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In November 1981 Reagan signed National Security Directive 17, which allowed covert support to anti-Sandinista forces. The U.S. government armed, trained and funded the Contras, a group of rebel fighters based in Honduras, in an attempt to overthrow the Nicaraguan government. As part of the training, the CIA distributed a detailed manual entitled "Psychological Operations in Guerrilla War", which instructed the Contras, among other things, on how to blow up public buildings, to assassinate judges, to create martyrs, and to blackmail ordinary citizens.] In addition to backing the Contras, the U.S. government also blew up bridges and mined harbors, causing the damaging of at least seven merchant ships and blowing up numerous Nicaraguan fishing boats. They also attacked Corinto harbour on October 10, 1983, causing 112 wounded according to the Nicaraguan government. After the Boland Amendment, passed in 1982, made it illegal for the U.S. government to provide funding for Contra activities, Reagan's administration secretly sold arms to the Iranian government to fund a secret U.S. government apparatus that continued illegally to fund the Contras, in what became known as the Iran–Contra affair. The U.S. continued to arm and train the Contras even after the Sandinista government of Nicaragua won the elections of 1984.

His administration initially brushed off the AIDS epidemic and hindered the CDC and NIH response. People directly under him called it God's punishment against homosexuality. Over 80,000 Americans died from AIDS in the 80s. As of 2018, about 700,000 people have died of HIV/AIDS in the United States since the beginning of the HIV/AIDS epidemic, and nearly 13,000 people with AIDS in the United States die each year.

He bombed Libya, killing 15 civilians.

This is hardly exhaustive. His policies as California governor and POTUS upended social programs, increased crime, poverty, childhood malnutrition.