About two decades ago, Namibia was one of the hardest-hit countries in the HIV/AIDS epidemic.
The State Department has credited it with saving 26 million lives so far.
The move would codify cuts already made by the U.S Department of Government Efficiency (DOGE), which dismantled USAID and absorbed it into the U.S. State Department in the first months of Trump’s term and dramatically reduced PEPFAR’s reach.
NPR asked the State Department to comment on the impact of aid cuts on PEPFAR.
The State Department did not respond in time for our deadline for publication.
About 20 years ago, Namibia was among the nations most affected by the HIV/AIDS pandemic. Over one-third of adults had a positive HIV test result.
Doctor. In a rural Namibian clinic, Mark Dybul recalls meeting a woman and her infant. Being infected with HIV, she was afraid of infecting the child. In the local dialect, she gave her child the name No Hope.
Dybul states, “It’s among the most devastating things you could ever hear.”.
An innovation.
The U. A. Things quickly changed with the President’s Emergency Plan for AIDS Relief, or PEPFAR.
George W. President. Bush reauthorized PEPFAR in 2008 after creating it in 2003. Dybul, who was later appointed U.S. S. . coordinator of AIDS worldwide.
Since then, PEPFAR has distributed billions of dollars annually to combat the HIV/AIDS epidemic through initiatives like free medications to stop pregnancy-to-child transmission and mass treatment of HIV-positive individuals to prevent the virus from developing into AIDS and from spreading to other people.
To date, it has been credited by the State Department with saving 26 million lives.
According to a story Dybul told in an interview with NPR this week, he returned to Namibia and “here she was — and here that child was, four years later, because of the support from the American people that provided the antiretroviral therapy to her, which prevented her child from actually getting the virus” — a virus that can be passed from mother to child not only during delivery but from breastfeeding.
How is PEPFAR going to fare?
PEPFAR’s future is uncertain at the moment. President Trump requested Tuesday that Congress revoke $8.3 billion in foreign aid, including $400 million for PEPFAR, that lawmakers had previously approved in the 2024 and 2025 budgets.
Work on infectious diseases, including HIV, would be significantly reduced as a result of the cuts.
It is a component of a rescission request that would cut $9.4 billion in funding for foreign aid and the Corporation for Public Broadcasting, which provides funding for PBS and NPR.
It would codify the U.S. cuts already in place. USAID was dismantled and was absorbed into the U.S. Department of Government Efficiency (DOGE). S. . State Department during the initial months of Trump’s administration, significantly diminishing PEPFAR’s scope.
Regarding how aid cuts affect PEPFAR, NPR contacted the State Department for comment. We were unable to get a response from the State Department before our publication deadline.
Awaiting a congressional decision.
Trump’s memo now has 45 days for Congress to react.
The action follows a March decision by U. A. District Judge Amir Ali claimed that by stopping foreign aid without Congress’ consent, the Trump administration had committed “illegal” behavior.
The revocation request “put the ball squarely in Congress’s court,” according to Mitchell Warren, executive director of AVAC, the PEPFAR-funded HIV prevention group that spearheaded the legal action.
Congress hasn’t done anything at all, at least not yet. “The real question is, will they do something?” Warren asks.
There is still uncertainty surrounding PEPFAR’s future because some members of Congress have indicated that they wish to prevent it from being cut.
For PEPFAR, however, the year has been mixed. In the days immediately following Trump’s inauguration, the program’s operations were first suspended.
A few weeks later, Secretary of State Marco Rubio gave PEPFAR the go-ahead to start up again, but only through HIV prevention programs for expectant and nursing mothers and the treatment of current HIV-positive patients.
Not everyone who is susceptible to HIV infection is represented by that.
Without increased prevention, Warren says, the number of people in need of treatment will increase quickly because there are still 1 in 3 million new HIV infections annually.
According to Warren, these cuts accomplish “exactly the opposite of what this administration says they want to do, which is to get countries to own their budget and own their AIDS response.”.
“We all want to see that change, but by not assisting nations in lessening the burden of treatment programs, we are making things more difficult for them. We’re actually going to expand it. “..”.
In agreement, Dybul said.
In his NPR interview, he states, “It’s important to note that this was never intended to be a forever program.”. “However, all of those gains will be lost if we quit the game. “.”.
The time should come when PEPFAR is no longer an issue. However, it won’t be finished tonight,” Dybul says.
For him, HIV was “absolutely catastrophic” just a few decades ago.
HIV frequently kills young people in their prime, which makes the epidemic especially cruel, according to Dybul.
The absence of all the adults would result in entire villages being governed by orphans. It is possible that nations would have vanished. That was the extent of its destruction. “,”.
He says PEPFAR and similar programs have improved health systems, saved lives, and increased stability in hard-hit nations like Namibia.
Also, U. S. Help also brought hope, according to Dybul. As a result of PEPFAR, he claims that “no one would any longer name their child No Hope.”.
In its absence, Dybul claims that “there is a hopelessness that occurs when you see everyone dying around you, you think you’re going to die.”.
