Our New Health Policy: FAFO

On his first day back in office, President Trump signed an executive order implementing a 90-day freeze on foreign aid. Shortly afterward, he unleashed Elon Musk and DOGE to help dismantle the U.S. Agency for International Development (USAID). By July 2025, the agency had been gutted, and the few remaining programs were transferred to the State Department. One fantasy behind these cuts was that the consequences would happen somewhere else—to “them,” the citizens of countries Trump once described in vulgar terms.

In February 2025, the Senate confirmed Trump’s nominee for Secretary of Health and Human Services: Robert F. Kennedy Jr., an environmental attorney with a long public record of anti-vaccine advocacy. Kennedy soon began undermining the Centers for Disease Control and Prevention, firing thousands of staff members and placing allies who shared his views in key health leadership roles. Kennedy and DOGE also targeted other essential agencies, including the Food and Drug Administration.

What could possibly go wrong? Welcome to the new American health care policy: FAFO (F**K Around and Find Out). Put politely, FAFO means that reckless choices eventually produce severe, unavoidable consequences.

We are already seeing dangerous diseases rise in several African countries, driven not only by the destruction of USAID but also by cuts to the President’s Emergency Plan for AIDS Relief (PEPFAR).

First, there is the Ebola outbreak in the Democratic Republic of Congo (DRC), declared on May 15. The Bundibugyo strain has been spreading rapidly and threatening to spill across the borders of Uganda and South Sudan. The number of people infected has reportedly risen to 3,200, with at least 1,405 deaths—and infections surged by roughly 1,000 in just 10 days.

According to the U.N., many nations want to provide help but face enormous difficulty reaching the remote areas affected. Historically, USAID led U.S. humanitarian operations during outbreaks like this, deploying rapid-response teams, funding local disease surveillance, and distributing medical gear. The intentional destruction of USAID has severely hampered both the DRC and the international response. To date, the U.S. has largely been a no-show, aside from blocking American health workers who helped with the outbreak from re-entering the country.

Africa—especially South Africa—is also seeing a terrifying resurgence of HIV/AIDS infections. Since its creation in 2003, PEPFAR has provided funding and resources that have saved an estimated 26 million lives in more than 50 countries. The simultaneous cutting of PEPFAR funds and dismantling of USAID has severely hampered global health efforts, including AIDS programs, leading to the closure of more than 1,700 HIV service sites and the layoff of 15,000 health care workers.

Trump and Congress have said that U.S. grants cannot go to organizations that encourage abortions or advocate for diversity, equity, and inclusion initiatives. In practice, the latter restriction targets high-risk groups such as sex workers, gay men, and people who use IV drugs.

Recent studies have estimated that the funding disruptions have led to more than 220,000 preventable deaths, including over 13,000 child deaths. Without restored U.S. funding, more than 1 million additional infections are possible in South Africa alone over the next 20 years.

Adding insult to injury, Trump has directed that all PEPFAR funding to South Africa be halted because of his false claim of a “genocide” against White Afrikaners.

What the zealots behind the budget cuts failed to reckon with is simple: contagious diseases do not respect borders.

But enough about “them.” What about “us”? The same people who destroyed our network of international health programs have also taken a pickaxe to domestic agencies like the CDC and FDA—the very institutions established to keep Americans safe and healthy.

Lately, a little-known parasite has been making headlines: Cyclospora cayetanensis, which causes cyclosporiasis. Cyclospora is a single-cell parasite transmitted through contaminated food or water. It can cause explosive, watery diarrhea lasting weeks to months if left untreated, along with stomach cramps, nausea, fatigue, and weight loss. For viewers of The Daily Show, Jon Stewart has described this illness as Trump’s DEI project: diarrhea, everywhere, indefinitely.

The cyclospora outbreak is a major multistate foodborne parasitic event linked to shredded lettuce, with more than 4,000 confirmed cases and thousands more suspected cases across 41 states. While cyclospora outbreaks do occur, this one is unusually large and disruptive (see graph below).

The outbreak’s identification was delayed by significant changes at the CDC and FDA. Last summer, the CDC downgraded its FoodNet program—which tracks foodborne illnesses and is run in partnership with the FDA—making the tracking of cyclospora, listeria, shigella, campylobacter, and other pathogens “optional.” FDA staffing cuts have also made it difficult to track the emerging outbreak and identify its source. The initial source was linked to Taylor Farms, which sources lettuce from Mexico and distributes to well-known food vendors, including Taco Bell and Walmart. More recent FDA announcements indicate that multiple other outbreaks may be associated with different sources of the parasite.

Oops.

Then there is our own measles epidemic, which began in West Texas last summer. It has not dominated the media—news cycles are short—but as of July 23, 2026, there have been 2,318 measles cases, already outstripping the 2,289 cases seen in 2025. Children age 5 and under make up 20% of cases, and 69% of cases are in people age 19 or younger. Seven percent have required hospitalization for complications such as pneumonia. This is the highest annual U.S. measles count since the major resurgence of 1989–1991.

The current outbreak is linked to declining rates of MMR vaccination. Before becoming Secretary of Health and Human Services, Kennedy was one of the country’s most prominent vaccine critics, falsely claiming that vaccines were linked to autism and other harms and undermining public confidence in vaccination.

Under Kennedy’s leadership, the CDC has downplayed the importance of vaccination. He has retooled the Advisory Committee on Immunization Practices, filling it with unqualified allies. During the initial measles outbreak in West Texas, he actively promoted non-evidence-based treatments, including high-dose vitamin A, steroids, and antibiotics. When asked about the outbreak in Congress, he had the temerity to say it had nothing to do with him.

U.S. House Speaker Sam Rayburn once said, “Any jackass can tear down a barn, but it takes a carpenter to build one.” It is time to demand that the jackasses stand down.

The intentional destruction of agencies designed to protect global and domestic health is already reaping the whirlwind—to the apparent surprise of the people who set it in motion.

Sadly, this is likely only the tip of the iceberg. Larger consequences are on the horizon. Known threats like polio have not disappeared and can easily reappear. Unknown threats—like the one posed by COVID-19—are always around the corner. Meanwhile, the infrastructure and resources designed to stop or mitigate those threats are being torn down.

FAFO indeed.

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