The world’s richest man, trillionaire Elon Musk, has flown into a days-long rage, incensed by claims his gutting of America’s international aid programs led to children needlessly dying.Throughout the early months of Donald Trump’s second presidency last year, Mr Musk worked as the head of a new government body called DOGE, whose stated goal was to slash wasteful public spending.DOGE quietly faded into the background ages ago, but is formally disbanding this month, having delivered nowhere near the $US2 trillion in savings Mr Musk initially predicted.America’s federal budget deficit remains as stupendous as ever – $US1.8 trillion in the most recent fiscal year – and its national debt is fast approaching $US40 trillion.At least he had fun, though. You might recall the Tesla, SpaceX and Twitter boss, wearing a black MAGA hat and dark sunglasses (indoors), gleefully waving around a chainsaw on stage at the Conservative Political Action Conference in February, 2025.“This is the chainsaw for bureaucracy! Chainsawww!” he shouted to the crowd.MORE: Where world’s richest men really hide their billionsThe people affected by that chainsaw’s short but chaotic insertion into the bowels of the US government weren’t quite so chuffed.That group includes not just the government workers who got sacked, the level of public sympathy for whom might be limited, but the beneficiaries of USAID, the agency overseeing all of the United States’ international aid spending.“We spent the weekend feeding USAID into the wood chipper,” Mr Musk boasted on social media after one apparently productive night, at about 2am.“Could have gone to some great parties. Did that instead.”How selfless.Foreign aid is always among the first targets of government cost-cutting, whichever country you’re in, and for obvious reasons. Why spend money helping foreigners overseas when there are people in need at home?But Mr Musk’s animus towards USAID was rooted in more than that question alone. He seemed to be under the impression that everything USAID did was a waste of money and, worse, a front for something malevolent.During his stint at DOGE, he called the agency “evil”, “a criminal organisation”, and “a viper’s nest of radical left marxists who hate America”, among other things.Hence the indiscriminate nature of his cuts, which essentially defunded the agency wholesale.The savings were among the most significant DOGE identified, clawing back tens of billions of dollars per year.Withdrawing the funding so abruptly, though, and with so little care or rigour, was always going to impose a different kind of cost. A human one.It’s one a prestigious medical journal, The Lancet, tried to quantify in a study last year. It focused on “assessing the impact of total USAID funding on mortality” across two decades, from 2001-2021, and on forecasting the consequences of the agency’s kneecapping.USAID funded food and medical assistance in deprived countries, particularly in Africa. It funded infrastructure and education. It vaccinated people who would otherwise be vulnerable to fatal but preventable diseases. It responded to dozens of natural disasters each year.The vast majority of that money is now gone.By The Lancet’s reckoning, USAID’s efforts across the two decades it examined helped prevent the deaths of more than 91 million people, including 30 million children. Its work caused huge reductions in mortality from HIV/AIDS, malaria and other diseases.“Substantial decreases were observed in mortality from tuberculosis, nutritional deficiencies, diarrhoeal diseases, respiratory infections, and maternal and perinatal conditions,” the study’s authors said.“By age group, the most pronounced reductions were in children younger than five years.”What happens when that work stops?“According to the forecasting models, the current steep funding cuts could lead to more than 14 million additional deaths by 2030, averaging more than 2.4 million deaths per year. These deaths include 4.5 million among children younger than five,” The Lancet concluded.If you are a parent, remember your son or daughter as a baby (my own son is approaching nine months). Imagine them dying in agony, with no access to medicine.Multiply that feeling by a million, and you have something like the estimated cost of USAID’s demise, for a single year.Mr Musk feels no weight of responsibility for that. In fact, he believes it is a fiction.This week, in the first of many, many posts on social media, he challenged anyone to “cite a single name of someone who died” because of his cuts to USAID.“They cannot cite a single name of someone who died out of the ‘millions’ they falsely claim have died. Not a single name!” he said.New York Times columnist Nicholas Kristof, who has reported extensively on the matter and spent time on the ground in Africa, visiting affected areas, answered the challenge.He replied to Mr Musk with a list of people whose deaths he had either personally witnessed or verified. They’d died from AIDS, malaria, complications during childbirth – all preventable deaths, he argued, had the aid continued to flow.“Elon Musk says no one can name a person who died from his aid cuts. In fact, I’ve met the kids who are dying, and I’ve talked to the families who lost children,” Mr Kristof said.“In my columns, I’ve cited many, many names of people who have died.”In that tweet alone he mentioned four such people: Yamah Freeman, Gbessey Kiadu, Ibrahim Koroma and Achol Deng, aged 23, one, less than one and eight, respectively.“I could go on and on,” he said.“In almost every village you go to in South Sudan, Uganda, Liberia, Sierra Leone or other countries I reported in, you find people dying because of aid cuts.”Mr Musk’s response was not to, say, ask for more details, or to have a private conversation with Mr Kristof, or to engage in anything resembling a good faith argument.Instead he spent days raging at Mr Kristof in a spree of often expletive-laden tweets.“Kristof is utterly evil,” was a quote repeated multiple times.“Kristof is lying through his teeth.”“Nothing that Kristof has said is true.”At one point, Mr Musk chimed in on a discussion between Mr Kristof and conservative political activist Christopher Rufo.“The moral calculus here is insane. According to Kristof, the USA is responsible for every poor nation in the entire world,” Mr Rufo had said.“If an ambulance runs out of fuel in rural Liberia, that is our fault. The liberal has a pathological tension between the feelings of omnipotence and guilt.”I should note that in the US “liberal” is synonymous with progressive.“No I don’t think we are responsible for all poor nations,” Mr Kristof told him.“But we were saving one life every 10 seconds with USAID, and we cut that off abruptly with no time for countries to adjust. So kids died unnecessarily. And I do think that it’s bad when kids die unnecessarily, don’t you?”After which Mr Musk interjected: “You’re an utter piece of s**t and a liar.”Mr Kristof eventually responded to the flurry of abuse with a column headlined: “USAID cuts killed people. That’s the Truth.” I encourage you to read it in full.“What I can say after visiting numerous impoverished villages is that aid cuts are unquestionably costing the lives of many children,” he wrote.“It’s reasonable to ask how much we should spend or how we should reform the system. But why would anyone begrudge $2 bed nets or $4 malaria vaccines to save children’s lives?“So let me offer a challenge to Musk: come with me on a reporting trip to South Sudan or Somalia or Mozambique. Meet starving children whose lives can be easily saved. Hold them. Look into their eyes. Talk to their terrified moms.“You’ll understand that these kids are just like ours, except that they didn’t do as well in the lottery of birth. And that just because we can’t save every child’s life doesn’t mean we should save none of them.”If he had a functioning moral centre, Mr Musk would accept that offer without hesitation, wouldn’t he?What reason could he have not to? Is the cost of a plane ride to Africa too much for history’s richest person? Can he not carve out a couple of days in his busy s**tposting schedule?If Mr Kristof is lying, then go, and come back crowing about how wrong he was.But Mr Musk won’t do that, and we all know it.He’s too scared of what he will find. He’d rather not know. Much easier to persist with the sick charade; to insist that you can cut off food to malnourished kids without consequence; to dismiss anything that punctures your comfortable illusion as a malicious “lie”.It would be one thing to gut aid regretfully, citing cold budgetary reality. To argue that yes, lives will be lost, but it’s still the right decision.That would at least be an honest conversation.Mr Musk instead wielded his chainsaw with a goofy smile. It brought him joy.And now that the awful aftermath is here, he doesn’t have the stones, let alone the decency, to look the people he condemned to suffer in the eye, or even to spare them a thought.Twitter: @SamClenchRead related topics:Elon Musk