Fiscal Constraints Threaten PEPFAR Funding

“He resigned in part because he fears this might lead to the U.S. withholding life-saving treatments if it didn't get what it wanted in return, such as rights to minerals in these countries.”

“That was a major reason for me stepping away. I think more broadly, I've had an increasingly challenging time reconciling the U.S. government's broader foreign policy activities with their global health agenda.”

“when access to life-saving services that we have historically provided for 20 years is now predicated on signing other deals which optimize our commercial interests but put lives at risk on the ground, that felt like a bridge too far for me.”

“We just saw the first tranche of data from PEPFAR since 2020. It shared large decreases in the numbers of people newly tested, diagnosed and treated for HIV.”

“for HIV. What do those numbers show when you look at them?”

“The 20 years of PEPFAR is that many countries have become dependent on donor resources. So in that sense, no, I don't have a problem.”

“Administration officials make the case that low-income nations need to end their dependence on the United States and take on more of the responsibility for ending HIV themselves.”

“They have far less financial resources to come invest in. It's hard to see an effort like that happening now.”

“concern is the speed with which we're moving in that direction and perhaps a failure to recognize that many of these countries have very little fiscal space.”