Administration’s cuts imperil progress
“Lesotho has the world’s second-highest prevalence of HIV, second-highest tuberculosis incidence and ninth-highest maternal mortality ratio. Its health care workers save lives. Through sun and snow, they deliver babies, administer vaccines and treat conditions from heart failure to tuberculosis. In just 15 years, their efforts have helped Lesotho achieve massive decreases in HIV incidence and a 10-year increase in life expectancy.
Americans should be proud of our contributions to this effort. Since it was established by George W. Bush in 2003, PEPFAR has saved more than 25 million lives. Yet in 2024, across 55 countries with PEPFAR-funded programs, the initiative accounted for less than 0.1% of U.S. spending.
The new administration’s cuts imperil this progress. While a March 5 Supreme Court ruling ordered the administration to release appropriated funds, Trump’s sweeping 90-day aid suspension and defiance of prior court orders have already caused harm.
In Lesotho, where nearly one in four adults lives with HIV, funding cuts mean widespread staffing layoffs and terminated treatment. They mean fewer girls in school. They mean delayed diagnoses, broken linkages to care and preventable deaths. For key populations at elevated risk of HIV exposure (including LGBTQ+ individuals and the textile workers who produce Trump-branded apparel), they mean reduced safety, more discrimination and poorer health.”