Without firing a shot Donald Trump may well earn a spot among the Top 10 leaders in history presiding over death in their respective countries and beyond.
He probably (it is to be hoped) will not match or exceed the death count of Mao Zedong (60 million), Josef Stalin (40 million), or Adolf Hitler (30 million), the 20th Century’s most prolific killers. But Trump’s heartless elimination of USAID funding in Africa and other continents suffering from medical crises exacerbated by civil wars and famine, and his proposed cutbacks to Medicaid and Obamacare eligibility for vulnerable lower income Americans, could easily land him on the list of leaders responsible for millions of unnecessary deaths.
Because he has cut treatment centers abroad that strive to minimize the spread of controllable diseases Trump may well unleash global pandemics that could rival deaths from the Black Plague of the Middle Ages, the Spanish Flu of the post World War I era, and Covid-19.
Trimming fat from the federal budget is a worthy endeavor, to be done as with a surgeon’s precise use of a scalpel. But using a chain saw to reduce the budget is a grotesque use of executive power as it ignores repercussions from the surgery.
USAID programs in some 120 countries helped fight tuberculosis, HIV, malaria, polio and other infectious diseases, as well as supplying food to stave off the ravages of famine.
Estimating deaths is not a precise calculation, but it provides an informed analysis of the potential impact of Trump’s cutbacks. For example, eliminating PEPFAR (President’s Emergency Plan for AIDS Relief, started by President George W. Bush in 2003) would result in the loss of an adult life every three minutes and a child’s every 31 minutes, according to Brooke Nichols, an associate professor of global health at Boston University (https://www.bu.edu/articles/2025/mathematician-tracks-deaths-from-usaid-medicaid-cuts/).
On May 28, NPR reported “modeling out of Boston University estimates that the abrupt cuts to USAID have meant nearly 300,000 people have died to date.”
The Black Plague and Spanish Flu killed tens of millions during a time when global travel was rare. Even after Trump’s ban on visitors from some Third World countries, America is more vulnerable to epidemics brought in from abroad because USAID programs have ended most hopes of containment while domestic vaccination rates for communicable diseases, such as measles, have decreased. Highly contagious and even deadly, measles outbreaks have popped up throughout the United States. As of June 5, the Center for Disease Control reported 1,168 confirmed cases of measles this year. Three deaths resulted.
The danger is compounded by Trump’s proposal to cut back on the federal government’s Medicaid financial support to states. The Hill news organization reported, “The Center for American Progress found that about 34,200 more people would die annually if the federal government reduced its current 90 percent match for the expansion costs and states responded by dropping their Medicaid expansions (https://thehill.com/policy/healthcare/5261905-medicaid-cuts-house-republican-budget-plan/).
Staying healthy, unfortunately, is not an option for far too many, at home and abroad. Nor is the ability to provide sufficient food for their families. All too often a last resort is government assistance. There is, or should be, a special place in Hell for a leader who strips away health care and life-preserving food from the needy.
According to Telegrafi, an Albanian news site, the Top 10 propellers of death in their respective country and internationally during the last 150 years are:
- Mao Zedong (China) 60 million
- Josef Stalin (USSR/Eastern Europe) 40 million
- Adolf Hitler (Germany/Europe) 30 million
- King Leopold II (Belgium/Congo) 8 million
- Hidaki Tojo (Japan/Far East) 5 million
- Ismail Enver Pasha (Ottoman Empire) 2 million
- Pol Pot (Cambodia) 1.7 million
- Kim II Sung (North Korea) 1.6 million
- Mengistu Haile Mariam (Ethiopia) 1.5 million
- Yakubu Gowon (Nigeria) 1 million
Interestingly, some well known tyrants didn’t make the list. Saddam Hussein (Iraq) killed 600,000; Idi Amin’s toll in Uganda is estimated at 300,000-400,000; Benito Mussolini (Italy) 250,000.
Trump will most assuredly crack the Top 10. It is only a question of how high on the list will he rank.
