Why not?

People killed: around three quarters of a million.

Everyone quoting this number is quoting what certain people predicted would be the number after a year without aid. I have never seen anyone cite a number that was not a projection written beforehand, based on estimates of what would happen with no aid.

Except that isn't what happened.

The "dissolution" and "aid freeze" were constantly tied up in the courts instead of being implemented. Marco Rubio was put in charge of USAID, and despite being a Republican, he is an actual human being who would show activity on an EEG and not an arc node of Trumpism. He issued waivers to keep funding the "critical" lifesaving operations of USAID going during the funding freeze, regardless of the courts' decisions. His explicit intent was to dissolve USAID as he saw it as a wasteful and counterproducrive program, but incorporate the parts of USAID that actually were useful (like these programs) into the State Department. From other pages linked on the same site, he appears to have done that. Rubio's "America First Global Health Strategy" lays out an extremely reasonable argument for what he is doing and why. He even goes into specific detail about how great PEPFAR is and why so much of its budget is being wasted on buck-wild overhead costs and inefficiencies instead of integrating local services.

The moral reason is that "refrained from rescuing" is not the same thing as "killed"; the equivalence is made up by people who will grab onto anything to Get Trump but they never apply the same standard for e.g. the Obama Presidential Library "killing" thousands of people by spending that money on something other than aid. (Except for like five Effective Altruists.)

The practical reason is that we don't have to lean on hypothetical "sophisticated modelling tools" any more now that we have data from countries that got their aid cut, and the data indicates the model was wrong, the projected deaths didn't happen.

Any NGO that had to lay off hundreds of people when the USAID check failed to come in one time is either a scam or so catastrophically mismanaged that it should not be getting that money to begin with. Not only does anyone need the ability to deal with unexpected expenses and losses, groups in impoverished African nations should expect major disruptions to their supplies and funding to happen. It's why you need to be there at all! When over 2/3rds of the money is going to administrative costs, and you respond to a disruption in funding by firing thousands of health care providers forever instead of firing administrators or furloughing administrators, you're either a scam or catastrophically mismanaged! All the news reports talking about this all said something to the effect of "these health providers are gone and fired and not able to provide health care any more ever," as though a temporary funding disruption made the NGO lose their fucking pager numbers.

If I remember correctly, the assertion ultimately comes from a USAID report - which I had some trouble finding, because, uh, all the USAID material has been taken down, but thank you Wayback Machine - which explains that only something like 12% of USAID money went directly to local service providers. But that doesn't mean that the rest was administrative overhead! Most of it was pass-through donations to other non-local charities, which could often provide relevant services at scale much more easily than the locals could.

Actual overhead costs seem to have averaged something like 10%, which is about what you'd expect. Recipients included groups like Gavi and the Global Fund, which are easily researchable and auditable.