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All this is sensible. I'm not trying to debate its merits as a coherent position.
I was specifically complaining about FistfullofCrows' pithy "if it was so important to have these millions for the poor people dying of TB then maybe soros or the whole of the EU can pitch in a few millions to go cure people", which I think is a bad and kind of baffling way to frame the question. It's really the "if it was", as opposed to "if it is", that sticks out to me. It seemed to be saying "we can prove, right now, that all this foreign aid isn't actually important, because the EU & Soros aren't taking up the slack". Which is bonkers and not the point. It can be genuinely important and still not a reasonable burden for the US to shoulder indefinitely, for all the reasons you cite. Or indeed the EU's or Soros's. People's unwillingness to do a hard and costly thing might be circumstantial evidence that it is indeed intractably hard and costly (duh) but it's just not some kind of gotcha that proves that the hard thing was never important. At the end of the day humanity can just collectively and intractably fail at doing an objectively important thing, because it's too hard and coordination problems are a bitch. That's life.
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