Trump’s foreign assist leaves millions without HIV treatment

Two weeks after the increasing freezing of President Trump about foreign assist, the HIV group abroad did not receive any funds, threatening the health of over 20 million people, including 500,000 children. Further exemptions from the State Department explained that the work may be continued, but there are no funds and legal documents.

Experts warned that with a close closing of the American Aid Agency known as USAID and its withdrawal of officers published abroad, there is no hope that the situation would resolve quickly.

HIV treatment and services were financed on the basis of the president’s emergency plan on AIDS Relief or Pepfar, a $ 7.5 billion program, which was frozen with all foreign assist on the first day of Mr. Trump’s office.

From the beginning in 2003, during the administration of George W. Bush, Pepfar provided life -saving treatment for up to 25 million people in 54 countries and enjoyed bilateral support. The program was to take place five years again in 2023; He survived the effort of some Republicans to end it and was renovated for a year.

Without treating millions of people from HIV, they would be exposed to a grave illness and premature death. Loss of treatment also threatens to reverse dramatic progress in recent years against HIV and may stimulate the appearance of HIV strains resistant to drugs; Both results can have a global influence, including in the United States.

The detention and dismantling of USAID was provided by “system shock”, said Christine Steling, deputy executive director at Unaids, the UN HIV department.

“Now you have to see how you can work with the system to make sure that what theoretically possible will actually happen,” she said.

On January 28, the Secretary of State Marco Rubio issued a waiver of drugs saving life and medical services, allowing the distribution of HIV. But the release was not mentioned by Pepfar, leaving organizations of recipients waiting for transparency.

On Sunday, another waiver of the State Department said more clearly that it would include HIV tests and treatment, as well as the prevention and treatment of opportunistic infections such as tuberculosis, according to the note viewed by the Fresh York Times. The note did not include HIV prevention – except for pregnant and breastfeeding women – or support for orphans and sensitive.

Although Pepfar is financed by the State Department, about two -thirds of its subsidies are implemented via USAID and Centers for Disease Control and Prevention. None of the organizations have published funds for scholarship holders since the freezing.

IN interview In the case of Washington Post, Mr. Rubio seemed to blame recipients for the fact that he did not act because of his dismissal, saying that he had “real questions about the competence” of groups. “I wonder if they deliberately sabotage to make a political point,” he said.

But experts who knew Pepfar’s requirements said that his comments denied the complexity of his approval system.

“News and tips of the State Department reveal the ignorance of how these programs function – and a disturbing lack of compassion for millions of threatened lives,” said Jirair Resssvosian, who was the head of the Pepfar staff in Biden administration.

For example, orders to stop forced each program to stop immediately. According to a higher official in a gigantic global health organization, which receives Pepfar funds, organizations are now legally obliged to wait for equally clear instructions and cannot continue on the basis of a general note.

“We have to wait for us to receive individual letters for each project that will tell us not only that we can start work, but to tell us which work we can start and how much money,” said the official. The clerk asked for them a name in fear of retaliation; 90 percent of the organization’s money comes from Pepfar.

Freezing also disrupts a network of smaller organizations that ensure HIV treatment and services in low -income countries.

In a survey of 275 organizations in 11 sub -Saharan countries conducted during the last week, they reported that their programs or services were closed or reversed people, said Dr. Stellah Bosire, Executive Director of the Africa Center for Health Systems and Health Systems and Pressure.

At least 70 organizations reported disturbances in the field of HIV prevention, testing and treatment, and 41 stated that some programs were closed. “Without immediate intervention, financial suspensions can lead to destructive reversal of progress in the field of public health,” said Dr. Bosire We -Mail.

According to Mackenza Knowles-Coursin in Kenya, 40,000 doctors, nurses and other healthcare professionals, who was the deputy head of communication at the American mission in Nairobi. In South Africa, the stopping of financing will affect the salaries of over 15,000 healthcare employees and operations throughout the country, said the National Minister of Health, Aaron Motsoledi, during last week of a television press conference.

Some organizations rely on the mosaic of subsidies, with a stream of financing from one donor for the purchase of drugs, and another stream applied for paid staff. Interrupting even one source can kutsted clinics, leaving them without medicine to give up or spend them.

Uganda’s key populations, an umbrella organization that provides HIV treatment and other services, lost 70 percent of financing. He closed 30 out of 54 falling centers throughout the country, which issue medicines, and terminated contracts 28 out of 35 employees.

The organization has received approximately USD 200,000 a year from CDC via the Infectious Diseases Institute at Makerere University, as well as a subsidy of $ 8 million within five years from USAID, which provided assistance in apartments and employment, including gays and transgender people, And it was closed, and was closed, and was closed to comply with Mr. Trump’s executive ordinance on diversity, equality, inclusion and availability.

In 2023, Uganda adopted a common law that criminalized consensual sex between adults of the same sex and established relations of the same sex, while having HIV’s penalty through death. This caused the eviction of many Ugandans from their homes and dismissed from work.

“Cases of human rights violations have not really slowed down, and now it’s really disturbing,” said Richard Lusimbo, Consortium General Director at Uganda’s key population.

“We don’t even have capacity or even tools we need to actually answer some of these problems,” he said.

Some organizations spend medicines to children, which requires more skills than adult treatment. Children’s drugs are adapted to their age, weight and earlier exposure to anti -network drugs, and children must be carefully monitored for medicine resistance.

In children who purchased HIV after birth, the infection can do the disease very quickly, and death occurred from eight to 12 weeks after birth-shorter than 90-day pause on foreign assist.

On Tuesday evening, the Trump administration meant that almost all Global Working Stand for USAID on vacation and dismissed people published abroad to return to the United States within 30 days.

“There is a loss of institutional memory that can be purposeful, but also creates backlog in documentation and paralyzes the whole system,” said Elisha Dunn-Georgiou, president of Global Health Council, a member organization of health groups.

“Who are you asking questions?” She said. “How do you go to the next step?”

Without USAID staff in the processing of applications for release, they are afraid that they will not see funds in the near future. Even gigantic global health organizations try to stay on the surface; Some have already restricted programs and staff.

Even if the funds return quickly, restarting programs and returning to something reminiscent of normality, said Mrs. Dunn-Georgiou.

“Reverbursing something costs something, so I don’t think we really know if it is possible at all,” she said.

Lynsey Cracito AND Stephanie Nolen reporting brought.