“The picture of the world’s richest man killing the world’s poorest children is not a pretty one,” Microsoft founder and billionaire philanthropist Bill Gates said of Elon Musk during an interview with The Financial Times earlier this month. Gates indirectly referenced Musk’s role in gutting the federal agency United States Aid for International Development (USAID), where billions of dollars had gone towards global poverty reduction and the eradication of diseases for decades. That is, until Musk led the charge for President Donald Trump’s unofficial Department of Government Efficiency (DOGE) to dismantle USAID in February. “And unless we reverse pretty quickly, that’ll be over a million additional deaths” of children worldwide, Gates said in an interview on The Late Show with Stephen Colbert, expanding on his Financial Times comments.

Despite what Gates and others may think, Musk’s disdain for human lives isn’t limited to his role in leading DOGE. Nor is this just Musk’s thinking. Trump has deployed in his administration and in his relationships with billionaires a group of the old and new eugenicists. Some of these leading men believe in a philosophy known as longtermism. For humanity to survive and spread itself across the galaxy in its trillions in the eons to come, men like them must steer the way. For it is they who must make the tough decisions of allowing a significant number of present-day humans to die off to protect this distant future. And with Trump, men like Musk are guiding US domestic and foreign policies in eugenicist and longtermist ways, leaving millions in actual or potential peril.

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Perhaps the leading example of old-style eugenicist thinking in Trump’s orbit is Robert F Kennedy Jr, currently serving as US Secretary for Health and Human Services (HHS). There are two positions he publicly holds which truly show Kennedy to be a 20th-century eugenicist. One is his stance against vaccines over the years, especially the MMR (measles, mumps, and rubella). In the 1990s, a handful of scientists once claimed MMR was responsible for an uptick in the frequency of doctors diagnosing children as autistic. Even though numerous studies have refuted these claims, anti-vaccine advocates like Kennedy continue to undermine public confidence in vaccine programmes. “They get the shot, that night they have a fever of a hundred and three, they go to sleep, and three months later their brain is gone. This is a Holocaust, what this is doing to our country,” Kennedy said in 2015 of MMR and his belief that it can cause autism. He later apologised for his offensive use of autism in comparison with the Holocaust.

The other is his ableism, wrapped as it is in racism. In April, Kennedy decried the increasing prevalence of autism in the US as something that “destroys families,” adding that children who “regressed … into autism … will never pay taxes, they’ll never hold a job, they’ll never play baseball, they’ll never write a poem, they’ll never go out on a date. Many of them will never use a toilet unassisted.”

Kennedy has refused to believe the data, that autism is not spreading like a disease, but instead, society has the tools to more easily identify people who are on the spectrum socially and neurologically, people who otherwise lead active lives. Similarly, in 2023, Kennedy spread an anti-vaccine rumour that was ableist, racist and conspiratorial in nature. “COVID-19 is targeted to attack Caucasians and Black people. The people who are most immune are Ashkenazi Jews and Chinese,” Kennedy said on video in July 2023 at a fundraiser for his aborted 2024 presidential run. Not only is there no evidence of a conspiracy to infect certain white and Black folk with COVID. There is no evidence to suggest that any particular group is immune to the disease. Kennedy’s racism apparently is also anti-Jewish in nature.

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Earlier this month, Kennedy announced that he had authorised Medicaid and Medicare to share private data with the National Institutes of Health (NIH) in building a national database of autistic recipients “to uncover the root causes of autism” – which he considers a “preventable disease” – by September. Above and beyond his other statements, this decision smacks of the work of eugenicists from the previous century. Except that state governments across the US and fascist governments like Nazis used such lists to institutionalise those with autism and other disabilities from society. In the US, sterilisation was the method used in an attempt to protect the collective gene pool from contamination, while Nazi Germany famously used euthanasia. Clearly, Kennedy is an old-style anti-vaccine, ableist and racist eugenicist.

The new eugenics of the 21st century, though, is longtermism. Longtermism is really a 21st-century version of Social Darwinism’s “survival of the fittest” and the eugenics movement it spawned. Longtermism is not specifically about preserving a master white race. Yet longtermism also plays well within the eugenics sandbox. Longtermism’s advocates are at work to save humanity from extinction by making humans better and by making better humans. But this “betterment” comes with two caveats. One is that effective altruists – white men like Elon Musk, Bill Gates, or Jeff Bezos, for example – are fittest to act on behalf of future humanity. Two, this requires that they make decisions about whole classes of people whose use of the planet’s resources might lead to humanity’s demise. Billions of present-day humans might ultimately be sacrificed to save humanity’s distant future.

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Musk expressed his fundamental belief in who deserves to live and die in a three-hour interview on the Joe Rogan podcast back in February. “So that we’ve got civilizational suicidal empathy going on … The fundamental weakness of Western civilization is empathy. The empathy exploit. They’re exploiting a bug in Western civilization, which is the empathy response.” According to Musk, if the “they” do not “have empathy for civilization as a whole, the “they” have committed themselves “to a civilizational suicide”. The “they” Musk and Rogan referred to for three hours included undocumented migrants, white liberals and progressives, Democrats, and LGBTQIA folx.

There are other like-minded longtermists in Trump’s world, including tech billionaire Peter Thiel, who believe that Social Security is an “intergenerational Ponzi scheme”. Thiel’s is a nod towards Musk’s DOGE work against providing social welfare for elderly humans, a signal that Trump’s regime is developing ageist and ableist policies in the name of cutting wasteful spending, or eugenicist policies, really. Policies that could kill many elderly and disabled Americans.

Together with Trump, Kennedy and Musk have done their level best to remake the federal government in their own eugenicist images. Kennedy has acted in connection with Musk’s DOGE in cutting off funds for HHS, NIH, and other programmes around vaccination, disease and epidemic prevention, and cancer research since assuming his post in mid-February. There is essentially a gag order in place preventing Centers for Disease Control officials from discussing the spread of strains of bird flu among animals and humans working in the poultry industry. When pressed at a May 14 congressional hearing about his work as HHS secretary to gut the agency, Kennedy admitted that he would still “probably” vaccinate his children “for measles” in 2025. Yet in that same hearing, Kennedy again cast doubt on the MMR vaccine, a hint towards his ableist stance against people with autism. This while the US, and especially the state of Texas, are amid one of the worst measles outbreaks in the past 50 years. So far there have been over 1,000 cases, predominantly of unvaccinated children, two of whom have died.

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This renewed commitment to limit federal government resources dedicated towards the health and safety of all Americans has eugenics and longtermism written all over it. The work of Musk and Kennedy, in particular, have undermined the role of the federal government in the public eye. Their reluctance to help people in need and their belief that those with physical and intellectual disabilities (particularly those who are elderly or autistic) are a drain on economic resources are all part of a view that many Americans are expendable, even unto death.

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.