What This Former USAID Head Had to Say About Elon Musk and DOGE
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Hey, Mims, what would you do with a billion dollars? I think I'd buy a million iPhones.

and give them away in a Mr. Beast-style stunt that's sure to net me the most viewed YouTube video in history. Well, 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. There'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 nonprofit 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.

We'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.

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, where you'll hear from the leaders of the bold name companies featured in the pages of The Wall Street Journal. Today 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. And 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 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. And 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. Big 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.

I 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 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.

You 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. And 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. It 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 US, 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 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. The 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 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. But 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

We've heard how Shah approaches giving, but next he talks about why he thinks it is wrong to demonize USAID.

People 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.

Why do over 50% of the Fortune 500 use Elastic? Because Elastic has done the hard work of making it easier for companies to do generative AI right. Elastic's Search AI helps them make insightful and impactful decisions at speed. Across search, observability, and security, Elastic has the power to take your data into the future. Explore the possibilities of AI with your data at explore.elastic.co. Elastic, the Search AI company.

Speaking of that political divide, one area of public assistance that's become very political is USAID. You used to run USAID. It 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. Within 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 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, 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.

It's been a bipartisan, long-standing part of American foreign policy. 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. 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 supported. Do 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. I 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. Now, 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. And it created the independence we wanted to create. We could have done that with PEPFAR earlier. We could have said, OK,

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 by 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. And 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. But on food as medicine, we think we have some like-minded partners. That's next.

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The 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?

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. And lastly checked. And so, you know, there were there was a lot of misinformation and 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

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.

But 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. You know, China was part of that response. The 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. What 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 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 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 we 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

And 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. And 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 healthcare 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. Kennedy Jr. also uses this terminology, food as 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 as 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. So 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, you know, 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 resources

science and innovation that can help transform lives for the better. So 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, you know, 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 the 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? Well, 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 of things. 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

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 uh and so we've maintained that and we're different from others as you point out as a result so our art 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, you know, this kind of fraud in this example, 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.

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. And again, people follow the U.S. lead. So when the U.S. goes down so dramatically, very soon after those announcements, the U.K. announced they'll cut their aid in half.

We've seen a lot of European countries redirect their aid budgets to refugee support domestically, which is a great cause, but it does lead to a reduction in their own assistance. So what we're basically seeing is a global collapse of the effort to extend health and food to the world's most vulnerable people and communities. And whatever you might think of USAID, the hundreds of partners that the European countries used

and that the Americans have used to support that work are all in deep peril right now. So, you know, we're working with them, we're listening to them, we'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. I want to circle back to how we began.

You run the Rockefeller Foundation created by John D. Rockefeller, once one of the world's richest men, used to work for the Gates Foundation created by one of the world's richest men of this era. If the world's current richest man, Elon Musk, called you up today, what advice would you give about helping humanity? How should he be using his billions and billions of dollars?

Oh, gosh, that's a great question. I'm not sure I should be in the business of giving Elon Musk a lot of personal advice, but I would say this. Free trips to Mars. I mean, he, I'll say, no, he's, you know, he's, I used to really believe this and I still do. You know, that Tesla power wall,

If you can innovate a version of that that is better and cheaper and cheaper and cheaper is probably the solution to unlocking human poverty on this planet. I've always felt that the magic they've done on making electricity something that can be distributed, renewable and totally accessible could change the face of the earth and change the face of poverty and inequity pretty fundamentally. And in fact, there was a time when I think Tesla

acquired another Musk company that was doing that type of work. SolarCity. Yeah, SolarCity. His cousin's company. Yeah, exactly. So, I mean, you know,

Give us the 50 best technologists who are innovating there. Let's partner them with Indian and African entrepreneurs. Let's create the lowest cost, most scalable version of that solution. And let's use the power of the private sector in partnership with government and people like us that have some risk capital and a desire to make a difference. And let's lift the bottom billion people on this planet up into a stable place of growth and opportunity. And you'll do more for us.

humanity, for safety, for security, and for happiness on this planet than perhaps anything else we could do together. So it sounds like your advice to Musk would be maybe return to form, like Musk of 10, 15 years ago, where the vision was about energy, energy poverty, and the abundance that comes from making energy universally available. Yeah.

Well, that would certainly unlock human potential in a pretty fundamental way. And I will say we get the honor of working with young entrepreneurs who I think many of whom were inspired by the Elon Musk of 10 years ago.

in India and in Africa and in Latin America who are working on exactly these types of solutions. He obviously has some really special genius to have built what got built in the private sector and not all of these entrepreneurs will have that, but some of them are pretty extraordinary.

As a foundation, we're different than other institutions because we want to get behind those entrepreneurs and help them be as successful as possible. Well, Raja, thank you for joining us today. Thanks so much. It's been great to be with you. We reached out to Doge, the State Department, and Elon Musk for comment. They did not respond. And that's Bold Names for this week. Our producer is Danny Lewis.

Michael LaValle and Jessica Fenton are our sound designers. Jessica also wrote our theme music. Our supervising producer is Catherine Millsop. Our development producer is Aisha Al-Muslim. Scott Salloway and Chris Zinsley are the deputy editors. And Falana Patterson is the Wall Street Journal's head of news audio. For even more, check out our columns on WSJ.com. I'm Tim Higgins. And I'm Christopher Mims. Thanks for listening.

Why do over 50% of the Fortune 500 use Elastic? Because Elastic has done the hard work of making it easier for companies to do generative AI right. Elastic's Search AI helps them make insightful and impactful decisions at speed. Across search, observability and security, Elastic has the power to take your data into the future. Explore the possibilities of AI with your data at explore.elastic.co. Elastic, the Search AI company.