An under-reported story of the tumultuous first months of the second Donald Trump administration is how his team are brutally cutting back long-established federal institutions. The National Institutes of Health and the US Agency for International Development have seen huge swathes of staff fired, grants paused, funding slashed and projects reliant on government aid abruptly shuttered. This is already having massive consequences downstream, both in research into devastating diseases and in humanitarian work with some of the poorest and most vulnerable people on Earth. Why should Christians care about these federal bureaucracies and what Trump is doing to them? Isn’t this just about trimming away woke excesses and focusing on excellence? And what might be lost, including for the church, if the US government gives up on medical research and international development for good?