During Donald Trump’s first term, I served on the National Security Council and witnessed the president’s dedication to putting America first. What I see from his second term is a commitment to make good on that promise by eliminating spending that does not advance America’s national interest. The administration is right—there is waste within the U.S. foreign aid system, and it should be eliminated. Aligning foreign aid with U.S. interests is common sense.
But I’m concerned that we are weakening our status as a world leader by pulling the plug on critical programs that make us strong in the face of foreign adversaries who wish to undermine our influence. Within DOGE’s quest to reduce waste, America’s anti-malaria strategy, one of our nation’s most successful initiatives of the past 20 years, has essentially been shut off.
Make no mistake: U.S. spending on malaria (less than .02 percent of the federal budget) is anything but wasteful. Since 2000, U.S. and global malaria programs have prevented 2.2 billion cases and saved 12.7 million lives worldwide.
The PMI was launched in collaboration with the U.S. military, private sector, and international partners to support countries aligned with the U.S. government’s interests. The program reduced malaria through targeted prevention, testing, treatment, and tracking interventions. In all my years of service, I have not seen a more efficient endeavor involving collaboration between the military, private sector, and U.S. government.
Although malaria has nearly been eradicated in 45 countries, the threat still exists. In 2023 alone, there were 263 million malaria cases worldwide and nearly 600,000 deaths.
Continuing the fight to rid the world of malaria is critical to our safety, security, and prosperity.
The United States’ role in combating malaria not only saves lives and stimulates economies in other regions—making them viable recipients of American exports—but also counters China’s elevated presence in Africa and rising influence in the foreign assistance space. Continuing our work to eradicate this disease strengthens our diplomatic ties and helps maintain our advantage over China.
The public health benefits of malaria prevention for Americans are numerous. With mosquito species capable of carrying the disease present in over 30 states, there is always a risk of malaria reemerging domestically if it remains widespread abroad. The United States already sees between 2,000 and 2,500 malaria cases each year due to travel from malaria hot spots like sub-Saharan Africa and parts of South America and Southeast Asia. Recently, the United States recorded nine homegrown malaria cases—the first in two decades. While rare, these cases are a reminder that we cannot let down our guard against this deadly disease.
Stopping outbreaks early in other countries minimizes the chance of a resurgence in areas where malaria has been eliminated. Additionally, American troops stationed in malaria-prone regions face fewer health risks when host nations implement effective disease control measures, ensuring their readiness and safety.
To its credit, the Trump administration recognizes the importance of malaria elimination. Recently, the State Department issued a waiver allowing critical malaria services to resume. I applaud Secretary Rubio’s effort to restore funding for the prevention and treatment of malaria within 30 days. That funding should be fast-tracked. Next, the administration should issue start-work orders for all programs to begin indoor spraying, net distribution, testing, and treatment for malaria.
In the first year of his first term, President Trump expanded the PMI into three new countries. Today, with new tools, the president has a historic opportunity to significantly reduce malaria deaths by the end of his second term, potentially making the disease a footnote in history. What a legacy that would be.
We know what causes malaria and how to prevent and treat it. We must continue the fight against this deadly disease—our country’s safety, security, and prosperity depend on it.