Complex Systems with Patrick McKenzie (patio11) Prestige media, new media, and the US government, with Kelsey Piper
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Sep 19, 2025 
Kelsey Piper, a journalist and co-founder of The Argument, engages in a captivating conversation about the challenges facing modern journalism and governance. They discuss the detrimental effects of social media on meaningful discourse and critique prestige media's constraints. Kelsey provides insights into PEPFAR, highlighting its critical impact and mismanagement during funding cuts. With proposals for reform, she emphasizes the importance of civic participation and engaging with practical realities to rebuild effective media and governance.
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PEPFAR Funding Halted After USAID Cuts
- After the USAID shutdown, PEPFAR funding stopped and clinics immediately lost money and supplies.
- Organizers used Discord to coordinate and rapidly expose canceled PEPFAR grants to force fixes.
Modeling Aid Cuts Requires Substitution Paths
- Estimating mortality from aid cuts requires modeling substitution, restorations, and long-term effects.
- Piper notes many early models assumed no substitution and thus overestimated permanent harm.
Coordinate Clean Exits From Programs
- If exiting a life-saving program, coordinate transitions proactively with other funders to avoid service collapse.
- Give advance notice so NGOs and foundations can plan substitution and avoid bankruptcies.