logo
America's global AIDS relief program is on the brink

America's global AIDS relief program is on the brink

Yahoo23-03-2025

America's most celebrated global health program is on life support, former U.S. government officials and global health advocates say.
President Donald Trump's decision to suddenly halt and then terminate most U.S. foreign aid, and GOP concerns that organizations receiving government grants to combat HIV and AIDS were performing abortions, have key congressional Republicans broaching what was once unthinkable: ending PEPFAR, the program President George W. Bush created to combat HIV and AIDS in the developing world. Bush has long championed it and the 25 million lives it's saved as the best example of his 'compassionate conservatism.'
But Trump has lumped the President's Emergency Plan for AIDS Relief in with other foreign aid programs he sees as indicative of the way Washington has put the needs of foreigners over Americans and the seismic shift in GOP attitudes since Trump took over the party.
The Bush Institute, an arm of the center that promotes Bush's legacy, is pleading with the administration and Republicans to keep the program alive, making the case that it's good for America.
'PEPFAR is a strategic investment in our own national security,' Hannah Johnson, a senior program manager for global policy at the institute, wrote earlier this month, arguing that 'it engenders goodwill toward the United States at a time when Russia and China are competing for greater influence, in ways that are not beneficial in the long-term for the African continent.'
She called on the administration to continue the program — 'whether through USAID, the CDC, the Pentagon, or the State Department. It is a matter of life and death.'
Since late February, the Trump administration has terminated hundreds of millions of dollars in PEPFAR grants and contracts amid its rapid effort to align foreign aid with its 'America First' policy, according to a list obtained by POLITICO. Next week, the 2003 law that established PEPFAR is set to expire with no indication it'll be renewed anytime soon.
Congress did appropriate funding to cover PEPFAR's expenses through September earlier this month. Its programs can continue even if the law authorizing it expires, but only if Trump wants to spend the money. PEPFAR's budget is between $6 and $7 billion per year.
Trump has halted most programs overseen by the U.S. Agency for International Development, which handled a majority of PEPFAR's projects, but so far hasn't touched the Centers for Disease Control and Prevention's, which run nearly $2 billion a year.
The cuts the administration has made have alarmed public health advocates. A sudden end to PEPFAR could kill six million people in the next four years, reverse decades of progress and lead to growing HIV epidemics across the world, over 500 AIDS physicians and researchers warned in a letter to Secretary of State Marco Rubio.
'Over time, these policy decisions may be proven illegal in U.S. courts but the human suffering and loss of lives happening now cannot be reversed by any court order,' they wrote, asking Rubio to restart all PEPFAR projects.
The State Department did not respond to a request for comment on the letter.
Abortion politics
PEPFAR enjoyed bipartisan support until two years ago, when congressional Republicans accused then-President Joe Biden of indirectly funding abortion abroad by providing PEPFAR funds to groups that support or provide abortions. After allowing the law that authorizes the program to expire in 2023, Congress ended up reupping it for one year last March. Every previous renewal was for five.
Then in January, the Biden administration acknowledged that a routine check on grant compliance in the southeast African country of Mozambique found that four nurses in a small province whose salaries were funded by PEPFAR provided abortions, which is legal in the country.
Mozambique refunded the money — $4,100 — but Senate Foreign Relations Chair Jim Risch (R-Idaho), whose panel oversees PEPFAR and would lead any effort to renew it, said it called into doubt his support for the program. 'This violation means that the future of the PEPFAR program is certainly in jeopardy,' he said in a statement at the time.
Advocates of PEPFAR have in the past turned to Rep. Michael McCaul, an 11-term Texan representing a swath of suburbia from Austin to Houston and friend of Bush's who'd helped convince fellow Republicans in 2024 to reup PEPFAR for a year despite their misgivings.
But in January, GOP term limits for committee chairs forced McCaul to give up his post atop the House Foreign Affairs Committee. McCaul's replacement, Florida Republican Brian Mast, told POLITICO earlier this year that he wants to rethink the U.S. investment in PEPFAR.
'If Americans are spending billions of dollars for multiple decades funding extremely expensive HIV medication for 20 million Africans, there should be a conversation about that,' he said. 'At what point do some or all countries start to handle that on their own?'
The bottom dropped out for PEPFAR shortly after Trump's inauguration in January when, as one of his first actions, he closed the agency that sponsors most foreign aid, USAID, and then terminated billions in State Department funding.
The cuts included grants and contracts supporting HIV prevention for teenage girls and gay men, who are at high risk of acquiring HIV in some countries in Africa; efforts to control the spread of HIV in Nepal, Uganda and Ukraine, and clinical trials researching a vaccine and other HIV prevention measures.
A State Department spokesperson said a list of the programs obtained by POLITICO 'is inaccurate and unverified' but didn't provide more details.
Payments for some of the PEPFAR projects still intact, such as a major contract to supply and deliver HIV drugs, aren't flowing to the organizations running them, keeping crucial lifelines effectively frozen, according to a person familiar with the USAID programs allowed to speak anonymously for fear of reprisal from the administration.
Eight countries already face significant disruptions to HIV drugs and are expected to run out in the coming months, the World Health Organization, an arm of the United Nations, said Monday, listing Kenya, Lesotho, and Ukraine among them.
The Trump administration has argued in court that it needed to verify most payments manually to ensure there's no fraud involved but a federal judge ordered it to pay a large batch of backlogged invoices for foreign aid programs. In many cases, those payments are still pending: There are about 10,000 payments that need to be processed, the State Department said in a court document on March 19.
The administration has kept a few hundred USAID employees out of more than 10,000. Trump is folding what's left of the agency into the State Department. Just over a dozen PEPFAR specialists from USAID's global health bureau will be hired at the State Department office managing the program, according to a State Department memo obtained by POLITICO.
Mast told POLITICO that he's considering reupping the law undergirding PEPFAR in September when the State Department will also come up for reauthorization.
Mast suggested he'll prioritize shifting responsibility for HIV and AIDS prevention and care to the countries that have relied on PEPFAR: 'There's countries — and their leaders — that have just taken it for granted that the United States is just going to pay for their HIV medication forever.' Some of those countries have worked with China on mineral extraction and other things, Mast said, suggesting America's PEPFAR investment didn't serve the U.S. as many tout it.
He said those countries could borrow money to provide HIV-prevention services that were funded by PEPFAR to their citizens.
The Trump administration's shock-and-awe approach in freezing and then cutting most of foreign aid, and, with it, many PEPFAR programs, has left global health advocates and some on Capitol Hill wondering what's left of the program that until recently was fiercely supported by most Republicans and Democrats.
'It's hard to understand how PEPFAR, as we know it, can continue at this moment,' said a House Democratic aide granted anonymity to speak candidly.
Trump's plans
PEPFAR is an ecosystem of services that goes beyond providing medication and includes testing and reaching out to vulnerable groups, such as teenage girls, the aide said. The program 'is not going to be as successful if we chip away at pieces along the way and strip it down to something that is just, perhaps a straight provision of medication,' the aide added.
Pete Marocco, the foreign assistance director at the State Department who has led the foreign aid cuts and USAID's dismantling, told lawmakers from the House and Senate foreign affairs committees in meetings earlier this month that around $4 billion from PEPFAR's annual funding wasn't spent on lifesaving treatment and went to advocacy instead, according to two people with knowledge of the conversation speaking anonymously because they aren't allowed to publicly comment on private meetings. Marrocco also said the program only needed about $2 billion to provide lifesaving treatment, according to the two people.
Marocco didn't provide a list of terminated or retained programs to lawmakers, Rep. Sydney Kamlager-Dove (D-Calif.) and Sen. Jeanne Shaheen (D-N.H.) said after meeting him.
The State Department said it doesn't comment on its officials' communications and briefings with Congress.
While uncertainty about what's been eliminated and what remains persists, the cuts will damage the foreign aid system, including the programs that the administration may want to keep, said Andrew Natsios, a Republican who ran USAID in the Bush administration.
Dr. Atul Gawande, who ran USAID's global health programs in the Biden administration, said the funding freeze and terminations are putting the whole program at risk.
'This is the end of PEPFAR as we know it, and if certain issues aren't addressed, it's just the plain end of PEPFAR,' he told reporters in a call in late February.
Some global health advocates and lawmakers are holding out hope Gawande is wrong.
'PEPFAR, unlike the health programs that are based at USAID, is based at the State Department; does still have a team there overseeing the program; was given, at least on paper, the ability to continue some care and treatment,' said Jen Kates, senior vice president and director of the Global Health & HIV Policy Program at KFF, a health policy think-tank.
Sen. Chris Coons (D-Del.), a member of the Senate Foreign Relations Committee, acknowledged that it will be difficult for the program to recover from the blows it has suffered over the past few weeks.
'But I'm determined that it's not the end for PEPFAR. It is too important, too valuable, too effective a program for us to give up on,' he said.

Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

Gavin Newsom is having his social media moment
Gavin Newsom is having his social media moment

Fast Company

time7 minutes ago

  • Fast Company

Gavin Newsom is having his social media moment

'Fuck around' and 'find out,' read a TikTok post, following a screenshot announcing that California is suing President Donald Trump for deploying the National Guard to the streets of Los Angeles. But the TikTok wasn't shared by a typical meme account—it came from California Governor Gavin Newsom. 'I damn near fell over when I realized this was Gov. Newsom's page,' one user commented. Since Friday, demonstrations have erupted across Los Angeles in protest of the president's immigration policies and the ongoing Immigration and Customs Enforcement raids. Although many of the demonstrations have remained peaceful, there have been violent incidents including authorities deploying tear gas and rubber bullets, and protestors setting Waymo vehicles ablaze throughout the city. As tensions escalated, the Trump administration deployed the National Guard and Marines—despite objections from local officials—sparking a lawsuit from the state, threats of arrest against Governor Newsom, and a surge of defiant memes. 'And remember kids, the next time anybody tells you 'the government wouldn't do that', oh yes they would,' says the popular TikTok sound used on Newsom's official account video, playing over screenshots of news headlines and images of armed forces confronting demonstrators. In another viral video from the governor's page, which amassed over 5.4 million views, Taylor Swift's 'You Need To Calm Down' plays over a series of photos of the two politicians. 'r u ok?' the post asks, with a caption reading: 'America's keyboard warrior.' Newsom's clapback drew widespread praise in the comments. 'I do disagree with Newsom a lot but him standing up to tyranny and standing with your state takes some serious guts. Hats off to you Newsom,' wrote one user. He's also taken to his personal account to deliver meme-laced messages to Trump—one featuring a photoshopped image of the president wearing a crown, captioned 'send in the troops.' The slideshow ends with a shot from the musical Hamilton, with text reading: 'Democracy is under assault right before our eyes. It's time for all of us to stand up.' The online showdown has significantly boosted Newsom's social media presence, growing his personal TikTok account by approximately 397,000 followers and his official Governor account by 479,000 since Friday. Newsom is the latest in a growing number of politicians leveraging memes and social media to bypass traditional media and speak directly to the public through humor. Famously, Kamala Harris gained momentum during her presidential campaign with ' Brat summer ' and the coconut tree trend, while Joe Biden leaned into the viral ' Dark Brandon ' meme during his reelection campaign. Although meme strategies can generate enthusiasm and visibility, the 2024 election results suggest that online popularity doesn't always translate at the polls.

UnitedHealth Seeks $1B Latin America Exit: Sources
UnitedHealth Seeks $1B Latin America Exit: Sources

Yahoo

time7 minutes ago

  • Yahoo

UnitedHealth Seeks $1B Latin America Exit: Sources

UnitedHealth Group Incorporated (NYSE:UNH) is one of the best Dow stocks to invest in. The company is considering several offers for its Latin American business, according to two insiders familiar with the situation, as it works to recover from a series of major setbacks, including the removal of its CEO and a reported criminal accounting investigation. The largest US health insurer has aimed to exit Latin America since 2022, but selling its Banmedica unit has become more urgent recently due to multiple challenges, one source said. A senior healthcare professional giving advice to a patient in a clinic. New CEO Steve Hemsley told shareholders last week that he is focused on regaining their confidence following a disappointing earnings report and a Wall Street Journal story about a criminal probe into alleged Medicare fraud. UnitedHealth Group Incorporated (NYSE:UNH) maintains it has not been notified by the Department of Justice and stands by its business integrity. UnitedHealth Group Incorporated (NYSE:UNH) has received four non-binding bids for Banmedica, which operates in Colombia and Chile, totaling around $1 billion, according to sources who requested anonymity due to the confidential nature of the negotiations. While we acknowledge the potential of UNH as an investment, we believe certain AI stocks offer greater upside potential and carry less downside risk. If you're looking for an extremely undervalued AI stock that also stands to benefit significantly from Trump-era tariffs and the onshoring trend, see our free report on the best short-term AI stock. READ NEXT: and Disclosure. None. Sign in to access your portfolio

Mayor Bass, regional mayors call for end to ICE raids in Southern California: "Our communities are not battlegrounds"
Mayor Bass, regional mayors call for end to ICE raids in Southern California: "Our communities are not battlegrounds"

CBS News

time7 minutes ago

  • CBS News

Mayor Bass, regional mayors call for end to ICE raids in Southern California: "Our communities are not battlegrounds"

After days of violent and destructive protests in Los Angeles, fueled by an increase in immigration enforcement operations, Mayor Karen Bass and other regional mayors called for an end to Immigration and Customs Enforcement raids. At a news conference Wednesday morning, Bass said the unrest in a portion of Los Angeles started last Friday after immigration operations were carried out in several parts of Southern California. Bass told reporters that LA and surrounding cities were "peaceful" before the raids. Mayor Karen Bass called on the Trump administration to end the immigration enforcement operations taking place across the Southern California region. KCAL News She explained that the raids have caused fear in immigrant communities, and accused President Trump of worsening the situation when he ordered the deployment of National Guard and U.S. Marine troops. She called for an end to ICE raids and the federalization of troops. "When you start deploying federalized troops on the heels of these raids, it is a drastic and chaotic escalation and completely unnecessary," Bass said. Mr. Trump posted on his Truth Social platform, claiming that his decision to deploy troops to LA saved the city from burning to the ground. "The great people of Los Angeles are very lucky that I made the decision to go in and help!!!," he wrote. Her speech came a day after she implemented a curfew in a portion of downtown LA after five consecutive nights of demonstrations, which have escalated to clashes between protesters and law enforcement officers, as well as hundreds of arrests. Since the start of the protests, parts of downtown LA have been covered in graffiti, businesses have been looted and public property has been vandalized. TOPSHOT - A car burns as a demonstrator waves a Mexican national flag during a protest following federal immigration operations, in the Compton neighborhood of Los Angeles, California on June 7, 2025. RINGO CHIU/AFP via Getty Images During an interview Wednesday morning on CBS Los Angeles, Bass explained that the curfew will be extended until it is necessary to ensure public safety. The curfew currently runs for one square mile in the downtown area from the 5 Freeway to the 110 Freeway and from the 10 Freeway to where the 110 Freeway and 5 Freeway merge from 8 p.m. to 6 a.m. Bass has also taken to social media to share how the raids are affecting the city. In a post on X, she wrote, "Angelenos are trying to live their lives—going to work, caring for their families—while facing the constant threat of sudden immigration crackdowns." Other mayors from across Southern California joined Bass, calling for an end to the ICE raids. The Mayor of Huntington Park, Arturo Flores, a U.S. Marine Corps combat veteran, told reporters that the military neighborhoods. "The deployment of Marines on our U.S. soil is an alarming escalation that undermines the values of democracy," Flores said. "Our communities are not battle grounds." Flores said the ICE raids being carried out in his community and others across the region are a form of intimidation that traumatizes hardworking residents. He said fear-based tactics are being used to target immigrant communities. The Mayor of Paramount, Peggy Lemons, added that residents are choosing not to leave their homes or send their children to school out of fear that ICE will take them away. "For many in our city, this has been the most devastating time in recent memory," Lemons said. She said immigrants, who play such an important role in the makeup of the region, should not have to live in constant fear.

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into the world of global news and events? Download our app today from your preferred app store and start exploring.
app-storeplay-store