Few people appreciate President Donald Trump’s effort to reform the federal government like I do. As director of the Centers for Disease Control and Prevention, I witnessed firsthand the perils of untamed bureaucracy.
Launched in 1946 to combat malaria, the CDC has experienced severe mission creep over the past several decades. Almost contrary to its original objective of controlling and preventing communicable disease outbreaks, the agency now focuses on many areas that are well beyond its historical purview, such as gun violence, climate change, and social determinants of health. Today, the CDC commands an annual budget of more than $9 billion to perform, in many cases, redundant work that Congress has already tasked other agencies with doing.
When the administrative state expands its scope, not only do taxpayers bear the burden, but agencies become less nimble and able to respond to crises. It’s this lack of efficiency that Trump is working to correct across the whole of the federal government. The U.S. Agency for International Development, whose budget had ballooned to more than $40 billion, was a justified target for review and a reduction in force.
However, not everything funded through USAID needed to go into the woodchipper. That includes our lifesaving programs overseas — there are quite a few programs that make America safer, stronger, and more prosperous. One example is the President’s Malaria Initiative.
Secretary of State Marco Rubio’s announcement that 18% of USAID programs will remain at the State Department, including critical malaria programs, is the right approach to end what’s broken and keep programs that work. Since its beginning, U.S. malaria aid has prevented billions of cases and saved lives — millions of them. These programs help America attain a position of strength in regions that are otherwise susceptible to overtures from our rivals.
From a public health standpoint, blocking the spread of this infectious disease overseas means we don’t have to deal with outbreaks here. Malaria cases in the United States are rare, and virtually all of them are imported. Controlling it abroad prevents full-blown crises at home.
And the fight against malaria is notably one of the U.S.’ most pro-life initiatives. Our efforts keep children and pregnant women, who are most susceptible to malaria, alive in some of the most vulnerable places on the planet. Americans recognize that it’s our moral duty not to stand idly by and allow innocent people to suffer needlessly.
Malaria aid also bolsters America’s economy. Not only are U.S. companies at the forefront of developing life-saving malaria treatments, vaccines, and insecticides, driving innovation, and creating jobs at home, but over half of malaria deaths occur in just four countries: Nigeria, the Democratic Republic of Congo, Niger, and Tanzania. The stability and health of these nations are vital to the United States for security, critical minerals, and trade.
And talk about being cost-effective: Lifesaving malaria medicine costs just 87 cents, a rapid diagnostic test costs just 28 cents, and protective bed nets are less than $2. Overall, malaria prevention is 0.02% of the federal budget and far cheaper than having to treat outbreaks after people get seriously ill.
Lastly, it’s a geopolitical tool that prevents adversaries such as China from expanding their influence, outmaneuvering us in Africa, and undermining our economic and security interests.
For decades, U.S. leadership in fighting malaria has been a strategic advantage, yielding “soft power.” Through effective health assistance, America has fostered goodwill with African nations that are critical partners in trade, counterterrorism, and global stability. China is playing the long game, and it knows that malaria control is a powerful diplomatic tool. Through its Belt and Road initiative, Beijing has already ramped up its malaria projects, strategically targeting key African nations to deepen political and military ties. It is using medical aid to buy influence, sway elections, and push its communist agenda, all while undermining American interests. Extending our malaria commitments keeps China at bay.
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Trump understands that we can drain the swamp while investing in America’s safety, security, and prosperity. By continuing malaria aid, the president is putting his mark on combatting this deadly disease.
Malaria assistance is not about charity — it’s about winning. Winning against disease, chaos, instability, and, most importantly, China in the fight for global influence. America doesn’t back down. We lead. Fighting to eradicate malaria ensures we continue to do so.
Dr. Robert R. Redfield was the director of the Centers for Disease Control and Prevention from 2018 to 2021. He is a senior fellow for biosecurity and public health policy at the Heritage Foundation. He has been a public health leader actively engaged in clinical research and clinical care of chronic human viral infections and infectious diseases, especially HIV, for more than 30 years.