FICTIONAL FLOTATION DEVICE

Nicholas Kristof — (New York Times) @NickKristof

Musk Said No One Has Died Since Aid Was Cut. That Isn’t True.

Elon Musk says that no one has died because he slashed humanitarian aid. I went to South Sudan to check if that's true. It's not. Within an hour of starting interviews, I had the names of a 10-year-old boy and an 8-year-old girl who had died because of decisions by wealthy men in Washington.

The visit that moved me the most was to a remote area that used to have no health care, where women routinely died in childbirth. Then a US-funded maternity clinic opened through @UNFPA in December, and not one woman has died since. I showed up, and people mistakenly thought I was responsible for the clinic. One new mom wanted to name her baby for me, and the village elders thanked me and hailed America's generosity. What they didn't know was that Trump/Musk had cut all funding for UNFPA and that as a result the maternity clinic will close this month, and women will once again be bleeding to death in the dust…

So, what of this? What immediately stands out for me here is the last sentence “Trump/Musk had cut all funding for UNFPA…” To begin with, do you think the US is the sole funder for the UNFPA? Sounds like that’s what’s being offered (intentionally or otherwise.) And how many readers will be left with that impression? Doubtless, plenty. Further, do you think America provides all or even most of the funding to UNFPA operations just in Africa or East Africa or maybe the UNFPA's entire South Sudan program? Is your sense that all such health and humanitarian aid organizations are entirely reliant upon US taxpayer gifts?

On that thought, what do you think running an emergency maternity clinic in rural South Sudan, even for a decade, could possibly cost? (Having spent time in rural Uganda, the nation immediately south, I would guess very little, shockingly little… Probably less than the cost of a stairway to nowhere in Canada...) And do you believe the UNFPA and other UN groups and NGOs have no similarly allocated resources going to South Sudan or neighbouring nations and that none of that funding, medical materiel, or personnel could shift (without killing people the moment those resources move)?

What, and then you think that the doctors working for these folks (from South Africa, Belgium, New Zealand, Japan and elsewhere who volunteer their time and expertise in crisis situations and who have no financial concerns but also other sources of funding) would have no choice but to drop everything and walk away only to let people bleed out — and would do so over half the price of a latte (or even a ten thousand lattes)? And you think all this took place the moment these emergency physicians (saving lives by the hour) were notified taxpayer dollars from America would be cut off?

Well, it has to be asked: What universe do you live in?

These are all wild claims. (Yes, I see all the above as explicit claims of the author. Why? Because they’re all so firmly implied and, really, required to make the assertions the author does…) So, let’s pretend you didn’t know the answer to any of these questions. How hard would it be to find answers? At the very least, don’t all organizations of this sort have websites and don't they also publish annual reports that include their funding sources and expenses as well as their program’s (real or make-believe) outcomes? And what do you think happens when we open up any recent annual report for any UN agency? It’s going to be all or even mostly US taxpayer funding?

Now, is it just me or do all such assertions (from opponents of the current Republican agenda) sound like nothing more than Republican talking points? Isn’t this Trump’s whole pitch, that US taxpayers are unfairly floating the whole of the world in the most unfair deal ever dealt? Seems like it. So, what, the author agrees that American taxpayers do disproportionately subsidise planet Earth? Only, he thinks that’s just fine and maybe their obligation for being just so damn great? Probably. But is any part of that true?

Without even looking I can tell you that the Scandinavian countries typically contribute far more to development and humanitarian aid in real dollars, and far more still when you consider the per capita apportionment, than wealthy peer nations like the US (or Austria or Switzerland, Qatar or Saudi Arabia, Singapore or South Korea.) And, too, nations like Canada, Australia, and New Zealand tend to be closer to those more effective and generous nations than to America. Right. So what are the chances all those nations, weirdly, contribute nothing or only very little in this particular case? And what’s the likelihood that no UNFPA funders or other groups could or have stepped in to fill in any gaps across the world or just in South Sudan? I put the likelihood at about zero. Well, shall we try to answer some of these questions (or respond to these unstated assertions, as I see them)?

FIRST THING’S FIRST: WHAT THE HELL IS THE UNFPA?

The United Nations Fund for Population Activities (aka the United Nations Population Fund) is the sexual and reproductive health agency of the UN. They explain their operation thusly:

We promote gender equality and empower women, girls and young people to take control of their bodies and their futures. We work with partners in more than 150 countries to provide access to a wide range of sexual and reproductive health services. Our goal is ending unmet need for family planning, preventable maternal death, and gender-based violence and harmful practices including child marriage and female genital mutilation by 2030.

Okay. Fine.

Well, is it fine? To be honest, I do find this whole thing pretty challenging; mostly because the people defending continued funding for this program and others like it are all the same folks who insist upon notions such as cultural relativism and who hold as axiomatic that America is an inherently racist project (like all of Europe)... Damn, it's so hard to follow or even make sense of these folks. I mean, just to be vaguely consistent shouldn't the Democrats and their defenders be fighting to cut the same program they're endorsing? Shouldn't they be reading out in Congress the program description above to explain why they needed to end the UNFPA? Shouldn't they be spelling out for laypersons every night on the news and in protests and riots in ten cities all the ways the UNFPA is a Eurocentric, colonialist project directed at genocide through their express aim to reduce the African population and extinguish culture? I could write the script in three minutes. In fact, it writes itself... Next thing you're going to see is Trump arguing for the removal of the Second Amendment and lifelong gun control activists will respond by handing out rifles at daycares. And, to me, that would be less surprising than this.

But, alas, what we’re actually concerned about here is funding. 

TOTAL UNFPA FUNDING

From what I can tell, this organization’s average annual budget is roughly around $1.2 billion. (Troublingly, every document I look at of theirs gives wildly different numbers. So, I can only cite specific documents and can’t actually tell you what’s really going on and be confident in that…) Interestingly, their funding only ever seems to climb exponentially and almost doubled between 2016 ($839M) and 2022 ($1.55B). I won't digress again, but it has to be asked: Shouldn't their funding needs go in the opposite direction if they're effective at saving lives and transforming culture and that this what the population wants? *Insert "I'm just asking questions" meme*

Well, so where do those millions and billions come from? The UNFPA tells us “the United Nations Population Fund is entirely funded by voluntary contributions from governments, intergovernmental organizations, the private sector, foundations, and individuals, not by the UN regular budget.” So not solely foreign governments (or, then, US taxpayers). Good to know.

And then what funding has the UNFPA been getting from the US government? Well, in light of the recent cuts, they just published a statement on US funding covering this very matter and noting a loss of 41 grants (or “48” in other documents) from USAID and the US State Department. There, too, they note that these grants amounted to “nearly $290 million” which they say “provided critical maternal healthcare, protection from violence, treatment for rape and other life-saving care in more than 20 countries and territories in crisis.” (Curiously, elsewhere they state US funding totalling “$377 million”, which is what’s cited in the Times piece. Oh, and their 2022 annual report says it’s $185 million. So, yeah. I hope we can agree that whether 30% or 104%, whichever it may be, this a rather significant discrepancy and nothing like a rounding error...) Sadly, their documentation doesn’t offer any particulars or context for this funding. Saying that they get dozens of grants from multiple agencies doesn’t help anyone understand the impact of any one of those grants or how those may be overcome by others or, well, anything.

Trying to understand if this current funding cut from the US government is unprecedented or even significant, as framed, I looked and found something shocking. Between 2002 and 2008, George W. Bush blocked almost $250 million in congressionally approved funding. And why was that done? The funding was denied by the executive branch, funding already allocated by the US Congress (an action folks are currently freaking out about and calling unconstitutional when Trump does it), on the grounds that the UNFPA was backing Chinese campaigns of forced sterilization and abortion. A letter from the Under Secretary of State for Political Affairs spelled out how the administration had determined the UNFPA's support for China's population program violated the Kemp-Kasten Amendment, in place specifically to prohibit American foreign aid going to support operations of this very sort. The Guardian published a response to this funding pause, stating that it was a baseless act of pure evil. "This decision by the Bush Administration ranks alongside other dark chapters in American history, such as the McCarthy hearings and the Salem witch trials, where individuals were condemned out of hand on the strength of uncorroborated, unsubstantiated and, frankly, malicious 'evidence'." Amazing.

More than that, I found that the Obama administration reinstated funding for the UNFPA when he came to office in 2009, which Trump then withdrew in 2017 (a move resulting in Canada and the Netherlands immediately creating a fund to replace all US funding), which was then reversed once more when Biden took office in 2020. So the elimination of all US taxpayer funding of UNFPA is neither unique or even unprecedented, even in recent times. And, as a result, no one can claim US taxpayers have been a reliable source of funding for the UNFPA program.

To my mind we could stop this wee investigation right here and disregard the whole story as uninteresting and transparently propagandistic. But there’s a lot more here giving us a much better picture of the whole situation. So let’s keep at it.

Regardless of the lack of novelty in this recent funding cut, we might ask if this sum from US taxpayers is a lot of money or whether other nations or mere foundations or private individuals have granted as much or more than the US government? Well, a quick search finds that back in 1999 the Gates Foundation gifted the United Nations Fund for Population Activities a donation equivalent to $4.1 billion in 2025 dollars ($2.2B back in ‘99). So, to me, that looks like just one offering from a single foundation put up many times the highest US government donation estimate of $377 million. And there have been significant additional one-time donations from this foundation alone since then: for example, in 2023, another $100 million for the UNFPA’s Supplies Partnership. Does that not make this taxpayer sum (whatever that may be in reality) seem somewhat less than the unimaginably huge offering it’s being framed as and more like a fraction of the annual earned interest on just one Gates Foundation donation? To me it does.

So, I wonder what other taxpayers around the world contribute to this UN fund? The UNFPA has a Donor Contributions section on their website (that is absent the Gates billions). The most recent reporting is 2023. Under “core” funding (which are unrestricted funds allowing the UNFPA to select their own priorities) we see that the top donations come from Norway ($57 million), Germany ($52 million), and Sweden ($41 million). The US is down the list, below Netherlands, Denmark, and Finland with a contribution of $30 million — which is among the lowest per capita core contributions (that seems relevant because all of this is ultimately about “US taxpayer funding”.) Per capita, this $30 million contribution amounts to around $0.09. For contrast, Canadians provide about $0.28 per person, Ireland offers around $0.90, and the big spenders like Norway are contributing around $10.32 per person. Right. These are different things.

For non-core funding (often tightly earmarked for specific causes), the largest sum comes from the United Nations itself (so all of us), at $234 million. The US is the next largest contributor with $131 million, followed by the UK at $119 million and Norway at $57 million, then the European Commission at $51 million, and Canada at $51 million. Yes, the US contribution most certainly counts but, again, this still makes American taxpayers one of the lowest per capita donors among a very large cohort of contributors. So, for non-core funding Norway is way up at $10.34, the UK is at about $1.75 per person, and Canada is putting up $1.28 per person. What does the US contribute with this huge sum? Less than $0.39 per person. (Keeping in mind that The New York Times wants $15 per month, or $130 per year, just for a subscription to their rag that would no longer exist if it weren't for the games and recipes!)

Okay, so US dollars don’t make up all, most, or even much of the funding for the UN’s sexual and reproductive health operations around the globe. Even more significantly, for a large swathe of the 21st century US taxpayers contributed nothing at all to the UNFPA. Right. And as such no one can look at this and believe that America is overspending, unreasonably outperforming other countries or even individual foundations, either. Certainly America's taxpayers act nothing like the world's flotation device, without whom developing nations and all those struggling therein would otherwise be unable to keep their heads above water.

But that’s the global picture. We then have to consider the actual case provided by the author of the New York Times article. 

SOUTH SUDAN

Then, from the above context of US taxpayers contributing relatively little, we can ask what of the total of UNFPA’s funds go to South Sudan. To begin with, we know the UN program has distributed $1.5-ish billion in annual funding across 150 nations. So, evenly that would be $10 million per country if no country was prioritized. To look for real numbers, by their own accounting, we find that the UNFPA funding for South Sudan (population 12 million) amounted to a little over $11 million. And if we wanted to account for the US contribution to that $11 million maybe we could just take whatever number you like ($185M, $290M, or $377M) and consider that as a proportion of their $1.5 billion budget? Say, 12% or 24%. So would it be unreasonable to think that the US contribution of this $11 million to South Sudan was $1.3 million (or maybe $2.6 million)? Okay. And we can be sure virtually none of that went to the one clinic the New York Times and their article’s author highlights. 

Without getting into what the money is actually being spent on, how do you make sense of this $11 million sum? Immediately, I want to compare it with something for scale. (A banana? No.) How about Harvard University? Their total student and faculty population sits at only 25,000 (just 0.2% of the population of South Sudan) and they had a 2024 operating revenue of $6.5 billion. Almost half of that, $3 billion, was gifts and endowment revenue, not research grants or tuition. The damn budget for the Harvard University library system alone was $165 million. So then what is $11 million? Nothing. Exactly nothing. The faculty of the Harvard Math department could do a bottle drive or bake sale and accidentally double the total US contribution to UNFPA South Sudan operation. Right.

But where did those millions go? On page 68 of the UNFPA’s most recent annual reporting, you’ll find the “key results achieved” for all their operations in South Sudan. There they highlight their targeting of 1,400,000 people (or 12% of the population) and their achieving:

• Sex education programs at 73 local schools 

• 55 communities in 10 states pledging to eliminate child and forced marriage

• Improvements to guidelines for and surveillance of mother and child mortality

• Installation of an electronic warehouse management system for medical stores

• Sexual and reproductive health services for 400k people at “non-humanitarian-targeted” health facilities

  (...which sounds to me like tampons and birth control at universities and high schools, but I don’t know and they don’t say)

This doesn’t look to me like this UN program is primarily keeping the women of South Sudan (total six million) from bleeding out in the street, as presented. If that’s what’s happening you’d think they’d highlight as much over their implementation of supply management software or condom delivery — which take up all the space on their website, “impact” PDFs, and annual reporting. It’s not even clear that anyone is directly saving lives. Their accounting seems to be something like “condoms + IUDs = fewer pregnancies which means lower infant and maternal mortality.” I mean, wouldn’t you expect South Sudan to be triaged and getting a little more funding than 1/150th of the UNFPA budget if what was happening on the ground was mass maternal and infant fatalities. 

For context, the New York Times article does pose the question: “How many women will die worldwide from hemorrhage, sepsis or eclampsia as a result of this rash decision in Washington?” Their answer? “One gauge is that the Population Fund estimates that American financial support over the last four years prevented 17,000 maternal deaths, so that may be a plausible estimate of how many moms will die unnecessarily in the coming four years as American aid is withdrawn.” So that’s not South Sudan but across 150 countries and not in one year but over four. Is this meant to make the situation look dire or America’s contribution significant? To me this looks like very little as the US alone has between 800 and 1,200 maternal-related deaths annually (or several thousand over the same four year spread.) And there’s no reason to suspect this meagre sum couldn’t be made up, and almost immediately, by the world community or even just one concerned philanthropist, or the subscribers to The New York Times could pay $1 more per year... (QUESTION: If it was Elon Musk who covered the difference would you then be obliged to protest or burn down the UNFPA headquarters and its offices and outlets around the world? Seems worth asking.)

Sure, we could also look at the historical context, dive into infant mortality rates around the globe and across time, or assess the South Sudan health situation as it relates to conflict. We could do all kinds of things to broaden the scope of this and try and make even more sense of it all. I don’t think any of that is necessary. To my mind, all of this I’ve pulled together here makes the reporting on this situation so far from being serious, never mind catastrophic, that it’s hard to see how the article even got published. As ever, what are these people even up to? To me it looks like political propaganda dressed up as weird saviour porn. It looks gross.