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Lessons from Past Activist Leaders for Today’s Fights for Health and Social Justice
As the Trump administration’s crusade against democracy and our nation’s public health and healthcare systems continue, we can learn from the lives of Denise Oliver-Velez and Walt Odets.
Jul 24, 2026
Two recent deaths highlighted the importance of earlier activist leaders to struggles for health and social justice. Denise Oliver-Velez, who died on July 15, was a founder of the Young Lords Party in New York, a group that mobilized Puerto Rican and other communities to fight for their health and dignity. She also helped set the stage for alignments between movements for the rights of people of color and those focused on the rights of women.
Walt Odets, a psychologist, died on July 5th in Berkeley where he had provided therapy for gay men for decades. His activism had focused on how best to prevent AIDS and ending the stigma that this country imposes on LGBTQI people.
Their stories remind us of the important role activists play in combating injustice and reversing cruel and harmful policies. As the Trump administration’s crusade against democracy and our nation’s public health and healthcare systems continue, we can learn from these two lives lessons for today’s activists who can bring the values and passions of Oliver-Velez and Odets into the present period.
Through the campaigns she helped to organize, Oliver-Velez brought to life an alternative vision of a healthcare system that put serving people first. In 1970, the Young Lords occupied Lincoln Hospital, an underfunded, understaffed public hospital with decaying facilities and low quality of care, known in the community as the Butcher Shop. The Young Lords sent members into the hospital lobby to collect complaints from patients, which they then presented to hospital administrators. When conditions did not improve, the group occupied the hospital, winning an agreement to hire more Puerto Rican doctors committed to serving their community and to support the Lords to set up new community health and substance use programs. At a time when the city was closing public hospitals to save money, Lincoln was rebuilt and a new modern hospital was opened, in part due to persistent pressure from the Young Lords and their healthcare worker allies.
Between them, these two very different activist leaders demonstrated some of the qualities today’s activists most need to fight current threats to health and social justice.
Oliver-Velez was attracted to the Lords because they were “a puente,” a “bridge between groups, the cultural/nationalists, the Marxists, the whites, the Black and the Asians.” She also wanted to overcome the machismo that divided so many radical groups. She wrote that she and other women in the Lords “made it very clear that we were not going to be just secretaries, that we were warriors too.” Oliver, Iris Morales, and other women leaders in the Young Lords organized a Women’s Caucus which moved the Young Lords Party to adopt feminist principles as central to their political agenda.
These women led campaigns on reproductive justice; against sterilization abuse; for safe, legal abortion; and raised awareness about the institutional oppression of women. Much of their work focused on health—breakfast programs for school children, a campaign to force the city to combat lead poisoning more aggressively, and the fights to improve Lincoln Hospital. Decades before “health for all” became an international rallying call, the Young Lords showed how ordinary people can force government to translate this aspiration into action.
Odets’ practice and tactics were different. He criticized the gay movement’s approach to AIDS prevention, arguing that its guidance on safe sex was ambiguous and failed to prevent infection. He insisted movements had to tell the truth about evidence. He also championed the needs of HIV-negative men, arguing that a movement seeking health for the gay community as a whole at had to consider the needs of these men, even if their lives were not in as imminent peril as those who were HIV+.
“For gay lives,” Odets wrote “the granting of legal rights and authentic acceptance are two different issues in a society steeped in phobic aversion to real diversity.” Odets distinguished between the legal fight for societal recognition, i.e., gay marriage, and the psychological fight for self-acceptance and the rejection of social stigma. He hoped to engage the gay community in addressing both the political and emotional requirement for building solidarity and to prepare gay men to both fight for their rights and insist on their self-worth. Rather than separating these two domains, he strove to integrate them.
Between them, these two very different activist leaders demonstrated some of the qualities today’s activists most need to fight current threats to health and social justice. Both found ways to connect their personal experience to their political beliefs, a prerequisite for authenticity in organizing others.
Oliver-Velez showed the power of bringing people together across the racial-ethnic and gender divides that characterize our society and enable those in power to divide us. Odets emphasized the importance of paying attention to both the political and the psychological dimensions of activism. Activists who appeal to the mind and the heart are more likely to build the long-term support needed to change policies and systems.
Both were willing to acknowledge differences among activists, then look for ways to bridge these divides . Neither Oliver-Velez nor Odets feared conflict, but they did not demonize fellow travelers who disagreed with them, leaving the door open to build bridges.
I have been studying, teaching, writing about, and participating in health activism for more than 50 years. Never have the threats to human and planetary health seemed starker. Never has the responsibility of government to protect health been under such concerted attack. Fortunately, thousands of young and old activists are organizing to combat today’s threats, showing the possibility of an alternative to the dark and cruel view of well-being coming from leaders in Washington. By applying the lessons learned from Oliver-Velez and Odets to today’s battles, we pay tribute to them by strengthening the fights for a healthier, more just world.
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Human Rights Watch Calls Out 'Troubling Conditions' in Trump Health Aid Agreements With Africa
“After the sudden and devastating pullback from US assistance in 2025, governments are now being pressured to accept agreements with contingencies that jeopardize human rights."
Jun 08, 2026
The Trump administration is requiring African nations to agree to a series of "troubling conditions" to restore lifesaving health aid, according to a Human Rights Watch report on Monday.
The administration's abrupt shuttering of the US Agency for International Development (USAID) last year shut off billions of dollars and caused havoc across Africa's healthcare system, resulting in what public health models project could be hundreds of thousands of preventable deaths.
But under what has been dubbed the “America First” Global Health Strategy, the administration has negotiated secretive agreements with dozens of these countries to restore some of the funding. Most of them have been kept under lock and key by the US.
Those that have been made public have come with terms that Human Rights Watch said "raise concerns that health aid is being inappropriately leveraged to extract terms beneficial to the US in negotiations around natural resources and access to sensitive health data from recipient countries."
In March, a draft memorandum of understanding with the government of Zambia was revealed to have conditioned $1 billion for HIV, tuberculosis, malaria, and other disease prevention for millions of people, on the country's acceptance of a separate bilateral treaty that would have given US companies greater access to the country's minerals.
A leaked State Department memo, prepared for Secretary Marco Rubio, put the exploitative terms plainly: “We will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale.”
After the details of that agreement were met with backlash, the text of agreements with several other countries—Ethiopia, Kenya, Mozambique, Nigeria, and Uganda—were suddenly removed from the State Department’s Freedom of Information Act Library.
A Human Rights Watch assessment of the agreements with those five countries—as well as agreements with Rwanda and Liberia that were leaked—revealed that in order to restore a portion of the more than $800 million collectively stripped from them by the US, they'd have to agree to several coercive measures that jeopardize the reproductive and privacy rights of their citizens.
“The agreements show the US intends to condition vital health assistance for millions of people on acquiescence to troubling conditions,” said Julia Bleckner, senior health researcher at Human Rights Watch. “After the sudden and devastating pullback from US assistance in 2025, governments are now being pressured to accept agreements with contingencies that jeopardize human rights.”
All seven of the agreements require the governments to provide the US with "broad access to data and information" to monitor compliance with the Helms Amendment, which forbids the use of US foreign assistance to pay for abortion care.
The agreements with Mozambique, Rwanda, and Liberia require them to provide “any data” requested by the US to ensure compliance with the amendment, while Uganda's permits the US to conduct unannounced spot checks of health facilities and clinics.
"By making a broad package of health aid contingent on broad and potentially invasive surveillance of Helms compliance, the agreement could encourage a more restrictive regulation of abortion than national law mandates and give rise to further violations of the right to healthcare,” says the report.
The agreements also give the US permission to directly audit clinics, laboratories, and health programs to ensure compliance with the conditions. Six of them require clinics to provide access to "any data" requested by the US at a sample of facilities it chooses.
Agreements with five countries also mandate that they share biological specimens taken from patients and associated information related to novel infectious diseases, which HRW described as part of an effort to undermine a global pathogen access and sharing system being created by the World Health Organization, from which Trump has removed the US.
HRW said in a news release:
The agreements raise serious concerns about use of people’s private health data, without clear limits, uniform safeguards, or meaningful protections for patient confidentiality, including in several countries with weak or absent domestic data protection laws. The agreements contain no prohibition on this data being shared with US pharmaceutical companies without patient consent.
“Governments negotiating health assistance agreements with the United States face difficult choices,” Bleckner said. “They should be wary of terms asking them to sign away their populations’ rights and push for the inclusion of civil society representatives and multilateral global health organizations like the Global Fund in deliberations.”
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'Things Are Not Okay': US Threatens to Withhold HIV Funding Unless Zambia Allows Plunder of Its Minerals
"The State Department is threatening Zambia with an embargo on essential medicines in order to plunder its minerals," said one HIV prevention advocate.
Mar 17, 2026
The US State Department is threatening to strip HIV/AIDS and other disease prevention funds for more than a million people in the African nation of Zambia in a bid to extort the country for greater access to its mineral wealth.
The New York Times reported Monday on the draft of a memo prepared for Secretary of State Marco Rubio, which states that "we will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale."
The Trump administration is considering whether to "significantly cut assistance" from the President’s Emergency Plan for AIDS Relief (PEPFAR), which provides daily HIV treatment to around 1.3 million Zambians and other funds for tuberculosis and malaria medications that save tens of thousands of lives each year.
At the time that PEPFAR was created, under the administration of President George W. Bush, HIV was killing around 90,000 people per year in Zambia. That number had been reduced to 16,000 in 2024, according to data from the Joint United Nations Program on HIV/AIDS (UNAIDS).
"Things are not okay," said Justin Wolfers, an economics professor at the University of Michigan and a Brookings Institution fellow.
Threats to cut PEPFAR are part of a broader push by the Trump administration to wield desperately needed foreign medical aid as a tool of coercion against impoverished nations, whose health systems have been thrown into turmoil by the Trump administration's massive cuts to the US Agency for International Development (USAID) last year.
According to the Times, 24 African nations have signed memoranda of understanding (MOU) under the Trump administration's so-called "America First Global Health Strategy" in order to unlock some US funding that has been cut.
Many of the deals require nations to increase their own health spending in order to restore just a fraction of what the US previously provided:
"According to an analysis by the nonprofit Partners in Health, health funding under the agreements would drop by 69% to Rwanda, 61% to Madagascar, 42% to Liberia, and 34% to Eswatini, where a quarter of adults live with HIV," the Times reported in January.
Meanwhile, the deals have come with other, often ideological, strings attached. Kenya's memorandum requires it to provide data guaranteeing that no funding is being used for abortion care, and to direct funds to certain Christian faith-based providers, even though they refuse services like HIV care to LGBTQ+ people.
Nigeria's agreement likewise requires more than $200 million to over 900 Christian faith-based healthcare facilities across the country and emphasizes protecting Christian victims of violence from the Islamist group Boko Haram, even though the majority of the group's victims are Muslim.
Some countries have rejected the deals, calling them one-sided and exploitative. Last month, Zimbabwe walked away from a deal that would have provided $367 million over five years because it required the country to give the US unfettered access to citizens' health data and biological samples.
The deal offered to Zambia is similar to those offered to other countries in that it requires the government to commit $340 million in health spending in exchange for $1 billion from the US over five years, less than half of what it received under previous US administrations. It also demands that Zambia provide citizens' health data to the US for 10 years, longer than the deals agreed to by other nations.
But the deal also stipulates that, to receive any funding, Zambia must provide US corporations with easier access to the nation's vast mineral wealth.
Zambia has some of the world's largest reserves of minerals such as copper, lithium, and cobalt, which are essential to green energy technology. The Trump administration says the country has given China greater access to its mines than it has given to the US.
Zambia would also be required to share mining databases with US experts and renegotiate a massive 2024 contract with the Millennium Challenge Corporation, a US-based foreign assistance agency, to reduce mining regulations.
After the terms of the deal leaked to The Guardian last month, Asia Russell, director of the HIV advocacy organisation Health GAP, derided it as a proposal for the "shameless exploitation" of Zambia.
In February, Zambia rejected the deal, with a spokesperson for the Ministry of Health saying it "did not align with the position and interests of Zambia."
Now the Trump administration is using HIV treatment funding in an effort to force its leaders back to the table and make an example of them for other countries that may seek to go their own way.
The memo describes threats to AIDS funding as a way to demonstrate the "use of sticks" to other countries with which it seeks to negotiate.
If Zambia refuses to sign, it says, “sharp public cuts to American foreign assistance would significantly demonstrate to aid-receiving countries the seriousness of our interest in collaboration and our insistence on tangible benefits under our America First foreign policy."
Zambia has already been stripped of more than half its annual PEPFAR funding from the US since the Trump administration returned to power last year through a combination of foreign aid freezes, rescissions, and budget cuts that stripped billions from the program.
A survey of 76 HIV clinics across 32 mostly African countries that received PEPFAR funds, conducted by the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium, found that, as a result of cuts, many experienced disruptions to testing and treatment, including drug shortages and staff layoffs.
Citing modeling studies, the researchers estimated that funding disruptions to PEPFAR just last year "resulted in more than 120,000 deaths by November 2025, including more than 13,000 child deaths."
Another study by Imperial College London predicted that just the three-month disruption at the beginning of President Donald Trump's second term would result in more than 37,400 excess deaths by 2060.
In a statement posted to social media on Monday, Republicans on the House Foreign Affairs Committee defended the threats to cut PEPFAR, saying that "Just like every other country, Zambia is free to walk away from these negotiations." The Republicans said it was "ridiculous to assume the United States should fund entire health systems for countries that turn around and give priority access to critical supply chains to China."
Russell said that "the State Department is threatening Zambia with an embargo on essential medicines in order to plunder its minerals."
While she said "Zambia’s MOU text is the first we know of that explicitly ties exploitation of mineral wealth," she noted that similar "exploitative conditions" are reportedly part of other nations' memoranda as well, but that information is scarce because they have been "negotiated in secret" and texts have not been made public.
Julius Kachidza, the chair of Zambia’s Civil Society Self-Coordinating Mechanism, said that yet another massive cut in US government funding “would be apocalyptic. It could be quite a disaster, especially to me. And the majority of people living with HIV in Zambia.”
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The Trump Administration Is Waging a Global War on Children
By cutting aid abroad and the social safety net at home, while spreading vaccine skepticism, the administration is ensuring that more children will suffer and die.
Feb 15, 2026
Most of us understand that children are vulnerable, innocent, and must be protected and nourished. But too often in our country, and the world, that doesn’t happen—and now the US government is waging a global war on children.
It started with the closing of the United States Agency for International Development (USAID), thus removing US humanitarian and development aid to people in the worst situations in the world. The cruel closure of USAID denied and continues to deny more than 95 million people access to basic healthcare and nutrition, leading to an estimated 1.6 million additional deaths in 2025, many of which were children.
The current administration also significantly weakened the President’s Emergency Fund for AIDS Relief (PEPFAR). These cuts, plus the closing of USAID, severely limit the international efforts of humanitarian organizations which work to control mother-to-child transmission of HIV. If funding for HIV prevention and treatment continues to fall, by 2040, an estimated 3 million children will contract HIV and nearly 1.8 million will die of AIDS-related causes.
As if that were not enough, the administration pulled out of the vaccine alliance Gavi, an international organization that has paid for more than 1 billion children to be vaccinated worldwide. This allows vaccine-preventable diseases to flourish among unvaccinated and vulnerable children. Many will be permanently disabled or die.
The administration turning its back on the “sh** hole” countries will come back and bite America in the ass, with innocents suffering the most.
The administration has directed these closings of international programs overwhelmingly against Black and brown people who, according to the president, live in “sh** hole” countries. This is his program of “America First,” where “those” people don’t matter—where their children don’t matter.
Moral judgement aside, helping those suffering in other countries is actually in our best interest. Not only would this show some badly needed humanity and compassion, it is also the best public health approach to protect all of us from contagious diseases.
But too many in the United States live in a right-wing news bubble where they aren’t aware of the suffering in the “sh** hole” countries or simply don’t care. And so many don’t realize that the diseases that foreign aid was working to control (AIDS, tuberculosis, polio, Ebola, and vaccine-preventable diseases) endanger us all. They are not just “their problem,” they are also “our problem.” As these diseases spread and multiply in other countries, the nature of the US economy and international trade will bring them here. The administration turning its back on the “sh** hole” countries will come back and bite America in the ass, with innocents suffering the most. Outbreaks of vaccine-preventable diseases are not “the cost of doing business,” as the Centers for Disease Control and Prevention’s (CDC) Deputy Director, Ralph Abraham, MD, callously stated. The US has managed to “do business” while controlling vaccine-preventable disease for decades.
But the administration’s war on children does not stop with the “sh** hole” countries. Here in the US, the “Big Beautiful Bill” made draconian funding cuts to safety-net programs. This intentionally endangers children in millions of US families because it ends access to healthcare and adequate nutrition.
Even that was not enough. Robert F Kennedy Jr., secretary of Health and Human Services, has promoted an anti-science, anti-vaccine agenda by weaponizing the CDC to reduce the availability of vaccines in the US and to keep up a constant drumbeat of anti-vaccine disinformation. The CDC is no longer a trusted source of science-based public health information; it is now a clearinghouse for Kennedy’s anti-science, anti-vaccine misinformation, conspiracies, and lies. Many parents are rightfully confused by the barrage of anti-vaccine propaganda coming from Kennedy; vaccine hesitance is rising, resulting in soaring cases of measles, whooping cough, influenza and tetanus among children. And more will come as Kennedy’s flood of misinformation and fear-mongering about vaccines continues, supported by the highest levels of the administration.
Among this group dangerous beliefs are developing, exemplified by the comments of the Kennedy-appointed Chair of the Advisory Committee on Immunization Practices, Kirk Milhoan. He recently voiced the belief that the individual freedom to refuse vaccines is greater than the freedom to choose not to be infected by contagious diseases. He questions requirements for childhood vaccines, and believes that declining vaccination rates are an opportunity to see what happens when vaccine-preventable diseases run rampant, rather than the tragedy that it is. This is not a sane or ethical experiment; history tells us the answer: The viruses and bacteria will win, and children will suffer.
Kennedy and the administration recently began this unethical experiment when they cut the number of vaccines in the childhood vaccine schedule, guaranteed to reduce vaccine use. Kennedy removed recommendations for rotavirus, Covid-19, influenza, RSV, hepatitis A, hepatitis B, and meningococcal vaccines. These are serious diseases that cause children to suffer and die.
They claim that the new recommendations allow parents the “freedom of choice” about these vaccines, after “shared decision-making,” but this has always been the case for childhood vaccines. What they say is freedom has a tragic cost, and this version of freedom effectively declares that the death of children by vaccine-preventable diseases is an acceptable cost, the cost of doing business, with that cost paid in kids’ lives.
Some may call this freedom. We call it a war on children.
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'Middle Finger to the LGBTQ Community': Trump Halts US Commemoration of World AIDS Day
The move came on the heels of a report detailing how the Trump administration's foreign aid cuts set off a crisis in global AIDS response efforts.
Nov 28, 2025
The Trump administration drew outrage this week for ending formal US commemoration of World AIDS Day, directing US State Department officials to "refrain from publicly promoting" it through social media or other communication channels.
The decision was reported after the Joint United Nations Program on HIV and AIDS (UNAIDS) released an analysis detailing the harms done by the Trump administration's sweeping foreign assistance cuts.
Earlier this year, the Trump administration temporarily halted HIV-related funding, sending global response efforts into "crisis mode," USAID said. Though President Donald Trump ultimately dropped a proposal to slash hundreds of millions of dollars from the President’s Emergency Plan for AIDS Relief (PEPFAR), the administration's throttling of funds forced clinics to shut down and disrupted key community programs, the report states.
"The funding crisis has exposed the fragility of the progress we fought so hard to achieve,” said Winnie Byanyima, executive director of UNAIDS. “Behind every data point in this report are people—babies and children missed for HIV screening or early HIV diagnosis, young women cut off from prevention support, and communities suddenly left without services and care. We cannot abandon them. We must overcome this disruption and transform the AIDS response."
In its reporting on the Trump administration's decision to halt official commemoration of World AIDS Day, which is on December 1, the New York Times pointed to studies suggesting that "cuts by the United States and other countries could result in 10 million additional HIV infections, including one million among children, and three million additional deaths over the next five years."
Today, @realDonaldTrump gave a middle finger to the LGBTQ community. His deplorable cancellation of World AIDS Day commemoration was unconscionable and unforgivable. This action was fueled by raw bigotry and fealty to his Project 2025 masters.
FIGHT.https://t.co/PcyduBcbkI
— Truth Wins Out (@truthwinsout) November 26, 2025
Rep. Mark Pocan (D-Wis.), head of the Congressional HIV/AIDS Caucus, said in a statement that "silence is not neutrality; it is harm."
"I'm calling on the administration to immediately reverse this decision and recommit our fight against HIV/AIDS," he added.
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‘Children Died Waiting’ After Trump Freeze of USAID Operations Stranded Medications
"Shame," said one Democratic senator. "This is not leadership. This is callous arrogance."
Sep 30, 2025
An investigation published Tuesday reveals how the Trump administration's cuts to foreign aid—even those that have been quickly restored under public pressure—have proven deadly for children in poverty-stricken nations.
The halting of a global supply chain program that ships crucial antimalarial and HIV medications around the world was one of President Donald Trump's first actions, as Secretary of State Marco Rubio said that many of the programs run by the US Agency for International Development "run counter to what we’re trying to do in our national strategy" and moved to end USAID's operations.
Portions of the Global Health Supply Chain Program resumed within days of Trump's executive order suspending foreign aid, but as The Washington Post reported in its exclusive investigation, "the suspension had lingering effects that left aid deliveries severely disrupted for months" and severely reduced public health workers' ability to distribute lifesaving medications, screening tests, and other supplies to more than 40 countries.
While more than $190 million worth of anti-HIV/AIDS and antimalarial supplies were scheduled to arrive at distribution warehouses by the end of June, nearly $76 million did not arrive, including a majority of the medications to fight malaria.
Medical supplies worth $63 million did eventually make it to warehouses, but were delayed by 41 days on average, and many sat on warehouse shelves for weeks instead of being sent to clinics and hospitals.
The newspaper told the story of five-year-old Suza Kenyaba, one victim of the delay in the Democratic Republic of Congo, who contracted malaria when the medication supply chain was in a state of chaos due to Trump's order.
"The Trump administration's claim that no one has died from cuts to USAID is devastatingly and disastrously untrue."
The medication the little girl needed was just seven miles away from the clinic where she was battling a high fever caused by the infection, but the disruption to the supply chain program left the medicine stranded in a warehouse.
"The medication that USAID sent was seven miles away due to Trump chaos and suspensions," said Sen. Amy Klobuchar (D-Minn.). "It would have saved her life. Shame. This is not leadership. This is callous arrogance."
The Post published its report a week after Rubio appeared on ABC News and told anchor George Stephanopoulos flatly that "no one has died because the United States has cut aid."
The secretary of state claimed—contrary to evidence—that the administration had simply worked to structure programs to make them more efficient.
But as the Post reported, the stop-work order issued by the administration had rippling effects across the foreign aid pipeline. Chemonics, a contractor that operates the Global Health Supply Chain Program, lost access to a government payment system, inhibiting its "ability to order suppliers to resume work.” As a result, it was forced to furlough 750 people in its US workforce as well as lay off local staff.
While Rubio rolled back some of the foreign aid cuts in late January, issuing a blanket waiver for "lifesaving humanitarian assistance," Chemonics' logistics program that delivers medications from local warehouses to clinics like the one where Kenyaba was fighting malaria was not included in the waiver.
The investigation revealed, said one observer, that Trump has the "deaths of children on his hands."
Oxfam America called on Congress to "fund lifesaving aid."
"The Trump administration's claim that no one has died from cuts to USAID is devastatingly and disastrously untrue," said the group. "Their attacks on USAID stranded lifesaving medication and children died waiting."
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Supreme Court Lets Trump Withhold $4 Billion in Foreign Aid Approved by Congress
"This result further erodes separation of powers principles that are fundamental to our constitutional order," said one critic.
Sep 26, 2025
The US Supreme Court on Friday gave President Donald Trump the green light to withhold billions of dollars of congressionally approved foreign aid, a major win for the White House and executive authority and, according to critics, a body blow to the bedrock constitutional principle of congressional power of the purse.
At issue in Department of State v. AIDS Vaccine Advocacy Coalition is $4 billion in foreign aid allocated by Congress that the Trump administration determined was wasteful, including funding for international public health such as HIV prevention programs, which have been credited with saving millions of lives.
The high court's right-wing majority found that "the asserted harms to the executive’s conduct of foreign affairs appear to outweigh the potential harm" to aid recipients, while cautioning that "this order should not be read as a final determination on the merits."
BREAKING: Supreme Court lets Trump unilaterally freeze billions in congressionally appropriated foreign aid money apparent 6-3 vote with liberals in dissent @courthousenews.bsky.social
[image or embed]
— Kelsey Reichmann (@kelseyreichmann.bsky.social) September 26, 2025 at 1:43 PM
The Trump administration sought not only validation of its claimed ability to claw back spending previously approved by Congress—which under the Constitution generally holds power of the purse—but also of "pocket recission," a highly contentious budgetary maneuver to cancel previously approved federal expenditures by exploiting legal ambiguity in the Impoundment Control Act (ICA).
Democrats and many legal experts contend that pocket recissions are illegal, and Democratic lawmakers warned even before Trump's White House return that he would try to use the tactic in order to refuse to disburse funds allocated by Congress for social programs.
Justice Elena Kagan—who dissented along with fellow liberals Sonia Sotomayor and Ketanji Brown Jackson—asserted that the majority approved "essentially a presidential usurpation of Congress' power of the purse."
"The stakes are high: At issue is the allocation of power between the executive and Congress over the expenditure of public monies," Kagan said.
“That is just the price of living under a Constitution that gives Congress the power to make spending decisions through the enactment of appropriations laws,” she wrote. “If those laws require obligation of the money, and if Congress has not by rescission or other action relieved the executive of that duty, then the executive must comply.”
Earlier this year, the Supreme Court dealt a temporary blow to Trump's evisceration of the US Agency for International Development (USAID) in a ruling that left intact a lower court's decision ordering the resumption of approximately $2 billion in foreign aid frozen by the administration.
Friday's ruling could complicate bipartisan negotiations to avert a Republican government shutdown as the September 30 deadline looms. Democratic negotiators now worry that Trump, buoyed by the high court decision, could again refuse to spend funds designated by Congress.
“Today’s ruling allows the administration to unilaterally refuse to spend $4 billion in foreign assistance funds that it is required by law to spend," said Nicolas Sansone, an attorney at the consumer advocacy group Public Citizen and counsel for the AIDS Vaccine Advocacy Coalition. "This result further erodes separation of powers principles that are fundamental to our constitutional order. It will also have a grave humanitarian impact.”
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House GOP Votes Down Amendments to Restore Funding for Meals on Wheels, AIDS Prevention
"They're happy to give even more to the wealthiest with giant tax breaks," said Rep. Mark Pocan, "but when it comes to helping people in need, there's never enough to go around."
Sep 10, 2025
House Republicans have struck down a pair of amendments to fully fund the Meals on Wheels program and AIDS prevention as part of this week's markup process for the fiscal year 2026 US Department of Health and Human Services (HHS) budget.
The amendments were proposed by Rep. Mark Pocan (D-Wis.) to the bill recently released by the House Appropriations Committee, which proposes to cut HHS funding by 6%.
Part of that funding comes from Meals on Wheels, the charity that provides an estimated 250 million meals each year to senior citizens unable to cook for themselves. The charity says that 9 in 10 of its providers receive some amount of federal funding and that for 60% of them, it represents more than half their operating budget.
According to Pocan, who spoke Monday on the House floor, the Republican bill underfunds the food assistance program by $600 million, which he says is likely to cost 1.9 million people their access to food.
" Republicans in the appropriations process are leaving seniors to starve," Pocan said.
Combined with the $187 billion already cut from the Supplemental Nutrition Assistance Program (SNAP) by the "One Big Beautiful Bill Act," which Republicans passed in July, Pocan said it amounts to "the largest cut to food assistance in our nation's history."
Pocan juxtaposed these cuts with the "extravagant dinner" hosted this weekend at Trump's new, private White House "Rose Garden Club," which White House social media shows featured "steak and a fudge-filled seven-layer cake."
"I guess the theme of the White House event was 'let them eat cake,'" Pocan joked.
When he proposed the amendment as part of the markup process on Tuesday, Pocan spoke about his elderly mother's experience relying on the Meals on Wheels program when she dealt with mobility issues.
"I would hope that this is something where we could get together and say, 'Yeah, this should be a priority... We respect our seniors and we're going to show that through Meals on Wheels," Pocan said before his House colleagues.
Every single Republican on the Appropriations Committee voted against the amendment.
Republicans also unanimously struck down Pocan's amendment to restore nearly $2 billion for AIDS prevention cut from the House GOP bill, which makes up 25% of the total budget cuts to HHS.
In June, the Foundation for AIDS Research projected that Trump's proposal to cut $1.3 billion worth of HIV prevention funds "could cause an additional 144,000 new HIV diagnoses, 15,000 deaths, and 128,000 more people living with HIV in the US by 2030."
The Appropriations Committee budget goes even further than Trump's proposed budget released earlier this year, cutting over $1.7 billion worth of AIDS prevention funding.
It calls for the total elimination of Centers for Disease Control and Prevention funding to combat HIV and cuts $220 million allocated to Trump's own Ending the HIV Epidemic (EHE) initiative. It also eliminates $525 million from the Ryan White Program, which provides grants to over 400 HIV/AIDS clinics providing care and treatment.
"This is not a bill for making America healthy again, but a disastrous bill that will reignite HIV in the United States," said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. "Eliminating all HIV prevention means the end of state and local testing and surveillance programs, educational programs, and linkage to lifesaving care and treatment, along with PrEP. It will translate into an increased number of new HIV infections, which will be costlier to treat in the long run."
After Republicans voted down his amendment to reverse these "devastating" cuts, Pocan wrote on X, "They're happy to give even more to the wealthiest with giant tax breaks, but when it comes to helping people in need, there's never enough to go around."
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Trump Moves to Kill PEPFAR, Potentially Dooming Millions to Death From AIDS
"There will be an additional 6 million newly infected persons in the world," said the United Nations' top AIDS prevention official recently. "That has started already."
Jul 25, 2025
The U.S. program credited with saving an estimated 26 million lives and preventing millions of new HIV infections has not sufficiently provided a direct benefit to the United States, suggests Trump State Department planning documents for the George W. Bush-era initiative.
Congress rejected cuts to the President's Emergency Plan for AIDS Relief (PEPFAR) last week, even as Republicans pushed through nearly $8 billion in foreign aid cuts; the program has long had robust bipartisan support as it has enabled 5.5 million babies to be born without HIV to HIV-positive mothers, provided support to 7 million orphans, and driven a decline in new HIV infections in young women in every geographic area that implements its prevention program.
But as The New York Times reported Thursday, a draft plan at the State Department details proposals for "transitioning" low-income countries away from PEPFAR, with the Trump administration imposing what it calls "bilateral relationships" with the aim of ostensibly prioritizing public health in the United States.
Countries in the Global South would be asked to focus efforts on "the detection of outbreaks that could threaten the United States and the creation of new markets for American drugs and technologies," reported the Times.
The administration appears to be approaching PEPFAR with the logic, said journalist Ben Krauss, that the program "needs to be remade to exclusively serve American interests."
"Saving 25 million lives over the past two decades and pulling off one of the greatest humanitarian feats of the century was already serving American interests," said Krauss. "This is just evil."
The State Department documents also say the Trump administration believes "that the transition of PEPFAR can become the premier example of the U.S. commitment to prioritizing trade over aid, opportunity over dependency, and investment over assistance."
PEPFAR-funded programs in low-income countries have already struggled to stay afloat this year following President Donald Trump's foreign aid funding freeze soon after he took office in January. A stop-work order forced some programs to halt services like the provision of antiretroviral therapy and to lay off thousands of staffers.
A waiver issued in February allowed PEPFAR to continue certain programs, but the administration's cuts to and elimination of the U.S. Agency for International Development, which has implemented PEPFAR since its inception in 2003, has also impacted the initiative.
Under the plan outlined in the documents—which a spokesperson denied were "reflective of the State Department's policy on PEPFAR"—countries would be required to spend far more of their own funds on fighting the spread of HIV/AIDS. Countries that are close to controlling the epidemic, such as Vietnam and Botswana, would see an end to PEPFAR within two years, while countries that still have high rates of infection and receive significant amounts of U.S. funding, including Kenya and Zimbabwe, would have up to four years.
"There will be some countries that can manage where the PEPFAR investment is not as heavy or as large a proportion of their total effort," Robert Black, a professor at Johns Hopkins Bloomberg School of Public Health, told the Times. "But some of the African countries with enormous HIV problems and national financial problems, debt, and other development issues—I cannot see that they are going to be able to pick up all or even a large proportion of the costs in that kind of time frame."
Winnie Byanyima, the executive director of UNAIDS, the United Nations AIDS prevention agency, said earlier this month that the threats Trump has already made to AIDS relief programs across the globe have begun a "deadly funding crisis."
"Personally I am devastated," she said of the U.S. funding cuts at a U.N. summit in Seville, Spain. "Appalled. Shaken and disgusted. I don't have the English words to use."
Byanyima emphasized that HIV/AIDS prevention funding through PEPFAR and similar programs represents "a drop of money that is nothing in one of these rich G7 countries."
PEPFAR is funded through discretionary spending in the federal budget and accounts for less than .08% of U.S. spending.
"To create such crisis, such pain, and such anger on the ground," said Byanyima. "This cut, that's dedicated people losing jobs, loyal support gone, research ended, vulnerable people abandoned. And it is deaths. What went away immediately was prevention services, so we are very worried about the new infections and about deaths... There will be an additional 6 million newly infected persons in the world. That has started already."
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'Crisis of Disrupted Care': Nearly 800,000 Mpox Vaccines Meant for Africa Wasted Due to Trump USAID Cuts
Salim Abdool Karim, chair of the Africa CDC's emergency consultative group, has called Trump's "abrupt closure of USAID support for the mpox control effort in Africa" a "major blow."
Jul 18, 2025
Nearly 800,000 doses of the mpox vaccine, which were initially promised to fight the epidemic in Africa, are set to go to waste due to Trump's cuts to the U.S. Agency for International Development.
According to Politico, which quotes the Africa Centres for Disease Control and Prevention, the vaccine doses cannot be shipped because they are too close to their expiration date.
"For a vaccine to be shipped to a country, we need a minimum of six months before expiration to ensure that the vaccine can arrive in good condition and also allow the country to implement the vaccination," said Yap Boum, an Africa CDC deputy incident manager.
In September, the Biden administration pledged that the U.S. would provide more than 1 million doses to fight the epidemic in Africa, which has killed nearly 2,000 people, many of them children.
However, Politico reports that just 91,000 of them were delivered, and only 220,000 of them still have a long enough shelf life to be used if the Trump administration signs off on them.
The continent is already facing a dangerous shortage of mpox immunizations. As Science reported last month:
In September 2024, Africa CDC and the World Health Organization (WHO) jointly issued an mpox "continental preparedness and response plan" that called for vaccinating 10 million people in Africa within 6 months. An updated version of the plan, issued in April, narrowed who should be offered the vaccine and scaled back the target to 6.4 million people by August.
But according to a May 29 WHO situation report, only 720,000 people in seven African countries have received mpox vaccines. Doses are scarce, vaccination teams are short on health workers and transportation, and identifying who might have been exposed to the mpox virus and should get the vaccine first is a challenge.
Salim Abdool Karim, chair of the Africa CDC's emergency consultative group, called Trump's "abrupt closure of USAID support for the mpox control effort in Africa" a "major blow, especially since it played a key role in the logistics of vaccine storage and distribution."
A June report by Public Citizen put the striking shortfall of doses into even greater perspective. The group reported that Africa had nearly six times fewer doses of the vaccine than the United States had during the 2022-23 outbreak, which was markedly less severe than what Africa currently faces.
Graphic: Public Citizen www.citizen.org
They pointed to high prices charged by the vaccine's manufacturer, Bavarian Nordic. The company has sold the vaccines to UNICEF for $65 per dose, making them the second most expensive drug UNICEF pays for.
UNICEF called for Bavarian Nordic to quarter the price of the drug and increase doses available to fight the crisis, but the company did not respond to the request. As a result, UNICEF fell 350,000 doses short of the one million that it had hoped to commit.
This shortfall was made worse by the actions taken by the Trump administration. While halting USAID operations, the U.S. also ceased cooperation with the World Health Organization (WHO), which is a major player in organizing the allocation of vaccines.
The Trump administration's actions, the report said, have "prompted a concurrent crisis of disrupted care and severe funding shortfalls across a range of disease areas and health services."
Mpox vaccines are not the only form of international aid going to waste as a direct result of the Trump administration's cuts to USAID.
On Monday, Hana Kiros reported in The Atlantic that the Trump administration had given the order "to incinerate food instead of sending it to people abroad who need it":
Nearly 500 metric tons of emergency food—enough to feed about 1.5 million children for a week—are set to expire [Tuesday], according to current and former government employees with direct knowledge of the rations. Within weeks, two of those sources told me, the food, meant for children in Afghanistan and Pakistan, will be ash.
The Trump administration formally shut down USAID on July 1, after cancelling 83% of its programs at the beginning of Trump's term.
On the same day, a study was published in The Lancet, revealing that the organization's efforts over the past two decades had saved over 90 million lives, with the biggest reductions in mortality coming from its work to prevent HIV/AIDS, malaria, and other tropical diseases.
"Is [USAID] a good use of resources? We found that the average taxpayer has contributed about 18 cents per day to USAID," James Macinko, a health policy researcher at UCLA and study co-author, told NPR. "For that small amount, we've been able to translate that into saving up to 90 million deaths around the world."
According to Impact Counter, a database created by Brooke Nichols, associate professor of global health at the Boston University School of Public Health, nearly 250,000 children and 120,000 adults already had died over less than six months as a result of cuts to these programs, as of June 26.
According to the Lancet study, if those cuts extend into 2030, 14 million people who might otherwise have lived—including millions more children—might die.
"These deaths will not be the result of droughts, earthquakes, pandemics, or war," said Olivier De Schutter in a piece published Friday in Common Dreams. "They will be the direct consequence of a single, lethal decision made by one of the wealthiest men to ever walk this planet."
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