"We need new leadership," Van Hollen said in an interview, framing his leadership bid around his sharp criticism of the administration's upheaval of programs that promote global health and fight poverty. Van Hollen is the ranking member of the Senate Foreign Relations Subcommittee that oversees the State Department and what remains of the U.S. Agency for International Development, a perch that would give him considerable sway over investigations and legislation if Democrats take the chamber.

Priority number one, he said, is "an analysis of all the harm the Trump administration has done." He pointed to credible analyses estimating that more than 700,000 people worldwide died between January 2025 and January 2026 because of cuts to USAID, warning that continued trends could mean millions more deaths in the coming years.

"One of the great benefits of being in the majority is you actually have a gavel and can call a public hearing, and use that as a spotlight to help educate people around the country," Van Hollen said. He cited the administration's early missteps on Ebola as an example, recalling a February 2025 scene at the White House when Elon Musk, asked about cuts to Ebola-fighting funds, effectively acknowledged an oversight and claimed the money had been restored. Van Hollen said the restoration was inadequate and that there is good evidence the current Ebola outbreak in the Democratic Republic of Congo could have been better contained without the cuts.

The investigation, he said, would not be aimed at simply restoring USAID exactly as it was, but at understanding the full extent of the damage "with an eye toward reforming it."

Van Hollen also pointed to the power of the purse as a tool Democrats have been unable to wield in the minority. He noted that the administration rescinded more than $500 million in global health funds with the acquiescence of a Republican majority, and that roughly $1.5 billion appropriated for global public health appears to be being used not for health programs but to wind down USAID.

"This is an area where we could say no, you may not use these funds to wind down USAID," he said.

The administration has largely ignored congressional directives, Van Hollen argued, because much of that direction comes in the form of report language that is not legally binding — and Republicans in Congress have let it slide. "The more they let them get away with it, the more they do it," he said. Democrats would convert that guidance into statute, he said, so that if the administration diverts funds, lawmakers can go to court and argue the spending is legally required, not merely advisory.

Asked whether USAID might return if Democrats win the presidency and hold Congress in 2028, Van Hollen said there is nothing in the administration's approach worth preserving, but he is not advocating a simple return to the pre-Trump status quo. The agency's work, he said, protected Americans' health and built goodwill abroad, and Democrats need a deliberate plan for how that role fits into foreign and health policy.

The State Department did not respond to a request for comment.