Cutting HIV aid means undercutting US foreign and economic interests − Nigeria shows the human costs

About twenty years ago, the main focus for U.S. President George W. Bush was addressing Nigeria’s HIV crisis. With 3.5 million HIV cases in Africa’s most populous nation, the disease posed a threat to the region’s stability and U.S. interests. These interests included securing access to Nigeria’s significant oil reserves, maintaining military stability in the region, and safeguarding trade partnerships valued at billions of dollars.

In response to advocacy efforts from AIDS activists, Bush initiated the President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003. This U.S.-led program for HIV treatment has been instrumental in saving millions of lives globally. As a medical anthropologist working in Nigeria, I witnessed the impact of PEPFAR and how the treatments provided under it improved the lives of Nigerians, allowing them to focus on pursuing their aspirations without the fear of death or abandonment.

However, there is now a serious threat to global HIV prevention and treatment efforts. The Trump administration’s decision to limit access to a crucial HIV prevention tool, PEPFAR-funded preexposure prophylaxis (PrEP), could disrupt ongoing treatment for millions and prevent many others from receiving the necessary protection.

The Trump administration’s move to cut HIV prevention funding comes at a critical time when a significant advancement in HIV prevention, the drug lenacapavir, has been recognized as the 2024 Breakthrough of the Year. This drug offers six months of HIV protection with a single injection, simplifying prevention compared to previous daily pill regimens.

By restricting access to essential HIV treatments, the Trump administration’s actions risk undoing the progress made over the past two decades in eliminating HIV globally. The repercussions go beyond individual lives and could have lasting effects on communities.

My experiences in Nigeria have shown me the vital importance of access to HIV medication for families. It is crucial for maintaining the health and well-being of individuals and ensuring the prevention of transmission within communities.

The disruptions in global health funding due to shifts in U.S. political priorities, such as the Mexico City Policy, have had measurable negative impacts on maternal and child mortality rates and HIV cases worldwide. The withdrawal or reduction of aid programs can create lasting distrust within communities and hinder future efforts to provide assistance.

The future of global health security and economic stability is at risk due to reductions in foreign aid by the Trump administration. Public health crises transcend national borders, and inadequate responses can lead to widespread repercussions, as seen in past outbreaks like Ebola and H1N1. Inconsistent aid can also weaken American global influence and open doors for other countries, such as China, to expand their presence in global health initiatives.

The restrictions on PrEP access not only endanger progress in HIV prevention but also revive the difficult choices faced by women at the onset of the epidemic. The result could be a less secure world with continued suffering, the unraveling of hard-fought progress, and the unfulfilled promise of an AIDS-free generation.