What This Former USAID Head Had to Say About Elon Musk and DOGE

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0:45Well, we asked the president of the Rockefeller Foundation what advice he has for Elon Musk when it comes to using his billions of dollars to help humanity. And that's as Musk and Doge are taking a chainsaw to government aid spending. That's next.

1:03There's probably no bolder name in the history of U.S. business than Rockefeller. That's John D. Rockefeller. He made his fortune in oil more than 100 years ago, and he eventually used some of his money to create a non-profit organization that still bears his name to promote the well-being of humanity. All these years later, Raj Shah is the man responsible for that legacy as the president of the Rockefeller Foundation. That puts him on the front lines of trying to fill the gaps in foreign aid that evaporated with the Trump administration's elimination of the U.S. Agency for International Development, or USAID.

1:40We're trying to understand where the pockets of vulnerability are most aggressive, and we're trying to craft new solutions that countries can get behind. Because at the end of the day, this takes public and private, and philanthropy can't fill the gap. Shaw has special insight into the situation, having run USAID under the Obama administration. The agency's work has been criticized by President Trump and his ally Elon Musk. They say it was wasteful and did not reflect America's values. We have massive amounts of fraud that we caught. I think we probably caught way over a lot of billions of dollars already in, what, two weeks?

2:21Yes. And it's going to go to numbers that you're not going to believe. Still, during his time at USAID, Shaw says he saw the power it had in shaping foreign policy and helping America abroad. It's been a relatively small part of American foreign policy, by the way, less than 1 % of our total global budget. And it's allowed us to project American values and power into the 75, 80 lowest income countries and communities. From the Wall Street Journal, I'm Christopher Mims. And I'm Tim Higgins. This is Bold Names. We'll hear from the leaders of the Bold Name companies featured in the pages of the Wall Street Journal.

3:00Today we ask, how do nonprofits like the Rockefeller Foundation see their roles in an era when governments around the world are turning off aid and looking inward? Raj Shah, welcome to Bold Names. A few years ago, it was the 110th anniversary of your foundation, and you collectively made the foundation's largest single grant, I guess, in the history of the foundation. Half a billion dollars with the goal of reaching a billion people who live in poverty with renewable energy. How does that work? Well, you know, I have had the opportunity for many decades to work on issues related to poverty at home here in the United States and around the world.

3:44And it turns out, as you mentioned, there are about a billion people on this planet that live in the dark. They consume less than 150 kilowatt hours per capita per year of electricity. As a result, they can barely power a light bulb and a small appliance in their home. They are living in communities where it's It's very hard to create jobs and upward economic mobility and for businesses to succeed when there's no access to energy or energy is extremely expensive and erratic. But today we've mobilized tens of billions of dollars to reach a billion people who live fundamentally disconnected from the power grid with distributed renewable electrification.

4:24And when we make those investments, we make them in the form of equity investments in small companies in the form of policy engagement with countries to get countries to make their own investments and to change the rules to allow the private sector and entrepreneurs to enter the electricity service business. And we make them with an eye towards fiercely measuring results. So I can tell you that in the 40 million people we're now serving in more than a dozen countries, those communities are moving out of poverty. Women in those communities are getting jobs. girls in those communities are going to school, sometimes for the very first time.

5:00Big bets, equity investments, impact investing, risk capital. This all sounds a lot like Silicon Valley and from a tech perspective, like seed capital. Is that how you're looking at it? Yeah, exactly. I mean, we basically think our philanthropic resource, our endowment and the money that comes off of it is risk capital for society. And in particular, it's risk capital to find the innovative new solutions that can help people who are most vulnerable. You know, society is going to create great new technology solutions to power data centers right now because there's a ton of money to be made. It's obviously top of mind to anyone in the energy sector and energy industry you don't have the same creativity presence of capital and commitment to find solutions to replace diesel generators in northern nigeria that are providing power erratically in a noisy dirty way at 60 70 cents a kilowatt hour and so so we try to fill that gap by being society's risk capital find the solutions and then frankly when we find good solutions that are market ready, it's often local entrepreneurs and businesses that take it to scale if we can get governments to create a stable and appropriate regulatory framework to allow those businesses to succeed.

6:28I think one of the interesting things about the foundation is it's played such an important role in the creation of the modern field of public health, fighting the 1918 influenza a pandemic, helping eradicate hookworm in the U.S., helping develop the yellow fever vaccine. And I'm curious, what is it like running an organization with that history at a time when some very high profile U.S. leaders are questioning not only the efficacy of vaccines, but also suggesting they're unsafe? Well, I think of it more as our services, our knowledge, our history, and our understanding of the field is actually more needed now than in recent years.

7:09You know, I'm very proud of the role we played in helping America overcome COVID. And we worked hand in glove with the Trump administration, with dozens of states, and with more than 40 local municipalities, cities, tribal reservations, et cetera, to expand access to COVID testing for our country. In fact, we launched that effort with the op-ed that ran about five years ago in the Wall Street Journal because we felt the only way to get out of lockdown was to invest in science-based testing strategies so people knew who was safe and who wasn't, and we could get out of our homes and get kids back into school and live the kind of life Americans want to be able to live.

7:50And so, you know, we go where the science takes us. And for a long, long time from the invention of the yellow fever vaccine to today, we've been investing in safe, effective vaccination that has saved millions and millions of lives. And we'll continue to do that. We'll continue to enlist all the partners we can to make the case that vaccination, especially childhood vaccination, is both extremely safe and the most efficient way to save life around the world. Of course, we live in a time when science is now unfortunately highly politicized. You and I grew up in a time when vaccinating children was not controversial.

8:33It was the greatest public health win in literally the history of humanity. Now that's controversial in some circles. And it feels like we're moving rapidly toward a world in which vaccination rates for measles, for example, might be higher in some of the areas that you serve in sub-Saharan Africa, even then perhaps in the sunbelt of the U.S. if things keep going in the direction that they're going. Do you think a reversal like that is possible that we might be headed in that direction? Well, we we certainly are. You know, that's certainly a real problem, you know, as you point out. And, you know, I'd say two things about that.

9:11The first is, obviously, in a country that already has very widespread immunization for measles or any other childhood preventable disease, a few people, statistically speaking, can get away with not being vaccinated because they're piggybacking on the herd immunity of the overall population. But if enough people do that, over time, you get outbreaks. And we know we can expect more if this behavior continues. So we do ask ourselves, well, why do why have people lost trust in science based public health? And how do we reinvigorate that trust? And one thing we learned during COVID was that people didn't want to trust Tony Fauci speaking on television, or they didn't want to trust an institutional statement from the CDC or your government.

9:59But you know who they did trust? I mean, we worked with Governor Kemp in Georgia to identify black preachers and churches who would reach out to their congregations and say, you can trust this vaccine is safe and it'll protect you and help you be more active and out and about in your day to day life and help your kids get back to school and help the teachers be safe. They did trust local community leaders in rural communities. So we started to invest less in sort of exemplars of scientific excellence and more in local trusted voices across this country in red communities and blue communities. We've heard how Shaw approaches giving, but next he talks about why he thinks it is wrong to demonize USAID.

10:44People in America want to help their neighbor. And that's true whether their neighbor is in Haiti or whether their neighbor is inside the city of Detroit. And the truth is, when we do it with a high efficiency and a focus on results, we actually demonstrate the best of our values and make our country safe and make our people proud. Stay with us.

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11:51Speaking of that political divide, one area of public assistance that's become very political is USAID. You used to run USAID. has been one of the largest sources of assistance for more than 120 countries providing money for things like hunger relief and responding to infectious diseases. A lot of that has been very much disrupted. And I'm interested in hearing what you think will be the ramifications of that money apparently going away. Well, I'll tell you, my first week on the job at USAID, the Haiti earthquake happened. And President Obama called me in my office and America, military and civilian and the private sector partnered to mount the largest single humanitarian response.

12:39Within a few days, we're feeding 3 million people. We sent urban search and rescue teams that literally pulled 106 people from the rubble and saved their lives within hours. And the reality is, I mean, people in America want to help their neighbor. And that's true, whether their neighbor's in Haiti or whether their neighbor is inside the city of Detroit. And the truth is, when we do it with a high efficiency and a focus on results, when we're honest about fighting the waste, fraud and abuse that people should worry about with any form of public expenditure, but we do that with intentionality, we actually demonstrate the best of our values and make our country safe and make our people proud.

13:20And so it's been a bipartisan, longstanding part of American foreign policy. It's been a relatively small part of American foreign policy, by the way, at less than 1 % of our total global budget. And it's allowed us to project American values and power into the 75, 80 lowest income countries and communities. I have been in churches and schools. I was in a school in rural South India as a kid on a project. You look up above the blackboard and you see three pictures of India's independence leaders and a picture of John F. Kennedy. There have been projections that the complete elimination of USAID is going to lead to millions of deaths because of the very basic public health operations that it's supported.

14:06Do you agree with those projections? What are going to be the ramifications? I mean, let's just be blunt here. What do you think is going to be the impact of all that aid going away? I think these projections are accurate. I think if you look very specifically at the reality that USAID ran the supply chain for providing antiretroviral drugs to millions of Africans, that was a program created by George W. Bush, a Republican president, right, with extraordinarily strong support from churches and evangelical communities across this country who directly partnered in that program all across Africa.

14:40I used to travel through parts of Africa where the single biggest roadside item for sale was a coffin because so many people, especially of working age young men, were dying of HIV AIDS. And that was a huge destabilizing force for that continent's future and migratory force as a result of that instability. And PEPFAR program solved that problem. I mean, it didn't solve HIV AIDS completely, but it prevented it from being a death sentence, and it brought stability and growth back to communities that were absolutely devastated. That's one of the proudest legacies we have as a country, and we're now putting all those AIDS patients at risk again.

15:23Now, could we have done things differently? Absolutely. I mean, when I ran USAID, one of the first things I did after my four sleepless months of running the Haiti earthquake response was we cut 300 programs. We cut more than 300 programs because we felt couldn't clearly measure the results of them. They were very expensive. And we redirected that money to create a program called Feed the Future. The idea being if we could help farmers in these vulnerable places produce more food, we wouldn't have to create this dependency of long-term American food assistance. It moved 45 million people in vulnerable settings out of poverty and hunger and dependence on aid.

16:01And it created the independence we wanted to create. We could have done that with PEPFAR earlier. We could have said, okay, you countries should be paying more for your own antiretroviral care for your populations over time. But the drastic overnight ceasing of these programs will put a million kids at risk that we know we're receiving life-saving malnutrition support, probably six or seven million HIV AIDS patients, probably twice as many people in communities that have high malaria risk. And remember, the people who are most vulnerable to malaria are kids and malnourished kids in particular.

16:37And so there will be a lot more human consequence, a lot more death. And I can tell you that a parent in Kabul or in Somalia or in South Africa or in Guatemala cares as much about their kid and their kid's ability to live as my parents did in suburban Detroit. So, you know, we're going to have to rebuild now. While Shah disagrees on the Trump administration's handling of USAID, he still sees ways that the Rockefeller Foundation can work with the government in the U.S. There's probably not room for working together on some areas like vaccine science, because we have very different points of view.

17:18But on food as medicine, we think we have some like-minded partners. That's next.

17:53We'll be right back. Number one trusted based on August 2025 proprietary survey among real estate professionals.

18:07The Trump administration and his allies have argued that USAID was just full of wasteful spending, or at least spending on programs that they question as good use of government money. They like to point to$47 ,000 for transgender opera in Colombia or what they claim as a DEI musical in Ireland. You know, when they go down the list, I think they're doing it for laughs. How would you defend these kinds of claims if you were running USAID at this point? Well, you know, I haven't been there for a while, so I can't really be precise. But obviously USAID is not active in Ireland. Ireland is not a developing country.

18:45Last we checked. And so, you know, there was a lot of misinformation in all of that. Now, listen, I've run a government agency, and I think most of my counterparts who have done the same would admit that when you come in from the outside, I came in from the private sector, I'd worked for Bill Gates for years as he established his foundation. We were rigorously focused on measuring results and demanding accountability for the resources we put in play. And I have two chapters in my book about that work. And so I entered USAID with that mindset and found plenty of things to cut and to change and to redirect to get more bang for buck for American taxpayers.

19:22But, you know, this does this wasn't done that way. Right. This wasn't done with the mindset of let's figure out how to be more efficient. This was done in a way that I think is going to create real threats to the American population. I mean, I'll give you one example. When we led the Ebola response in West Africa in 2014, the CDC estimated that there would be 1.4 million cases of Ebola, including potentially hundreds of thousands in the United States. Ultimately, we beat Ebola back in West Africa with less than 30 ,000 cases. And frankly, when America leads, everyone else joins. China was part of that response.

19:59The Europeans were part of that response. Most importantly, of the 10 ,000 people we mobilized to fight Ebola in West Africa, nearly all of them were West African. And so there's something magical about American leadership on the world stage that others have followed for decades. And I hope we don't lose that in the current governance that we're exhibiting. Well, it seems like we are going to lose that because the approach that Elon Musk and Doge is taking is really clear-cutting. all of these agencies, all of these projects, all of this spending, even slashing domestic public health efforts. I guess the attitude is, because this is what Musk has done in his own companies, is take it all out, see what was load-bearing, what breaks, and then maybe you put that back in and let that guide what gets rebuilt.

20:56What do you think of that approach? I watch with awe at how that approach has built value in the private sector, you know, writ large, especially with companies known for disruption and innovation. So I don't have an immediate critique to that general approach. approach, obviously applying that approach without the focus on what's the outcome you want and are we going to get there and do you have a plan to get there and do you have innovative ideas on how to do it. That's the part that seems totally missing from all of this. So I'll just give you an example. At the Rockefeller Foundation, we just launched a major partnership with the Department of Veterans Affairs around an area of work called Food is Medicine.

21:37And it turns out that American veterans, 27 % of those that served and fought in Iraq and Afghanistan today live in this country and live in food insecurity. That's just wrong. They are also more likely to have diabetes and chronic disease. And we know that diet-related disease costs America$1.1 trillion a year. So we've invested$100 million working with the VA and others, private grocers, Instacart, other companies, to help people get what are called food as medicine interventions, like vegetables, prepared foods, medically tailored meals, precisely for those people most vulnerable to get diabetes and to have long-term consequences of chronic disease.

22:19and we found it is highly effective at helping them lose weight, helping them live healthier lives, reduces mental health problems, and makes a huge, huge difference for health care costs for payers in particular like the VA. I mean, that's how you deliver results for people and save money for taxpayers. The alternative, of course, is just shutting down the VA or taking lots of service professionals out of the VA structure and making it harder for patients to get doctor's appointments and nursing appointments and counseling appointments. And that's also what's happening right now. Health and Human Services Secretary Robert F.

22:56Kennedy Jr. also uses this terminology, food is medicine. Are you guys talking about the same thing? Is there room for working together? There is, there is. I will say there's probably not room for working together on some areas like vaccine science, as we talked about earlier, because we have very different points of view. But on food is medicine, we think we have some like-minded partners And we're already working with the Centers for Medicaid and Medicare Services to make sure states get waivers to try this program at greater scale. And our goal is to scale solutions largely through private sector solutions.

23:32So if we can save and insure money and improve the health of a vulnerable population, we're willing to be the risk capital required to prove that that works and let markets take those things to scale. And yes, we'll partner with this administration to get there at scale if they're interested. Just to be clear for our listeners, because I think this will help put what you do in context, does the Rockefeller Foundation get any federal aid or grants? No, no. We are a foundation that has our own endowment. We spend off that endowment, and then we raise money from other private givers and philanthropists, from the Giving Pledge community and others who have said they want to use their resources to make the world a better place and want to do it in the way we do it, making big bets on science and innovation that can help transform lives for the better.

24:25So I feel like that puts you in a very unique position because contrast that with Catholic Relief Services, which has said they may have to lay off as much as half of their staff for the good work that they do. And universities obviously having to slash all kinds of programs and really retreating as fast as they can in the face of demands from the current administration. So how do you view your role as not just an alternative to this sort of Musk-Doge program, but potentially in opposition to it? Is this a time when you feel like, okay, I need to step up and kind of get a little spicy, or I need to be this calm alternative to the current program?

24:59Well, it's interesting. I think we've been the calm alternative for a long time, and now we find that being the calm alternative is defined as being a little bit spicy. We just launched. Your mere existence. Yeah, yeah. I mean, we're just kind of putting our head down and helping vulnerable people in a science based way. We measure and publish our results and think that's a pretty good way to do this work. And it has worked since John D. Rockefeller kind of defined that approach. And he literally called it scientific philanthropy 110 years ago. And so we've maintained that and we're different from others, as you point out, as a result.

25:34So So our thinking is the following. We will work with anybody in order to achieve our goals and objectives. When our partners or an industry that we have been a part of, like global health, is at extraordinary peril and threat, we will be a part of gathering the community together and saying, okay, what do we do now? And sometimes what do we do now involves explaining the work and saying, hey, folks, this is yes, there might be this kind of fraud in this example. But but by and large, we've studied it and we can document that these are results oriented programs and activities. And we'll use our voice to do that.

26:13And if people think that's spicy, it's spicy. It's just a matter of speaking our own known truth. So can nonprofit groups just fill the void of USAID's disappearance? I mean, the Rockefeller Foundation has, what,$6 billion in assets? That's a lot of money. Can you just deploy that tomorrow? No, and it's not even close, right? And so if you look, it's not just USAID's disappearance, which might have been, you know,$40 to$60 billion, depending on how you measure and what you count. But this whole field of developmental assistance that maybe 40 or so countries provide to the other 120 or so countries is the official developmental assistance is probably around$220 billion on an annual basis.