A global HIV/AIDS program that saved millions of lives faces cuts under the Trump administration

Washington – The Trump administration is considering a spectacular reduction and a possible possibility of the president’s emergency plan for the relief of AIDS (PEPFAR), the American program to combat HIV / SIDS in developing countries which was largely credited to have saved 26 million lives since its creation in 2003, according to the managers of the congress and the multiple administration.

Created during the George W. Bush administration, Pepfar was launched with the support of the leading star of the U2 leader and defender of developing countries, Bono, as well as the Bill and Melinda Gates Foundation and the World Bank. During the two decades that followed, he benefited from strong bipartite support at Congress.

But as the Trump administration has sought to reduce costs through the US government, especially for world aid programs, Pepfar appeared on the Cup block. The administration initially offered a drop of $ 400 million compared to the budget next year, but this funding was restored at the last minute by the Senate led by the Republicans last week, which maintains it in the short term.

Four Congress Assistants told NBC News that the program was practically frozen, as well as most of the funding for USAID in early February. The contracts with the service providers were put on hold and the funding was reduced to what they called a “net”. They declared that most of the derogations from the State Department promised for intensive care did not materialize and that 51% of the current credits of the PEPFAR were either terminated or were not functional.

“They are sitting on money,” said Congress officials. “We don’t see it on the ground.”

According to aid, in April, the director of the State Department of the Office of Foreign Assistance, Peter Marocco, working with the DOGE team of Elon Musk to dismantle foreign aid, informed the congress that Pepfar would refocus on the transmission of maternal and children, excluding LGBT and the most preventive care that the program has done for decades.

Earlier this month, a senior State Department official told journalists: “The program was drowned in too much money, in some cases, you know, in a way beyond its main mandate.”

The manager said: “So, instead, we will focus on this rescue care” and “work with countries on autonomy” to ensure that there is no difference in the coverage.

The senior official said that Secretary of State Marco Rubio is a distinction between people who have HIV and who need direct vital treatment, and preventive care for sex workers as well as bisexual and gay men.

The head of the State Department also said: “This does not mean that the United States must pay for everyone in the world.”

“Many of these countries, they are graduated to the point where their HIV rates are low enough and their economy is healthy enough to continue paying for some of these things. We can enter, make positive changes and then go out rather than pay forever so that each sex worker in Africa has prepared,” said the official, referring to HIV drugs.

Deputy Secretary of State for Management and Resources, Michael Rigas, told Congress last week that, overall, in the administration’s budget request for the next financial year, there is a 54% reduction in administrative and non -direct PEPFAR funds. This is added to a drop of 15% in the request for direct care budget of the ministry in the same budget request.

Global health personnel of 700 people and field entrepreneurs before President Donald Trump took up his duties was reduced to 80 people after recent layoffs.

Last month, the director of the White House budget, Russell Vought, told a senatorial committee, without providing evidence, that the PEPFAR had spent $ 9.3 million “to advise Russian doctors on how to carry out abortions and a sex analysis.”

Democratic Senator Chris Coons de Delaware, principal member of the Foreign Relations Committee and former president of the African subcommittee, told NBC News that Pepfar had always planned to obtain countries that had developed their own hospitals and health care systems, such as South Africa, to finance the program by 2030.

According to Coons, this transition is already underway. But he and other criticisms of current budget cuts said that it was not possible in low -income conflict areas, such as South Sudan, the Democratic Republic of Congo and Haiti, to replace the American program as soon as possible.

However, according to a planning service project reported by the New York Times, the State Department would close American support in Botswana, Namibia, South Africa and Vietnam within two years. Nations with high HIV infection rates, including Kenya, Zimbabwe and Angola, are three to four years old, according to Times, while low -income countries would increase up to eight years under the proposal. NBC News did not see the plan project and a State Department official told NBC News that he had not been finalized.

Dr. Robert Black, epidemiologist at Johns Hopkins Bloomberg School of Public Health, who assessed Pepfar for Congress, told NBC News: “I think two years for a certain number of countries, for many countries in Africa, would be too short”, adding: “I cannot imagine that two years would be an effective transition.”

Black has also said that prevention is “clearly important” and that removal of prevention financing, which is envisaged in the Trump plan, would increase HIV levels and increase the burden.

Rubio, who, as a senator, supported PEPFAR and other foreign aids, defended $ 20 billion in global budgetary discounts on the Senate Committee for Foreign Relations in May, citing “double, waste and ideologically motivated programs”.

Questioned last week on the Pepfar cuts, former secretary of state Condoleezza Rice, who was used in the Bush administration when Pepfar was launched, told NBC News at Aspen Security Forum: “I think Pepfar will not only survive, I think it will focus on what we really need. scattered and diffuse in the types of programs we direct. »»

But, she added, “what makes America different as a great power is that we have not led only with power, but we also led with principle.”

Later at the conference, Rice said that the launch of Pepfar was “the most proud moment” of all of its government services. But she added that the United States also wanted to strengthen capacity and health care systems from other countries to maintain itself.

Former President Bush, in rare criticism of Trump policies, praised foreign aid employees in a video last month. He said to the employees of the State Department who had been dismissed: “You have shown the great strength of America through your work, and that is our good heart.”

Citing Pepfar’s rescue work, Bush said: “Is it in our interest that 25 million people who would have died, now live? I think it is. In the name of a grateful nation, thank you for your hard work and may God bless you. ”

In a video, Bono told foreign help staff: “They called you Crooks – when you were the best of us, there for the rest of us. And let’s think no less of us, when politics gives us a waste. It is not a left rhetoric to nourish hungry, cure the sick. If it is not murder. I don’t know what is. “