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hiv/aids
'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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