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They Called It the End of AIDS. Then They Killed the Program That Made That Possible. [1]
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Date: 2025-07-26
In 2003, the U.S. launched the most ambitious humanitarian health program in modern history: PEPFAR, the President’s Emergency Plan for AIDS Relief. Twenty-two years later, after saving over 25 million lives, the same country has quietly decided to kill it.
They won’t say that out loud, of course. They’ll blame “waste,” “duplication,” and “efficiency.” They’ll wrap it in the American flag, mumble something about sovereignty, and slap the word “freedom” on the casket.
But make no mistake: they are ending PEPFAR. And millions of people will die because of it.
A Death Sentence Disguised as Policy
The shutdown didn’t come with a headline. It came with a signature. Executive Order 14169, issued in January 2025, froze all USAID-managed global health contracts. What followed was carnage disguised as cost-cutting:
Clinics in Kenya shuttered mid-shift
HIV testing collapsed in Nigeria
Cold chains failed in Lesotho, and medication spoiled
Outreach workers in Zambia were laid off overnight
At least 341,700 people have died since the shutdown, according to models tracked by public health researchers at Boston University. That number includes over 230,000 children. And the death toll grows by the hour.
The administration said this was about “restructuring.” But there’s a word for quietly killing a program while claiming you’re modernizing it: euthanasia.
“The War on AIDS Is Over. America Surrendered.”
Let’s be clear about what PEPFAR was. It wasn’t just another government grant. It was the largest global health program ever run by a single nation. It operated in over 50 countries. It delivered antiretroviral therapy to over 20 million people. It built clinics. Trained doctors. Saved lives.
And it was bipartisan.
George W. Bush launched it. Barack Obama expanded it. Even Trump, despite gutting so much else, mostly left PEPFAR alone. It was the one place, for decades, where America seemed to remember its power could heal, not just harm.
That consensus is gone.
Now, far-right ideologues are branding PEPFAR as “woke foreign welfare.” Christian nationalist PACs are calling it a “front for abortion and LGBT propaganda.” And quietly, behind the noise, the budget lines are being zeroed out.
This isn’t reform. It’s a moral abdication.
Millions Will Die. And That’s Been Modeled.
Here’s what will happen if PEPFAR funding isn’t restored:
10.8 million people will contract HIV by 2030 who otherwise would not have
2.9 million people will die, most of them in sub-Saharan Africa
Entire generations of children will grow up parentless, as they did in the 1990s
Fragile health systems will collapse, with ripple effects on malaria, tuberculosis, and maternal care
These aren’t activist guesses. These are peer-reviewed estimates, published by top epidemiologists. And the most horrifying part?
We already have the medicine. We just won’t pay to deliver it.
The Real Reason This Is Happening
PEPFAR isn’t being defunded because it stopped working. It’s being defunded because it worked too well and in doing so, empowered the wrong people.
It helped LGBTQ+ communities gain access to healthcare. It empowered African public health ministries. It made Black and brown lives visible to a powerful American state and that’s what this version of America cannot tolerate.
This is the worldview that sees empathy as weakness. That sees global cooperation as betrayal. That sees public health as a political liability.
And so PEPFAR had to die.
“If We’re Not Careful, We’ll Have to Build It All Again”
We’ve been here before. In the early 2000s, AIDS was ravaging the Global South while the West averted its eyes. Then activists rose. Artists, scientists, and politicians said, “Not again.”
And for a moment, they were heard.
But memory fades. Accountability dies. And now we find ourselves back at the cliff’s edge, watching a preventable disease become a death sentence all over again.
We will not get another moment like this. We will not get another chance to stop it from unraveling. Either we act now or we start digging the graves.
What You Can Do
The decision to end PEPFAR isn’t final. Congress can intervene. Pressure works. Public outrage can save lives. But it requires speaking out right now.
Call your Members of Congress and tell them to fully restore PEPFAR funding and protect USAID’s global health mission.
Use this number to find your representative: (202) 224-3121
Help Us Keep Fighting
If you want to do more than call, help us build the pressure campaign that will make Congress act. Every dollar raised goes toward digital organizing, congressional outreach, and lifting up the voices of those who will be most harmed by these cuts.
Give now to support the movement:
https://givebutter.com/A4AL
Because if we don’t fight for these lives, who will?
Because if we let this program die in silence, it won’t be the last.
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