for instance, Foot, Quinn, and Kamm are all cited in that SEP article as giving accounts of the distinction, and many other philosophers have done so as well.
This is of course a heavily debated question in moral philosophy with solid arguments on both sides. Most people - and most moral philosophers - generally think there is a difference though. I think it is clear that the government deliberately and cold-bloodedly killing a bunch of innocent people is much worse than making the budgeting decision to not spend money that we don't have in order to save a few more lives.
> It would make no sense if the author valued *this* work of art at more than 47,500 lives- but I don't think anyone sincerely does, as the thought experiment was meant to illustrate.
Hmm? Many people sincerely do. I certainly do. The flaw in the thought experiment / intuition pump is that it relies mostly on the emotional power of imagining telling someone you're condemning them to death and then making your reason sound as trivial as possible.
I still think we should stop all foreign aid. This still doesn't explain why we should care.
It very clearly does, you just disagree with it.
No, it really doesn't. It covers other topics but doesn't actually justify spending money to help people in other countries. It seems to adopt the effective altruist position that people are worth the same no matter what country they're in.
you are correct that the post is built on an assumption that it is good to help people. even if you must stipulate that some people are of more value than others many people would still agree that it is good to help them. this is a common assumption in our culture and you should focus on disagreeing with it (if that is how you feel) instead of pretending it isn't there.
The problem is that you're talking about using American tax dollars to do so.
There should be a presumption that those should only be used to help Americans, and I don't see any argument for rebutting that.
I don't understand why taxes should only be used to help Americans.
I can kinda see it? You could see the US government as Americans forming a club to help each other (for coordination and redistribution), and putting money in a common pot for that purpose. It's a bit rude if George then waltzes in and demands to use the club's funds for some emergency rather than for club activities, even if the emergency is genuinely dire and the club is a tad frivolous.
I think I'd be pretty sympathetic to that argument in the context of paying down the national debt (rather than increasing the deficit by several trillion) and stopping programmes that don't help and indeed harm Americans (Ozy gives many examples).
Because they are paid by Americans. And not by choice, but because we have to. By threat of force.
The justification for that is that we're participating in this society and taxes are the price for that. So if taxes go to help the country, that's one thing, but when they are forcibly stolen from you and given to help another country, that's at least presumptively wrong.
You could make a case that some foreign aid is in the US's interest, but Ozy didn't do that, and that has to be balanced against the huge looming crisis facing our country: the debt. Just like global warming, the debt has to be dealt with using painful cuts to avoid disaster.
Do we need to start by proving the sky is blue? Obviously people are worth the same no matter what country they're in.
Don't start with this edgelord bullshit, we're having an adult conversation.
Worth the same in some abstract moral sense, sure.
We're talking about using American tax dollars to pay for this, though, and those should be used for Americans. This is not an "edgelord" position. I suspect it may be the majority view.
What do you mean an "abstract moral sense"? When you questioned the "effective altruist position that people are worth the same", what else did you think that was but a claim about morality?
In any case, I'm glad you now seem to have accepted that "effective altruist position".
It seems incoherent, though, to accept that and nonetheless think we should arbitrarily prioritise certain people. What's your reasoning for that?
I meant, people may have the same intrinsic worth, in some objective sense, but that doesn't dictate how we should allocate resources.
Like a friend or family member has the same worth as a stranger, but if you are personally choosing who to save, you'd presumably save the person you're close to.
I thought the EA position was a claim not just about moral worth, but about action. I don't agree with it.
I don't believe it's arbitrary in any way to prioritize Americans with American tax dollars. As I explained in another comment, that money was stolen from Americans based on the justification that it's the cost for living in American society. So that money should go to benefit American society.
Very few people truly believe that we should spend the same amount of money to help strangers as we do to help those of the same nationality. Indeed, we do not. However, most people agree that if somebody could get lifesaving medicine for an amount of money that is insignificant to your personal wellbeing, you should give them that money. Considering PEPFAR's cost per-person is approximately $4-5, it appears to pass this test. Further evidence for this claim is that it has been passed by a majority of the representatives of the American public, suggesting most people are in favor of it.
If you truly believe all tax spending should be completely self-contained, most of the people in the country appear to disagree with you.
And yet we elected Trump, who ran on a platform of stopping foreign aid.
As far as the representatives, few if any people back then were running on a platform of no foreign aid, so there wasn't much we could do pre-Trump.
I'm sorry, are you saying PEPFAR saves lives at $4-5 per person? That seems too low.
He did not, in fact, do this. Project 2025 was written with the goal of gutting the federal government, but Trump repeatedly disavowed having anything to do with this idea. If anything, it's likely that about half of his voters were betting that we would have something like the impotent Trump 2016 who talked about crazy nonsense every week but accomplished nothing other than appointing two Supreme Court justices. Trump ran on "America First", whatever that means, but to most people it meant deporting undocumented immigrants and reducing legal immigration. That much I will gladly concede a majority of Americans are in favor of. As for USAID, I doubt most people knew it existed a month ago.
As for your second point, uh, yeah? There was not anybody running on the "no foreign aid" platform because people didn't want that? Do you think all those republicans kept voting to extend PEPFAR for kicks? Anybody could have formed the Zero Foreign Aid block of congressional representatives at any point without a change in presidential administration. Seriously, how are you having trouble with this concept?
I'm saying that if you divide PEPFAR's annual cost by the population of the United States, it costs each taxpayer about $4-5 per year. This is proportionate with giving a five dollar bill to a homeless person to buy lunch, something that I would guess most Americans do at least once a year. Given that the typical American is willing to make at least one trade per year at the cost/benefit ratio of $5/one meal, I think there is substantial evidence that they would be in favor of paying $5 to reduce global HIV by the amount shown in this post's graph.
> This is proportionate with giving a five dollar bill to a homeless person to buy lunch
"lunch" lol.
To address your actual point - I would be interested to see a survey on the question of asking Americans to pay $5 a year to reduce HIV in Africa. But there's a big difference between an individual choosing to pay that money, and the government stealing it from you at gunpoint and forcing you to do it. That's really the issue. Just because Americans might choose to pay $5 to Africa doesn't mean that our tax dollars should be used that way.
He spoke many times at his rallies about not sending money to other countries. This isn't something new or a surprise.
Did you really think Trump was a huge foreign aid fan? Did anyone think that?
> There was not anybody running on the "no foreign aid" platform because people didn't want that? Do you think all those republicans kept voting to extend PEPFAR for kicks? Anybody could have formed the Zero Foreign Aid block of congressional representatives at any point without a change in presidential administration. Seriously, how are you having trouble with this concept?
People did want that, but their elected representatives did not.
This is exactly how Trump rose to power. He observed that there was a significant gap between what Republican voters wanted and what Republican politicians said.
As you said, voters wanted to deport people who are legally deportable and reduce immigration, and almost no politicians wanted that, so he took advantage of that gap, said the things voters wanted, and got elected.
Same for foreign aid. There was a consensus in favor of foreign aid among the Republicrat elites. Basically no politician spoke out against it, despite the voters hating foreign aid. So Trump got elected, in part, by talking a lot about other countries taking advantage of us and us saving money by not sending it to other countries. This was a huge theme of all his rallies and speeches.