Americans have plenty to worry about these days when it comes to infectious-disease outbreaks. This is the worst flu season in 15 years, there’s a serious measles outbreak roiling Texas, and the threat of bird flu isn’t going away. “The house is on fire,” Denis Nash, an epidemiologist at CUNY School of Public Health, told me. The more America is pummeled by disease, the greater the chance of widespread outbreaks and even another pandemic.

As of this week, the federal government may be less equipped to deal with these threats. Elon Musk’s efforts to shrink the federal workforce have hit public-health agencies, including the CDC, NIH, and FDA. The Trump administration has not released details on the layoffs, but the cuts appear to be more than trivial. The CDC lost an estimated 700 people, according to the Associated Press. Meanwhile, more than 1,000 NIH staffers reportedly lost their jobs.

Perhaps as notable as who was laid off is who wasn’t. The Trump administration initially seemed likely to target the CDC’s Epidemic Intelligence Service, a cohort of doctors, scientists, nurses, and even veterinarians who investigate and respond to disease outbreaks around the world. Throughout the program’s history, EIS officers have been the first line of defense against anthrax, Ebola, smallpox, polio, E. coli, and, yes, bird flu. Four recent CDC directors have been part of the program.

The layoffs were mostly based on workers’ probationary status. (Most federal employees are considered probationary in their first year or two on the job, and recently promoted staffers can also count as probationary.) EIS fellows typically serve two-year stints, which makes them probationary and thus natural targets for the most recent purge. EIS fellows told me they were bracing to be let go last Friday afternoon, but the pink slips never came. Exactly why remains unclear. In response to backlash about the planned firings, Musk posted on X on Monday that EIS is “not canceled” and that those suggesting otherwise should “stop saying bullshit.” A spokesperson for DOGE did not respond to multiple requests for comment.

This doesn’t mean EIS is safe. Both DOGE and Robert F. Kennedy Jr., Donald Trump’s newly confirmed health secretary, are just getting started. More layoffs could still be coming, and significant cuts to EIS would send a clear message that the administration does not believe that investigating infectious-disease outbreaks is a good use of tax dollars. In that way, the future of EIS is a barometer of how seriously the Trump administration takes the task of protecting public health.

Trump and his advisers have made it abundantly clear that, after the pandemic shutdowns in 2020, they want a more hands-off approach to dealing with outbreaks. Both Trump and Kennedy have repeatedly downplayed the destruction caused by COVID. But so far, the second Trump administration’s approach to public health has been confusing. Last year, Trump said he would close the White House’s pandemic office; now he is reportedly picking a highly qualified expert to lead it. The president hasn’t laid out a bird-flu plan, but amid soaring egg prices, the head of his National Economic Council recently said that the plan is coming. Kennedy has also previously said that he wants to give infectious-disease research a “break” and focus on chronic illness; in a written testimony during his confirmation hearings, he claimed that he wouldn’t actually do anything to reduce America’s capacity to respond to outbreaks.

The decision to spare EIS, at least for now, only adds to the confusion. (Nor is it the sole murky aspect of the layoffs: Several USDA workers responding to bird flu were also targeted, although the USDA told me that those cuts were made in error and that it is working to “rectify the situation.”) On paper, EIS might look like a relatively inconsequential training program that would be apt for DOGEing. In reality, the program is less like a cushy internship and more akin to public health’s version of the CIA.

Fellows are deployed around the world to investigate, and hopefully stop, some of the world’s most dangerous pathogens. The actual work of an EIS officer varies depending on where they’re deployed, though the program’s approach is often described as “shoe-leather epidemiology”—going door to door or village to village probing the cause of an illness in the way a New York City detective might investigate a stabbing on the subway. Fellows are highly credentialed experts, but the process provides hands-on training in how to conduct an outbreak investigation, according to Nash, the CUNY professor, who took part in the program. Nash entered EIS with a Ph.D. in epidemiology, but “none of our training could prepare us for the kinds of things we would learn through EIS,” he said.

In many cases, EIS officials are on the ground investigating before most people even know there’s a potential problem. An EIS officer investigated and recorded the United States’ first COVID case back in January 2020, when the virus was still known as 2019-nCoV. It would be another month before the CDC warned that the virus would cause widespread disruption to American life.

More recently, in October, EIS officers were on the ground in Washington when the state was hit with its first human cases of bird flu, Roberto Bonaccorso, a spokesperson with the Washington State Department of Health, wrote to me. “Every single outbreak in the United States and Washington State requires deployment of our current EIS officers,” Bonaccorso said.

EIS is hardly the only tool the federal government uses to protect the country against public-health threats. Managing an outbreak requires coordination across an alphabet soup of agencies and programs; an EIS fellow may have investigated the first COVID case, but that of course didn’t stop the pandemic from happening. Other vital parts of how America responds to infectious diseases were not spared by the DOGE layoffs. Two training programs with missions similar to that of EIS were affected by the cuts, according to a CDC employee whom I agreed not to identify by name because the staffer is not authorized to talk to the press.

The DOGE website boasts of saving nearly $4 million on the National Immunization Surveys, collectively one of the nation’s key tools for tracking how many Americans, particularly children, are fully vaccinated. What those cuts will ultimately mean for the future of the surveys is unknown. A spokesperson for the research group that runs the surveys, the National Opinion Research Center, declined to comment and directed all questions to the CDC.

And more cuts to the nation’s public-health infrastructure, including EIS, could be around the corner. RFK Jr. has already warned that certain FDA workers should pack their bags. Kennedy has repeatedly claimed that public-health officials inflate the risks of infectious disease threats to bolster their importance with the public; EIS fellows are the first responders who hit the ground often before public officials are even sounding the alarm bells.

Ironically, the work of the EIS is poised to become especially pressing during Trump’s second term. If measles, bird flu, or any other infectious disease begins spreading through America unabated after we have fired the public-health workforce, undermined vaccines, or halted key research, it will be the job of EIS fellows to figure out what went wrong.

The best way to dismantle the federal government, then repurpose it as a tool of personal power and ideological warfare, is to start with the soft targets. Entitlements and defense, which comprise more than half of federal spending and a large share of its fraud and waste, enjoy too much support for Elon Musk to roll them up easily. But nothing is less popular than sending taxpayers’ money to unknown people in poor, faraway countries that might be rife with corruption. Americans dislike foreign aid so much that they wrongly believe it consumes at least a quarter of the budget (in the previous fiscal year, aid constituted barely 1 percent). President John F. Kennedy understood the problem, and after creating the United States Agency for International Development, in 1961, he told his advisers: “We hope we can tie this whole concept of aid to the safety of the United States. That is the reason we give aid. The test is whether it will serve the United States. Aid is not a good word. Perhaps we can describe it better as ‘Mutual Assistance.’ ” At another meeting, Kennedy suggested “International Security.”

USAID continued for the next six decades because leaders of both parties believed that ending polio, preventing famine, stabilizing poor countries, strengthening democracies, and opening new markets served the United States. But on January 20, within hours of his inauguration, President Donald Trump signed an executive order that froze foreign aid. USAID was instructed to stop nearly all work. Its Washington headquarters was occupied and sensitive data were seized by whiz kids from Musk’s Department of Government Efficiency, or DOGE. One of their elder members, a 25-year-old software engineer and Matt Gaetz fan named Gavin Kliger, acquired an official email address to instruct the staff of USAID to stay home.

Contractors were fired and employees were placed on indefinite leave; those on overseas missions were given 30 days to return to the States with their families. Under orders to remain silent, they used pseudo­nyms on encrypted chats to inform the outside world of what was going on. When I spoke on Signal with government employees, they sounded as if they were in Moscow or Tehran. “It felt like it went very authoritarian very quickly,” one civil servant told me. “You have to watch everything you say and do in a way that is gross.”

The website usaid.gov vanished, then reappeared with a bare-bones announcement of the organization’s dismemberment, followed by the message “Thank you for your service.” A veteran USAID official called it “brutal—­from some 20-year-old idiot who doesn’t know anything. What the fuck do you know about my service?” A curtain fell over the public information that could have served to challenge the outpouring of lies and distortions from the White House and from Musk, who called USAID “a criminal organization” and “evil.” If you looked into the charges, nearly all turned out to be outright falsehoods, highly misleading, or isolated examples of the kind of stupid, wasteful programs that exist in any organization.

A grant for hundreds of ethnic-minority students from Myanmar to attend universities throughout Southeast Asia became a propaganda tool in the hands of the wrecking crew because it went under the name “Diversity and Inclusion Scholar­ship Program”—as if the money were going to a “woke” bureaucracy, not to Rohingya refugees from the military regime’s genocide. The orthodoxy of a previous administration required the terminology; the orthodoxy of the new one has ended the students’ education and forced them to return to the country that oppressed them. One of Trump’s executive orders is called “Defending Women Against Gender Ideology Extremism and Restoring Biological Truth to the Federal Government”; meanwhile, the administration suspended the online education of nearly 1,000 women in Afghanistan who had been studying undetected by the Taliban with funding from the State Department.

But hardly anyone in this country knows these things. Contesting Musk’s algorithmically boosted lies on X with the tools of a reporter is like fighting a wildfire with a garden hose.

With no workforce or funding, USAID’s efforts around the world—vaccine campaigns in Nepal, HIV-drug distribution in Nigeria, nutrition for starving children in Sudanese refugee camps—were forced to end. Secretary of State Marco Rubio (who championed USAID as a senator and now, as the agency’s acting head, is its executioner) issued a waiver for lifesaving programs. But it proved almost meaningless, because the people needed to run the programs were locked out of their computers, had no way to communicate, and feared punishment if they kept working.

The heedlessness of the aid wreckers recalls Nick Carraway’s description in The Great Gatsby of Tom and Daisy Buchanan: “They were careless people, Tom and Daisy—they smashed up things and creatures and then retreated back into their money or their vast carelessness, or whatever it was that kept them together, and let other people clean up the mess they had made.” An agency of 10,000 employees is shrinking to about 300 and, despite its statutory independence, being dissolved into the State Department. The veteran USAID official I spoke with foresaw a skeletal operation reduced to health and food assistance, with everything else—education, the environment, governance, economic development—gone. But even basic humanitarian programs will be nearly impossible to sustain with the numbers that the administration envisions—for example, 12 staff members for all of Africa.

“This is the infrastructure and architecture that has given us a doubling of the human lifespan,” Atul Gawande, the writer and surgeon who was the most recent, and perhaps last, head of the agency’s Bureau for Global Health, told me. “Taking it down kills people.”

Trump and Musk’s destruction of USAID was a trial blitzkrieg: Send tanks and bombers into defenseless Poland to see what works before turning on the Western powers. The assault provided a model for eviscerating the rest of the federal bureaucracy. It also demonstrated the radicalism of Trump’s view of America’s role in the world.

Every president from Franklin D. Roosevelt to Barack Obama understood that American power was enhanced, not threatened, by attaching it to alliances, institutions, and values that the American people support, such as freedom, pluralism, and humanitarianism. This was the common idea behind Harry Truman’s Marshall Plan for postwar Europe, Kennedy’s establishment of USAID, Jimmy Carter’s creation of the U.S. refugee program, and George W. Bush’s Emergency Plan for AIDS Relief. These weren’t simple acts of generosity. They were designed to prevent chaos and misery from overwhelming other countries and, eventually, harming our own. They expanded American influence by attraction rather than coercion, showing people around the world that the Leviathan could benefit them, too. Political scientists call this “soft power.”

Every president betrayed these ideas in one way or another, making U.S. foreign policy a fat target for criticism at home and abroad, by the left and the right. Kennedy used foreign aid to wage a bloody counterinsurgency in South Vietnam; Carter put human rights at the center of his policy and then toasted the repressive shah of Iran; Bush, claiming to be spreading democracy to the Middle East, seriously damaged America’s global legitimacy. USAID antagonized host governments and local populations with its arrogance and bloat. “We had a hand in our own destruction,” one longtime official told me. “We threw money in areas we didn’t need to.”

But the alternative to the hypocrisies of soft power and the postwar liberal order was never going to be a chastened, humbler American foreign policy—­neither the left’s fantasy of a plus-size Norway nor the right’s of a return to the isolationist 1920s. The U.S. is far too big, strong, and messianic for voluntary diminish­ment. The choice for this superpower is between enlightened self-­interest, with all its blind spots and failures, and raw coercion.

Trump is showing what raw coercion looks like. Rather than negotiate with Canada and Mexico, impose U.S. demands with tariffs; rather than strengthen NATO, undermine it and threaten a conflict with one of its smallest, most benign member countries; rather than review aid programs for their efficacy, shut them down, slander the people who make them work, and shrug at the humanitarian catastrophe that follows. The deeper reason for the extinction event at USAID is Trump’s contempt for anything that looks like cooperation between the strong and the weak. “America First” is more imperialist than isolationist, which is why William McKinley, not George Washington or John Quincy Adams, is Donald Trump’s new presidential hero. He’s using a techno-futurist billionaire to return America to the late 19th century, when the civil service was a patronage network and great-power doctrine held that “might makes right.” He’s ridding himself and the country of restraining codes—the rule of law at home, the rules-based order abroad—and replacing them with a simple test: “What’s in it for me?” He’s unilaterally disarming America of its soft power, making the United States no different from China, Russia, or Iran. This is why the gutting of USAID has received propaganda assistance and glowing reviews from Beijing, Moscow, and Tehran.

Transactional logic has an obvious appeal. Dispensing with the annoying niceties of multilateral partnerships and foreign aid brings a kind of clarity to international relations, showing where the real muscle is, like a strip-down before a wrestling match. Set loose, the U.S. might be strong enough to work its will on weaker friends and neighbors, or at least claim to do so. Trump’s threat of tariffs to intimidate Colombia into allowing deportation flights to land there was like the assault on USAID—an easy demonstration project. His domination of the propaganda sphere allows him to convince the public of victories even where, as with Canada, there was never much of a dispute to begin with. If NATO dissolved while the U.S. grabbed Greenland, many Americans would regard it as a net win: We’d save money and gain a strategic chunk of the North Atlantic while freeing ourselves of an obligation whose benefit to us wasn’t entirely clear.

It isn’t obvious why funding the education of oppressed Burmese students serves our national interest. It’s easier to see the advantages of strong-­arming weak countries into giving in to our demands. If this creates resentment, well, who said gratitude mattered between nations? Strength has its own attractive force. A sizable cohort of Americans have made their peace with Trump, not because he tempered his cruelty and checked his abuses but because he is at the height of his power and is using it without restraint. This is called power worship. The Russian invasion of Ukraine won Vladimir Putin a certain admiration in countries of the global South, as well as among MAGA Americans, while Joe Biden’s appeals to democratic values seemed pallid and hypocritical. The law of “might makes right” is the political norm in most countries. Trump needs no explaining in Nigeria or India.

Coercion also depends on the American people’s shortsightedness and incuriosity. Trump’s flood of executive orders and Musk’s assault on the federal government are intended to create such chaos that not even the insiders most affected understand what’s happening. An inattentive public might simply see a Washington melee—the disrupters against the bureaucrats. Short of going to war, if the U.S. starts behaving like the great powers of earlier centuries and the rival powers of our own, how many Americans will notice a difference in their own lives?

According to Rubio, the purpose of the aid pause is to weed out programs that don’t advance “core national interests.” Gawande compared the process to stopping a plane in midair and firing the crew in order to conduct a review of the airline industry. But the light of the bonfire burning in Washington makes it easier to see how soft power actually works—how most aid programs do serve the national interest. Shutting down African health programs makes monitoring the recent outbreak of Ebola in Uganda, and preventing its spread from that region to the rest of the world, nearly impossible. In many countries, the end of aid opens the door wider to predatory Chinese loans and propaganda. As one USAID official explained: “My job literally was countering China, providing develop­ment assistance in a much nicer, kinder, partnership way to local people who were being pressured and had their arms twisted.” When 70 Afghan students in central Asia, mostly women, had their scholarships to American universities suddenly suspended and in some cases their plane tickets canceled, the values of freedom and open inquiry lost a bit of their attractiveness. The American college administrator responsible for the students told me, “Young people who are sympathetic to the United States and share our best values are not only not being welcomed; they’re having the door slammed in their faces.”

Most Americans don’t want to believe that their government is taking life­saving medicine away from sick people in Africa, or betraying Afghans who sacrificed for this country. They might disapprove of foreign aid, but they want starving children to be fed. This native generosity explains why Trump and Musk have gone to such lengths to clog the internet with falsehoods and hide the consequences of their cruelty. The only obstacle to ending American soft power isn’t Congress, the bureaucracy, or the courts, but public opinion.

One of the country’s most popular programs is the resettlement of refugees. For decades, ordinary American citizens have welcomed the world’s most persecuted and desperate people—European Jews after World War II, Vietnamese after the fall of Saigon, Afghans after the fall of Kabul. Refugees are in a separate category from most immigrants: After years of waiting and vetting by U.S. and international agencies, they come here legally, with local sponsors. But Trump and his adviser Stephen Miller see them as no different from migrants crossing the southern border. The flurry of executive orders and memos has halted the processing of all refugees and ended funding for resettlement. The story has received little attention.

Here’s what the program’s shutdown means: I spoke with an Afghan special-forces captain who served alongside Americans—­when Kabul was about to fall in 2021, he prevented armed Taliban at the airport from seizing U.S. weaponry, but he was left behind during the evacuation. Arrested by the new regime, the captain was imprisoned for seven months and suffered regular and severe torture, including the amputation of a testicle. He managed to escape with his family to Pakistan in 2023 and was near the end of being processed as a refugee when Trump took office. He had heard Trump criticize the Biden administration for leaving military equipment behind in Afghanistan. Because he had worked to prevent that from happening, he told me, “that gave me a hope that the new administration would value my work and look at me as a valuable person, a person who is aligned with all the administration is hoping to achieve, and that would give a chance for my kids and family to be moved out safely.” Biden’s ineptitude stranded the captain once; Trump’s coldheartedness is doing it again.

A sense of loyalty and compassion isn’t extraneous to American identity; it is at the core of national pride, and its betrayal exacts a cost that can’t be easily measured. The Biden administration created a program called Welcome Corps that allows ordinary Americans to act as resettlement agencies. (My wife and I participated in it.) In Pennsylvania, a retiree named Chuck Pugh formed a sponsor group to bring an Afghan family here, and the final medical exam was completed just before Inauguration Day. When resettlement was abruptly ended, Pugh found himself wondering, Who are we? I know what I want to think, but I’m just not sure. The sponsor group includes Pugh’s sister, Virginia Mirra. She and her husband are devout Christians and ardent Trump supporters. When I asked her early this month how she felt about the suspension of the refugee program, she sounded surprised, and disappointed—she hadn’t heard the news. “I feel sad about that,” she said. “It does bother me. It’s starting to sink in. With these people in danger, I would wonder if there would be an exception made for them. How would we go about that?” Her husband frequently sends American-flag lapel pins to Trump, and I suggested that he write the president about the Afghan family. “I will talk to my husband tonight,” Mirra said. “And I will continue to pray that the Lord will protect them and bring them to this country by some means. I do believe in miracles.”

This article appears in the April 2025 print edition with the headline “The Era of Might Makes Right.” When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.