Thanks for comissioning this work and sharing it.
I found your comments about the methodology a bit confusing. Are these estimates for what the impact would have been, if PEPFAR hadn't been largely restored, or what it actually will be?
We first assigned these forecasts during a period in which it appeared that foreign aid might be reduced to effectively zero. After substantial outcry, some funding has been reinstated. Charles Kenny and Justin Sandefur,1 of the Center for Global Development, have compiled estimates of total USAID cuts by sector and by country. Some areas, such as infrastructure and civil society, appear likely to be hollowed out entirely. Others, like maternal health and agriculture, may continue at only a tenth of their previous funding. The most critical programming, at least in terms of immediate mortality impacts, such as PEPFAR, malaria, and nutrition assistance, appear likely to persist, albeit in a heavily reduced form — around 70% of its previous funding for HIV/AIDS, 50% for TB, and 40% for nutrition.
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We estimate that the combined impact of the projected cuts to these five programs will result in between 483,000 and 1.14 million excess deaths over one year.
Yes, I have an intuition that development is good, just like I have an intuition that ice cream is good. That doesn't mean that the price of the ice-cream should be ignored and assumed to be zero when deciding when to buy it, and nor should the costs of development be ignored and assumed to be zero.
It is the commerce clause interpretation that gives the federal government the right to regulate in this fashion. (Though I would point to Wickard v. Filburn as being the key case, rather than Gonzales v. Raich). The federal government doesn't have the right to do whatever it likes, it has certain enumerated constitutional powers - Wickard v Filburn and a couple of similar cases are where they decided to interpret those enumerated powers very broadly and give themselves the almost unlimited power they have today.
I agree the discussion of Guantanamo is a distraction.
I agree that all else equal it is an argument against development, though I still think development is good overall on net, and I think the extent to which development specifically is the cause of reduced fertility has been overstated.
More generally, I am very skeptical of arguments of the form "We must ignore X, because otherwise Y would be bad". Maybe Y is bad! What gives you the confidence that Y is good? If you have some strong argument that Y is good, why can't that argument outweigh X, rather than forcing us to simply close our eyes and pretend X doesn't exist?
What about cutting out eggs and adding some other source of protein, like beef?