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AVAC
AVAC
@avac.org
1 day ago
Preview
New Agreements for Funding Global HIV Program Miss the Mark A new amfAR report analyzes how the new Global Health MOUs fail to establish metrics to measure their success

A new report from @amfarofficial.bsky.social digs into the first US #globalhealth MOUs, raising concerns about transparency, metrics & accountability.

Track it all:

🔹amfAR report: tinyurl.com/2u69zk9j
🔹KFF MoU Tracker: tinyurl.com/25c2d78a
🔹Global Health Watch: avac.org/global-healt...

#PEPFAR

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usaid
usaid
@usaid.activitypub.awakari.com.ap.brid.gy
4 days ago
Dr. Caspian Chouraya in his home in Mbabane, Eswatini, says U.S. funding cuts have meant many of his projects have shut down, like support groups for teenagers with HIV. (Ben de la Cruz/NPR) Studying labor law is not why Dr. Caspian Chouraya went to medical school. For more than two decades, he’s worked in HIV/AIDS treatment and prevention. Now, he oversees HIV/AIDS programs in 12 African countries for the Elizabeth Glaser Pediatric AIDS Foundation. But in recent months, Chouraya finds himself talking to legal advisors and burying himself in the law surrounding layoffs in various African countries. This is because for months, U.S. funding has been arriving in fits and starts. Not knowing when funds will arrive is undermining one of the U.S.’s most successful global health initiatives — the worldwide fight to combat HIV/AIDS. The heart of this work is PEPFAR, the President’s Emergency Plan for AIDS Relief. It has been credited with saving 26 million lives since it was launched in 2003 under President George W. Bush. Congress has treated this effort with special care: In 2025, it pushed back on President Trump’s proposed cuts. And, in 2026, Congress appropriated far more money than Trump had requested, allocating close to $6 billion for global HIV/AIDS work, funding PEFPAR at virtually the same level as the previous fiscal year. Despite the money being available, people inside and outside the government say the State Department is deliberately withholding some of the funds. As a result, key HIV efforts — that even the Trump administration deemed “lifesaving” — are on the brink of shutting down. This comes against the backdrop of a major deadline: This week marks the six-month timeline the Trump administration set for itself to have new health aid systems ready to go. That process is running behind schedule, which is exacerbating the financial uncertainty. That uncertainty, in turn, is making it impossible for many NGOs reliant on that money to conduct vital anti-HIV work. ### “Projections were that HIV was just going to wipe out the entire nation” When Chouraya became a doctor, he says specializing in HIV/AIDS was a no-brainer. It was the early 2000s and, “in the wards where I was working, almost everyone admitted in there was an HIV patient,” he recalls. In the tiny nation of Swaziland (now Eswatini), more than a quarter of adults were infected with HIV — one of the highest rates in the world. “Projections were that HIV was just going to wipe out the entire nation,” he says. “It was really bad.” Thanks in large part to U.S. aid, the situation is now much better in Eswatini and many other countries. Since 2003, the U.S. has committed more than $100 billion to the work and built among the largest global health delivery systems that exists. From Uganda to Lesotho, from Cote d’Ivoire to Malawi, Chouraya supervises programs that include HIV treatment as well as technical assistance to ministries of health. But U.S. funding cuts this past year have meant many of his projects shut down. There were support groups for teenagers with HIV that are no longer meeting. There were cell phone plans, so clinics could stay in touch with patients — that’s disappeared. Chouraya says he even worries about the projects that are still supposedly slated to receive U.S. funding — he says he’s often left wondering, “Am I in? Am I out? Am I in? Am I out? What’s happening?” ### “It’s a stressful process” What’s happening is that the Trump Administration is ditching the decades-old system of global health aid. It was based on partnerships with entities ranging from local non-profits, large international organizations and national health systems. After dismantling the U.S. Agency for International Development — that oversaw tens of billions of dollars of foreign aid — and canceling large numbers of programs, the Trump administration laid out its own plan for foreign aid in September. Remnants of signage for the U.S. Agency for International Development on the facade of the Ronald Reagan Building and International Trade Center building in Washington, D.C., on Dec. 29, 2025. (Briendan Smialowski/AFP | via Getty Images) The new strategy “is one that’s putting the U.S. on a path of first transitioning down its support and transferring more financial responsibility to [individual] countries,” explains Jennifer Kates, senior vice president and director of Global Health & HIV Policy at KFF. Over time, the goal, she says, is to reduce how much the U.S. is investing in global health as country governments step into that role. “That was always a goal [of PEPFAR],” explains Kates. The Trump administration is accelerating that transition, but the way it is unfolding carries risks, she warns. Under the State Department’s America First Global Health Strategy, the U.S. is negotiating new contracts directly with governments receiving aid, and then developing “detailed implementation plans with shared responsibilities, targets, and accountability mechanisms.” The State Department gave itself six months — until March 31 — to do all this. In the meantime, the strategy says, “bridge funding” was to be provided so that “existing life-saving activities will be continued.” But the second installment of bridge funding, slated to arrive in December of last year and cover three months, was often late. For Chouraya’s work in Cote d’Ivoire — which includes 53 health facilities — the funding came in March. He says his team had already been forced to scale back trainings and other activities in an effort to preserve essential services, like delivering drugs to patients. By the time the funds came through, he says, it was too late to make major changes to the work they’d already curtailed. Given the uncertainty, he’s had to “work on giving notices to staff so that we can prepare for possible termination of their contracts.” In the tiny nation Eswatini (formerly Swaziland), Dr. Caspian Chouraya has dealt with some of the highest HIV/AIDS prevalence rates in the world, more than a quarter of adults were infected with the virus. (Ben de la Cruz/NPR) He worries his organization will get sued if the U.S. funds don’t come but there hasn’t been time to give employees the required legal warning. “It’s a stressful process,” he admits. “I don’t want to lie.” ### “If you want to talk about waste and abuse, this is really extraordinary” Now, the six months of bridge funding are over and the uncertainty is repeating itself. Many organizations in the countries receiving aid report being told by the U.S. Centers for Disease Control and Prevention that the bridge plan is extended for another three months: April through June. An official with a large nonprofit working in a low-income country outside of Africa told NPR that they received a notice in March from a CDC official with whom they regularly communicate. The text shared with NPR shows the CDC official recommending the nonprofit “slow spending in anticipation of this lapse in funding” and that “you can continue to use funds on hand.” NPR agreed to grant the official and the nonprofit organization anonymity because they fear retaliation from the U.S. government. While organizations have permission to keep working, it is unclear if and when money for the extension will arrive, says Emily Bass, author of _To End a Plague: America’s Fight to Defeat AIDS in Africa_. She says this is no way to run a health program. “If you want to talk about waste and abuse, this is really extraordinary,” she says. “If you do six months, and then another three months, you are getting less return on your investment than you’d get if you were investing in a stable program.” She says this stresses the workforce, who then look for more reliable jobs elsewhere rather than working most effectively. More than two dozen countries have signed agreements with the U.S., including Uganda, Rwanda, Nigeria and Ethiopia. But Bass says developing implementation plans — that often include things like new procurement systems and new digital health strategies — has proved much slower. In the past, doing all the risk assessments and necessary evaluations to ensure funds are not misused, can take a year or more. She says the six months timeline was “totally unrealistic” from the get-go. The State Department rejected this assessment in a statement to NPR. “Mischaracterizing such a transition as wasteful gets it backwards, as money would otherwise continue to pour into a system that resisted scrutiny, bypassed partner governments, and measured success by dollars out the door rather than lives saved.” The statement went on to say that funds are now being “directed more strategically [and] with greater accountability.” ### “A controlled demolition” Dr. K.J. Seung has been trying to make sense of that strategy. He’s been reading the financial tea-leaves left in government spending data. He’s an associate physician in the Division of Global Health Equity at Brigham and Women’s Hospital. His conclusion is that much of the money is stuck at the State Department. Historically, global HIV/AIDS dollars generally flowed first to the State Department, as required by Congress, and then the State Department divided it primarily between CDC and USAID. There were country and regional plans as well as regular coordinating meetings in order to make sure the work was aligned across the various agencies. But there were also rivalries — and who got to control a bigger share of the work was hotly contested. “It’s really Shakespearean,” says Bass. “Historically, PEPFAR has been the source of numerous turf wars between USAID and CDC,” says a former State Department official who requested anonymity for fear of retribution. “Because everyone is in survival mode, that has not helped the existing turf wars.” Now, Bass, Seung and others believe the battle is playing out in a new way with the State Department not sending the full amount of money typically sent onward to the CDC. Because of its medical expertise, the CDC has overseen a large part of the U.S.’s global work on HIV testing and treatment. “CDC has really incredible technical expertise,” explains Hannah Johnson, deputy director of Global Policy at the George W. Bush Institute. “In a lot of countries, they’re some of your last technical experts on the ground.” However, in the past few months, the projects that fall under the CDC have faced a particularly high degree of funding uncertainty. “My take is the Department of State is deliberately and systematically choking off funding [to the CDC],” Bass says. She believes the goal is “aggregating power, resources and strategic direction capacity into the Department of State.” Seung agrees. “I’m guessing that this is actually a planned sunset [of CDC programs],” he says. “It’s being done with very little media fanfare.” Others foresee the CDC acting more as a contractor on an as-needed-basis rather than a full partner. A CDC official who requested anonymity because they fear retaliation, says this is an active policy choice. “What the financial data shows is not an accident or an administrative delay,” the official says. “Congress appropriated these funds. The money exists. The State Department is simply not transferring enough of it to CDC to keep these programs running.” The official points out that because of the way USAID was dismantled, the CDC’s HIV/AIDS work “is now carrying the last intact pillar of the program and….it could run out of funds by June. That’s not a funding cliff — that’s a controlled demolition. The people who will pay the price are the more than 12 million people living with HIV who depend on these programs for their treatment.” Chouraya says he does not know what’s causing the funding delays but, he confirmed, the programs under the CDC have faced the most delays and financial unpredictability. He says he’s been in triage mode. “We are trying our level best right now to make sure that the frontline, the ones that are doing the direct service delivery, are as minimally affected as possible,” he says. But that’s not always possible. For example, he says, “in Mozambique, when we look at their funding, they don’t have any money remaining.” In a statement to NPR, the CDC said it is using “available resources” to support lifesaving HIV/AIDS work but that “all additional questions regarding funding, funding processes, and the public release of data should be directed to the Department of State.” The State Department, in turn, told NPR that funds are flowing “as they have always been” and it is taking “decisive steps to ensure continuity of lifesaving” services. Legislators are now asking questions. “The delays and uncertainty we have already seen are cause for serious concern — and my staff and I are pushing the administration to take immediate action to prevent any interruption to lifesaving services,” Sen. Patty Murray, D-Wash., told NPR in a statement. “[It is] this administration’s legal responsibility to ensure PEPFAR continues to serve people and save lives — without interruption.” Kates from KFF worries reversing what the Trump administration has set in action would be difficult. Chouraya fears the same. He says, because of all the uncertainty, it is no longer a no-brainer for clinicians to specialize in HIV. “People are getting to a point where they’re saying, ‘I don’t think there’s a future in the field that I’m in right now,’ ” he admits. And that shift has a lot to do with how the U.S. is implementing its new global health strategy. Jonathan Lambert and Fatma Tanis contributed to the reporting. ### _Related_

Congress gave money for global HIV work. The Trump administration isn’t spending it U.S. work combatting HIV/AIDS has saved millions of lives globally. Under the Trump administration, funding has...

#NPR #George #W. #Bush #HIV #aids #PEPFAR #USAID

Origin | Interest | Match

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TAGHIVscience
TAGHIVscience
@taghivscience.bsky.social
5 days ago

The US State Department is now trying to shut the Global Health Supply Chain Program down entirely www.reuters.com/business/hea... #HIV #PEPFAR

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Helen Branswell 🇨🇦
Helen Branswell 🇨🇦
@helenbranswell.bsky.social
1 week ago
Preview
Is Trump killing the heralded U.S. effort to help the world battle HIV? The Department of State hasn’t given the Centers for Disease Control and Prevention all the money it needs to keep vital AIDS relief programs operating

#PEPFAR, which changed the trajectory of the #HIV epidemic, "is being slowly starved, through budgetary choke points and administrative fiat," at risk of dying a death of a thousand cuts, @cohenjon.bsky.social reports. www.science.org/content/arti...

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Bhekisisa Centre for Health Journalism
Bhekisisa Centre for Health Journalism
@bhekisisa.org
2 weeks ago
Preview
180 000 infections in 2024, 47 000 by 2045 — if SA rolls out the twice-a-year HIV prevention jab fast enough - Bhekisisa The HIV prevention shot lenacapavir will be rolled out at South African clinics within the next couple of months — from 2027, the health department will also buy generics. But how best to spend the…

Will #SA “do the right thing in its #Aids response this year” to help the world “when #Pepfar wouldn’t”? It depends on how the health department rolls out #lenacapavir. Here’s what models show. bhekisisa.org/health-news-...

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Deutsche Aidshilfe
Deutsche Aidshilfe
@deutscheaidshilfe.bsky.social
2 weeks ago

🧵1️⃣ Am #WeltTuberkuloseTag macht ein Beitrag im New England Journal of Medicine darauf aufmerksam, dass das mittlerweile von der Trump-Regierung stark beschnittene #PEPFAR- Programm auch mit seinen Maßnahmen gegen #HIV zur Senkung der Tuberkulosefälle und der TB-bedingten Todesfälle beigetragen hat.

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Henry Cust
Henry Cust
@henrycust.bsky.social
2 weeks ago
Post image

Everyone knew the 2025 US aid freeze would devastate HIV services in sub-Saharan Africa. Now the evidence is emerging

New working paper, real service data from 4 NGOs in Uganda & Zimbabwe: prevention ↓60%, testing ↓50%, treatment ↓30%.

#HIV #PEPFAR #USAID

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Bhekisisa Centre for Health Journalism
Bhekisisa Centre for Health Journalism
@bhekisisa.org
2 weeks ago
Post image

Will #SA “do the right thing in its #Aids response this year” to help the world “when #Pepfar wouldn’t”? It depends on how the SA health department rolls out #lenacapavir. Here’s what models show. #EndAids #PrEP bhekisisa.org/health-news-...

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AVAC
AVAC
@avac.org
3 weeks ago
Post image

"The same forces dismantling #PEPFAR & expanding the #GlobalGagRule are also attacking LGBTQ+ people, public health & bodily autonomy here in the US," said @johnmeadejr.bsky.social at the #AIDSWatch 2026 plenary.

Watch what must happen next, and why it matters youtube.com/shorts/rKLR_...

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AVAC
AVAC
@avac.org
3 weeks ago
Post image

AVAC, #AccessBridge & the #PEPFAR Country Management Team at the Kenya Health Integration Summit 🇰🇪

Lots of discussion on how funding disruptions threaten hard-won gains & what it'll take to keep the #HIV response on track & free from service disruptions.

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Ecowatchdog Jer ♻️💪🏽♎🐝🥕💜
Ecowatchdog Jer ♻️💪🏽♎🐝🥕💜
@jeremyhempy.bsky.social
3 weeks ago
Post image Post image

1 Yr ago we were protesting Tesla about this and i Cried alot for the poor people losing their medication #pepfar #usaid #genocide

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UCSF Prevention
UCSF Prevention
@ucsfprevention.bsky.social
3 weeks ago
Post image

youtu.be/YasmZwTFnGM - TOWNHALL VIDEO. Mainstreaming Behavioral and #SocialSciences in #HIVprevention and Treatment: Unpacking the latest #PEPFAR Five-year Strategy.

Featuring Andrew Forsyth, Ph.D.

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AVAC
AVAC
@avac.org
3 weeks ago
Post image

New issue of #GlobalHealthWatch is out!

France slashes its #GlobalFund pledge, the US launches a $4.5B bilateral health funding platform, #PEPFAR timelines slip, and The Lancet Regional Health – Africa debuts.

Catch up on the latest shifts shaping #globalhealth,
avac.org/blog/global-...

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1d10t_Error
1d10t_Error
@1d10terror.bsky.social
4 weeks ago
S13 E04: Iran, USAID & Soap Operas: 3/8/26: Last Week Tonight with John Oliver
S13 E04: Iran, USAID & Soap Operas: 3/8/26: Last Week Tonight with John Oliver YouTube video by LastWeekTonight

#johnoliver #lastweektonight #usaid #pepfar #musk #food #cleanwater #refugee #manmadedisaster

www.youtube.com/watch?v=bCro...

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AVAC
AVAC
@avac.org
1 month ago
Preview
Foreign aid is back from the dead — but it’s in the hands of the people who tried to kill it Both parties just approved billions for lifesaving aid abroad. Will Trump actually spend it?

ICYMI, www.vox.com/future-perfe...

"What this law mostly says is that Congress is back"...[but] “I’ll declare victory when every dollar Congress appropriated is spent by the administration.” - AVAC's Mitchell Warren

#HIV #PEPFAR #foreignaidfreeze

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Janice in Anchorage
Janice in Anchorage
@janiceinanchorage.bsky.social
1 month ago

This administration’s health policies are killing HIV patients worldwide. #PEPFAR
Has been a life-saving program since Bush days.

It is just plain evil to refuse funding this program.

#USDemocracy

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usaid
usaid
@usaid.activitypub.awakari.com.ap.brid.gy
1 month ago
Original post on webpronews.com

The Quiet Dismantling of USAID: How Trump’s Foreign Aid Overhaul Is Reshaping American Diplomacy and Global Health The Trump administration's executive order folding USAID into the State Depa...

#AITrends #American #foreign #policy #2025 #PEPFAR #funding […]

[Original post on webpronews.com]

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State of Health
State of Health
@stateofhealth.bsky.social
1 month ago
Video

💉 The US has approved a US$5.88B global HIV package—about US$4.6B for bilateral HIV programs, US$1.25B for the Global Fund and US$45M for UNAIDS—hailed as a “bold” recommitment to 95‑95‑95 goals.

#HIV #GlobalHealth #PEPFAR #GlobalFund

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Anne M. Holmes
Anne M. Holmes
@amholmes.bsky.social
1 month ago
Preview
Sickening sleaze Say what you will about Dubya (and, trust me, in my time I’ve had plenty to say about the 43rd President of the United States), he did one truly admirable thing. In 2003 he created the U.S. Preside…

As someone who has worked in the international aid sector, I know there are often strings attached. But that is amateur hour compared to the avaricious assholes in DC right now.
#PEPFAR #Dubya #InternationalAid #Wankmaggot

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AVAC
AVAC
@avac.org
1 month ago

"What this law mostly says is that Congress is back"...[but] “I’ll declare victory when every dollar Congress appropriated is spent by the administration.” - AVAC's Mitchell Warren

For more on AVAC's case: avac.org/avac-vs-dept...

#HIV #PEPFAR #foreignaidfreeze

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Deutsche Aidshilfe
Deutsche Aidshilfe
@deutscheaidshilfe.bsky.social
1 month ago

2️⃣ Aufgrund der Kürzungen beim US-Programm #PEPFAR ist die Zahl der Nutzer*innern der #HIV- #PrEP in einigen afrikanischen Ländern um bis zu 98% gesunken. Halte dieser Trend an, so Forscher Dr. Andrew Hill, sei das #UNAIDS- Ziel von weniger als 370.000 HIV-Infektionen pro Jahr nicht zu erreichen.

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Deutsche Aidshilfe
Deutsche Aidshilfe
@deutscheaidshilfe.bsky.social
1 month ago
Preview
US State Department resumes HIV prevention program excluding LGBT+ US State Department resumes HIV prevention program excluding LGBT+ The US Department of State has resumed HIV prevention services under the president’s Emergency Plan for AIDS Relief (PEPFAR) after…

Das US-Außenministerium nimmt Aktivitäten der #HIV- Prävention im Rahmen des #PEPFAR- Programms wieder auf. Die hochwirksame medizinische HIV-Prophylaxe #PrEP darf künftig aber nur schwangeren und stillenden Frauen zur Verfügung gestellt werden, nicht aber #MSM (Männern, die Sex mit Männern haben).

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TAGHIVscience
TAGHIVscience
@taghivscience.bsky.social
1 month ago
Preview
Impact of US government funding freezes on the HIV response: findings from a rapid survey in 32 countries AbstractIntroduction. After the freezing of US foreign assistance in January 2025, the International Epidemiology Databases to Evaluate AIDS (IeDEA) conduc

Impact of US government funding freezes on the #HIV response: findings from a rapid survey in 32 countries academic.oup.com/healthaffair... (open access) #PEPFAR #USAID

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TAGHIVscience
TAGHIVscience
@taghivscience.bsky.social
1 month ago
Preview
Early impacts of PEPFAR funding freeze on HIV service delivery in mid-Western Uganda - BMC Health Services Research BMC Health Services Research - Although there is an emerging evidence base on the impact of planned donor transitions from HIV programs, there is little research exploring the effects of abrupt...

Early impacts of #PEPFAR funding freeze on #HIV service delivery in mid-Western Uganda link.springer.com/article/10.1... (open access)

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Glen Jackson
Glen Jackson
@glenjackson.bsky.social
1 month ago
Preview
Artistlike (@artistlike) Last spring, conservative columnist David Brooks said on PBS Newshour that 6,000 kids had died from HIV/AIDS since Trump empowered Elon Musk to end all HIV/AIDS relief via PEPFAR and all other relief ...

David Brooks said on @pbsnews.org
that 6,000 kids had died from #HIV/AIDS since Trump empowered #ElonMusk to end all relief via #PEPFAR & all other relief via #USAID.
170,000 adults, 18,000 kids have DIED from preventable deaths by TRUMP!
23 MILLION are estimated to be killed by 2030.
#Evangelical

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TAGHIVscience
TAGHIVscience
@taghivscience.bsky.social
1 month ago
Preview
<em>Journal of the International AIDS Society</em> | IAS HIV Research Journal | Wiley Online Library Introduction HIV prevention and treatment supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR) have saved millions of lives. Rwanda is among the most successful countri...

Sustaining Rwanda's #HIV response after elimination of #PEPFAR funding: a modelling analysis of HIV epidemic and care continuum outcomes onlinelibrary.wiley.com/doi/10.1002/... (open access)

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HIV i-Base
HIV i-Base
@hiv-i-base.bsky.social
2 months ago
Colourful i-Base graphic. The main text reads: ‘Catastrophic’ US cuts to global aid will mean 23 million avoidable deaths in 4 years. At the top is i-Base’s website address: I hyphen base dot info. A smaller rectangle in the bottom right, reads: HIV news. 2026. There are various dotted patterns. The colours used in the image are two shades of khaki brown, dark purple, light blue, khaki green, magenta, pink, turquoise, orange, dark green, mustard and white.

Colourful i-Base graphic. The main text reads: ‘Catastrophic’ US cuts to global aid will mean 23 million avoidable deaths in 4 years. At the top is i-Base’s website address: I hyphen base dot info. A smaller rectangle in the bottom right, reads: HIV news. 2026. There are various dotted patterns. The colours used in the image are two shades of khaki brown, dark purple, light blue, khaki green, magenta, pink, turquoise, orange, dark green, mustard and white.

US funding cuts set to cause 23 million excess deaths in the poorest countries by 2030:

i-base.info/htb/53179

New @lancetgh.bsky.social paper predicts that 5.4 million of these will be children under 5.

#HIVsky #IDsky #GlobalHealth #GlobalAid #HIV #InfantMortality #malaria #LMICs #USAID #PEPFAR

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Bhekisisa Centre for Health Journalism
Bhekisisa Centre for Health Journalism
@bhekisisa.org
2 months ago
Preview
What will HIV funding look like in 2026? - Bhekisisa After a year of US funding cuts across global public health, including South Africa’s hard-hit HIV programmes, new realities are settling in. We spoke to Mitchell Warren from the New York-based HIV…

“Do we need every global health organisation? Do we need every global advocacy organisation?” A year after #Pepfar cuts, Avac's Mitchell Warren expects fewer acronyms in global health. But stronger ones. bhekisisa.org/health-news-...

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AVAC
AVAC
@avac.org
2 months ago
Preview
Impact of US Withdrawal from WHO, New Data on PrEP, Cure Academy Applications Open New this week: resources on the impact of harmful US policies on the HIV response; updated infographics on the ups and downs in PrEP; and an opportunity to apply for the US HIV Cure Academy in North…

Today's roundup shows the impact of US policies on the #HIV response, new data on declining #PrEP initiations following #PEPFAR stopwork orders, e a new graphic on how & why delivery of LEN for PrEP is moving faster than any other product + application details US #HIVCure Academy, buff.ly/6Q5Yk37

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Emma Lewis
Emma Lewis
@petchary.bsky.social
2 months ago
Preview
A year later: End of US PEPFAR leaves Cameroon HIV programs in critical condition Last year, reporting on what the U.S. anti-AIDS program PEPFAR had accomplished in Cameroon before it was defunded by the Trump administration, the U.S.

76crimes.com/2026/02/05/e...
It is so painful to see the #PEPFAR programme in decline thanks to Trump. As a State Department employee years ago, it was a part of my work that I was particularly proud of. I know the programme made a difference - in Africa, the Caribbean, and elsewhere. ☹️

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