Nicholas Enrich, former acting assistant administrator for global health at USAID, published “Into the Wood Chipper” (Simon & Schuster, foreword by Atul Gawande) detailing the inside story of DOGE's dismantling of America's primary foreign aid agency.
Key revelations: Trump appointees thought USAID “provided abortions” (it had strict legal prohibitions against this). Mark Lloyd, who led USAID's bureau for conflict prevention, claimed career staff had “killed his dog” during the first term and wanted to fire staff as revenge. Musk posted on X: “We spent the weekend feeding USAID into the wood chipper” — the same day his DOGE team had actually cancelled Ebola activity contracts while telling the White House they'd been restarted.
Enrich issued a memo in March 2025 warning of “severe domestic and global consequences” and was put on administrative leave within 30 minutes. By March 2025, Secretary Rubio confirmed 83% of programs (5,200 contracts) were cancelled. By July 2025, USAID was officially merged into the State Department.
Oxfam estimates: 23 million children lost access to education, 95 million lost healthcare access, and potentially 3+ million preventable deaths per year from the cuts. These are estimates — the actual toll will take years to quantify.
The book's memos were cited in a Supreme Court case on USAID dissolution. Enrich is a named, senior government official — not an anonymous source.
In July 2026, the human cost got a number. Atul Gawande, the surgeon and former USAID official who wrote the foreword to Enrich's book, estimated in a New Yorker interview that roughly 700,000 people have already died as a result of the cuts, and said the toll will keep climbing into the millions. The figure draws on analyses from Boston University researchers and a study in The Lancet, which found USAID programs had saved about 92 million lives over the previous two decades. Rep. Ro Khanna cited related projections that as many as 4.5 million children could die by 2030 if funding stays at current levels. Gawande cautioned that the 700,000 is a projection and that complete mortality data may take years to confirm.