That USAID study every outlet cited? The math doesn't work.

Before USAID was dismantled by Elon Musk and the Trump administration, it prevented 91,839,663 deaths over a 20-year period, according to a 2025 paper published by the world's most prestigious medical journal. It's amazing that NPR, the BBC, the AP, NBC, The New Yorker, and The Washington Post repeated this finding. None of them picked up on its absolute absurdity. The New Yorker's legendary fact-checkers didn't catch it, nor did The Lancet's editors and the paper's peer reviewers. With some basic arithmetic and a bit of common sense, you can see why it's nonsense. The lesson here is that when people cite data that confirms what they already believe for political reasons, check their math. >> [music] >> Let's put the claim that nearly 92 million people were saved by USAID between 2001 and 2021 into perspective. During this period, the world's total death rate fell substantially. [music] If it hadn't, meaning if the death rate prior to 2001 had remained steady for the next 20 years, >> [music] >> about 79 million additional people would have died, according to data from the UN. So, how could USAID have saved 92 million lives? That's more than 100% of the global mortality decline, meaning that not only was USAID responsible for saving all 79 million people who didn't die thanks to the fall in the global death rate, but it saved an additional 13 million. [music] Foreign aid likely accounts for part of the mortality decline, but USAID was only a fraction of total foreign aid worldwide. And there were plenty of other factors that contributed to the decline in mortality, >> [music] >> such as the 64% fall in extreme poverty from 1990 to 2025. China accounted [music] for 60% of the global decline in mortality. That undoubtedly has a lot more to do [music] with China's staggering 8.7% annual GDP growth rate than the 73 cents per person [music] that China received from USAID during the study period. The Lancet paper also fails to grapple with the fact [music] that the least developed countries and the ones that got the most money per capita from USAID saw their death rates rise. There were 8 million extra deaths in those nations. [music] That doesn't mean USAID was to blame for those extra deaths and it doesn't mean that the agency didn't do plenty of good. Correlation isn't causation. However, it does make the claim that USAID saved 92 million lives even more suspect. The authors failed to establish that USAID saved any lives at all because they built a statistical model based entirely on correlation. Funding for USAID doubled during the study period. Since global mortality fell over the same time span, the two trends correlate, which is all their evidence adds up to. The [music] authors did do a lot of complex statistical hocus pocus, which they explained in a dense technical online appendix, >> [music] >> making the analysis look sophisticated. But all they were doing was correlating two lines with no evidence that one affected the other. Swap out the upward trend in USAID funding and the same model could have been used to credit anything that rose over this period. [music] The S&P 500, the US national debt, the proliferation of selfies. Pick your variable. The methodology guarantees the answer. The straightforward way [music] to study the impact of USAID on mortality is to compare the rate of decline in countries with substantial [music] USAID funding to that in countries with little or no USAID funding. The authors would need to do additional work beyond that, but this approach at least avoids the reality that unrelated things go up or down all the time. The Lancet study authors only managed to conclude that USAID saved more than 100% of the decline in global mortality by excluding inconvenient data. In four of the 21 years, 2009, 2015, 2020, and 2021, global mortality rose, undermining the study's conclusion. So the authors use something called dummy variables to scrub the effect of those years from their estimate. They also erase the effect of 2008, in which USAID funding declined. The remaining numbers cover only the 16 years during which global mortality fell and USAID funding increased. The justification for effectively deleting five out of the 21 years was to adjust for major economic and health shocks. That's academic jargon that means we erased inconvenient data and we're not going to tell you why. An actual justification requires explaining why USAID funding seemed to increase global mortality at times and what specific criteria the authors used to exclude years. The authors also cherry-picked countries. They started with about 250 nations and territories that received USAID money and excluded 117 countries. 71 of the excluded countries were left out to ensure the internal validity of the study maintaining a more consistent and [music] relevant scope. That's a jargony way of saying it's none of your business. For the other 46 countries excluded, no reason was given, just a color-coded map. I first wrote about this atrocious study for Reason last July and since then others have challenged its findings. [music] In December 2025, The Lancet published two formal critical letters and an author's reply. Daniel Krugman, a PhD candidate at Brown, and two other researchers said the paper's key assumption collapses under minimal scrutiny, calling it an example of how numbers feed preconceived narratives. The authors defended their study by claiming that based on their knowledge, no published analyses have [music] reported effect sizes or magnitudes meaningfully different from these estimates. In other words, our errors don't matter because we haven't read anything different. [music] The Lancet paper extrapolates from the 92 million lives saved claim that without USAID, we could see more than 14 million additional deaths by 2030. Since [music] I first wrote about the topic, the UN has gathered a tiny bit of actual data that cast doubt on that prediction. [music] Egypt, a major USAID recipient, is one of the few low- and middle-income countries that report mortality data reasonably quickly. The Lancet model would predict roughly 58,000 [music] deaths in Egypt in May of 2025 following the demise of USAID. Yet, the data show 46,365 deaths that month. Fewer people died in Egypt in May 2025 after the cuts than in the same month To be clear, this is just one data point. It's also possible that some of the awarded money was still being spent in May of 2025. And just because deaths fell in Egypt after USAID was zeroed out, doesn't mean that its grants weren't doing any good. Egypt also isn't the poorest country in the world, and we won't have full data on truly low-income countries for a couple more years. But, this single data point does at least raise doubts about the apocalyptic predictions of what shutting down USAID will mean. UCLA's Dr. James Manc one of the co-authors of the original Lancet paper, was quoted by NPR last July reflecting on whether USAID was a good use of resources. "We found that the average taxpayer has contributed about 18 cents per day to USAID," he said. "We've been able to translate that into saving up to 90 million deaths around the world." He seems more interested in producing political slogans than in doing basic science. I'll add that his math is wrong and that taxpayers actually contributed more like a dollar a day to USAID, but that's beside the point. The implication is that anyone who supported axing USAID valued pocket change over tens [music] of millions of lives. You might think that killing USAID was reckless and cruel. You might think that foreign aid saves lives, as I do. Even so, you should advocate for a scientifically sound analysis that takes an honest look at the evidence, >> [music] >> even if it's a messy picture that doesn't produce a headline-grabbing finding. When you hear an outrageous statistic, don't be afraid to apply some basic math. A person spouting that eye-popping number is probably betting that you won't bother. To keep up with Wrong Number, including bonus content and more, click the link in the description to enter your email address. By joining the list, you'll also have a shot at winning a copy of my new book, Wrong Number: How to Extract Truth from a Blizzard of Quantitative Disinformation, which has a whole chapter that goes into even more detail on the Lancet's faulty USAID study. Thanks for watching. >> [music]