HIV Patients Ask, “Does this mean we are dying?”

When the USAID closure order came through, [our hospital] was forced to stop accepting new HIV patient registrations. Soon after,... our PEPFAR program manager was approached by a patient who asked a haunting question: “Does this mean we are dying?”

[The doctor] tried to offer reassurance, pointing to the temporary six-month waiver that allows limited continued support. But the patient’s response was stark: “What is six months? What comes after that?” 

This is the growing reality for many of our patients, who now live in fear and uncertainty. [We] worry that more people are losing hope, just as this man already has. Many in our community already lack confidence in the Kenyan government’s ability to establish a viable replacement for PEPFAR. With 1,873 HIV patients currently receiving antiretroviral therapy (ART) at [our hospital], we are already seeing a decline in the number of patients coming for their maintenance visits. This is deeply concerning, as interruptions in treatment lead to viral rebound, increased transmission, and the rise of drug-resistant HIV strains.  

Kenya’s leaders are in discussions about the future of HIV care, but without urgent intervention, the consequences could be devastating. Antiretroviral medications will not be affordable for many patients. Even older generic antivirals like acyclovir are relatively expensive for our population. The loss of USAID support threatens not just individual lives but also the country’s progress in the fight against HIV/AIDS.  

Now, more than ever, we must advocate for sustained global health partnerships. For the patients at our hospital, across Kenya, and the rest of the developing world, this is not just policy—it is life or death. 

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