We are now witnessing what the historian Richard Rhodes termed "public man-made death," which, he observed, has been perhaps the most overlooked cause of mortality in the last century. Brooke Nichols, the Boston University epidemiologist and mathematical modeller, has maintained a respected tracker of current impact. The model is conservative, assuming, for example, that the State Department will fully sustain the programs that remain. As of November 5th, it estimated that U.S.A.I.D.'s dismantling has already caused the deaths of six hundred thousand people, two-thirds of them children. The toll is appalling and will continue to grow.