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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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Trump State Dept Announces Withdrawal From UNESCO Over Palestine Inclusion
Like: Palestinian officials responded by urging the U.S. not to "bind its own international standing to the crimes and violations committed by Israel."
Jul 22, 2025
The Trump administration's unrelenting backing of Israel was on display Tuesday as the U.S. State Department withdrew support for the United Nations agency tasked with promoting education and cultural understanding—but the organization's leader pledged that it would continue its work while welcoming "all the nations of the world."
State Department spokesperson Tammy Bruce cited the decision by the U.N. Educational, Scientific, and Cultural Organization (UNESCO) to accept the state of Palestine as a member state as part of the reason for the Trump administration's withdrawal.
The inclusion of Palestine is "contrary to U.S. policy, and contributed to the proliferation of anti-Israel rhetoric within the organization," Bruce claimed without citing examples.
Audrey Azoulay, director-general of the agency, said the U.S. withdrawal—which President Donald Trump also imposed during his first term, and which will eliminate about 8% of UNESCO's international funding—was "regrettable," but that the organization would continue operating without a reduction in staff, having prepared for the president's exit.
"In spite of President Donald Trump's first withdrawal in 2017, UNESCO stepped up its efforts to take action wherever its mission could contribute to peace and demonstrated the pivotal nature of its mandate," said Azoulay, noting that UNESCO adopted a "global standard-setting instrument on the ethics of artificial intelligence," developed major programs for education in conflict settings, took action to defend biodiversity, and oversaw the reconstruction of Mosul, Iraq—all without the participation of the United States.
Azoulay added that the reasons for the U.S. withdrawal, which will go into effect in December 2026, "contradict the reality of UNESCO's efforts, particularly in the field of Holocaust education and the fight against antisemitism."
"Palestine firmly rejects the justifications provided by the United States for its withdrawal, considering them an unacceptable politicization of UNESCO's work and a failed attempt to deflect attention from the violations committed by Israel."
The Trump administration, along with many establishment Democratic and Republican lawmakers, has explicitly equated expressions of support for Palestinians and criticism of Israel with antisemitism. UNESCO has denounced the Israeli government and military for their destruction of schools and cultural sites and their killing of journalists in Gaza.
Azoulay emphasized that UNESCO is "the only United Nations agency responsible" for promoting Holocaust education and for the global fight against antisemitism, "and its work has been unanimously acclaimed by major specialized organizations such as the United States Holocaust Memorial Museum in Washington D.C., the World Jewish Congress and its American Section, and the American Jewish Committee (AJC)."
"UNESCO will continue to carry out these missions," she said, "despite inevitably reduced resources."
The agency is also well known for designating World Heritage sites, more than 20 of which are in the United States.
U.S. Rep. Gregory Meeks (D-N.Y.), ranking member of the House Foreign Affairs Committee, called the withdrawal from UNESCO "another assault by the Trump administration on international cooperation and U.S. global leadership."
Along with promoting education about the Holocaust, Meeks said, UNESCO "directly benefits the U.S. economy through its Creative Cities and World Heritage programs, through which the United States has recently secured two new World Heritage inscriptions in Ohio and Pennsylvania—promoting to the world the beauty, culture, and heritage of American cities."
Before Trump withdrew from UNESCO for the first time in 2017, the Obama administration cut funding to the organization after it admitted Palestine as a member state in 2011.
The state of Palestine's Ministry of Foreign Affairs expressed "deep regret" over the Trump administration's decision on Tuesday.
"Palestine firmly rejects the justifications provided by the United States for its withdrawal, considering them an unacceptable politicization of UNESCO's work and a failed attempt to deflect attention from the violations committed by Israel, the illegal occupying power, against heritage, culture, and archaeological sites in Palestine, as well as in other areas such as education, science, media, and the environment," said officials.
The ministry also advised the U.S. not to "bind its own international standing to the crimes and violations committed by Israel."
"Otherwise," it said, "it would find itself compelled to withdraw from the entire multilateral international system, in order to shield Israel from accountability, thus encouraging it to continue perpetrating its crimes as a rogue state operating outside the framework of international legality."
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50+ Dems Slam Rubio Plan to Burn 500 Metric Tons of Emergency Food Aid
"This action is not only morally indefensible, but also wasteful, strategically shortsighted, and completely counter to the entirety of your work while in the Senate."
Jul 18, 2025
More than 50 congressional Democrats on Friday condemned U.S. Secretary of State Marco Rubio's decision to withhold and destroy nearly 500 metric tons of emergency food aid for Afghanistan and Pakistan—a move that came a month after the Trump administration's State Department abolished all overseas positions at the United States Agency for International Development.
The USAID emergency food aid—which has been stored in a warehouse in Dubai for months and will expire before the end of July—is enough to feed around 1.5 million children for a week. The aid consists of high energy biscuits that are used primarily to satisfy the immediate nutritional needs of children enduring food crises. It is now set to be incinerated.
"This action is not only morally indefensible, but also wasteful, strategically shortsighted, and completely counter to the entirety of your work while in the Senate," the Democratic lawmakers wrote in a letter to Rubio.
"Given the alarming rates of food insecurity and famine in regions like Gaza and Sudan, the decision to burn lifesaving aid produced by American farmers and paid for by American tax dollars amounts to a tragic abdication of our global humanitarian responsibilities and hurts our own global interests," the letter asserts.
Secretary Rubio is planning to withhold 500 metric tons of vital food aid that could feed 1.5 million starving children… and then incinerate the food once it expires. UNACCEPTABLE!
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— Rep. Mark Pocan (@pocan.house.gov) July 18, 2025 at 12:55 PM
"We are also alarmed by reports indicating that internal USAID memos requesting urgent approval to move the biscuits went unanswered for months," the lawmakers said. "If accurate, this speaks to a systemic breakdown in communication and leadership that has paralyzed America's food aid delivery systems."
"The United States has long led the world in humanitarian assistance, not only as a matter of compassion but also as a cornerstone of global stability and diplomacy," the letter concludes. "Destroying aid that could save lives undermines that legacy and damages our standing in the international community. We urge you to immediately prioritize the distribution of all remaining and viable food assistance stockpiles. American leadership demands nothing less."
Rubio's decision comes a month after the secretary of state ordered the abolition of all overseas USAID positions amid the Trump administration's downsizing and elimination of the agency, one of many targeted by the so-called Department of Government Efficiency, formerly led by multibillionaire Elon Musk.
As Common Dreams reported in May, 66,000 tons of food—including grains, high-energy biscuits, and vegetable oil—were already mouldering in USAID warehouses.
U.S. State Department spokesperson Tammy Bruce attempted to justify Rubio's decision during a Thursday press conference.
"If something is expired, we will destroy it. It's a matter of whether or not it's safe to distribute," she said, adding that 500 metric tons amounts to "less than 1%" of all annual U.S. food aid.
"We, as an example, distribute roughly 1 million metric tons of food aid every year, which is reflective of the American people's generosity," Bruce said.
While many observers expressed surprise over the impending destruction of so much food aid, some contended that it tracks with the Trump administration's wider attitudes toward poor people.
" Republicans don't care if American children starve," said podcast host Lana Quest, "so why would they care about famine in other countries?"Keep ReadingShow Less
Rubio Orders Abolishment of USAID's Entire International Workforce
All foreign assistance programs will now be managed by the secretary of state.
Jun 10, 2025
A cable from the U.S. State Department Tuesday showed that the Trump administration is eliminating the entire international workforce of the foreign aid agency that has provided lifesaving assistance in the Global South for over six decades.
"The Department of State is streamlining procedures under National Security Decision Directive 38 to abolish all USAID overseas positions," read the cable, referring to the U.S. Agency for International Development. The document was obtained by The Guardian.
USAID was one of the first targets of the so-called Department of Government Efficiency (DOGE), whose former leader, billionaire Elon Musk, has baselessly called the agency a "criminal organization."
Secretary of State Marco Rubio announced in March that 5,200 of the agency's 6,200 international initiatives had been eliminated and that the few remaining programs were now under the control of the State Department.
The announcement by Rubio on Tuesday means all foreign assistance programs will be managed by the department, with the administration firing hundreds of foreign service officers, contractors, and local employees across more than 100 countries.
USAID officials and international humanitarian experts have warned since the Trump administration first moved to freeze foreign assistance in January that cuts to the agency would leave at least 1 million children without treatment for malnutrition, leave 200,000 more children paralyzed from vaccine-preventable polio over next decade, and cause up to 160,000 deaths from malaria.
But President Donald Trump has persistently claimed the agency is "run by a bunch of radical lunatics" and Rubio has said USAID operates "independent of the national interest."
"Everything they do has to be aligned with U.S. foreign policy," said Rubio earlier this year.
The announcement of the elimination of USAID's entire workforce came as government watchdog Public Citizen released a new report on Trump's stop-work order affecting the agency in January. The order "likely affected 32 USAID-funded clinical trials conducted across 25 countries and as many as 94 thousand participants."
According to the report:
- More than half of the trials (17 of 32) were specifically researching the world's deadliest infectious diseases: human immunodeficiency virus (HIV) infection, tuberculosis, and malaria.
- For eight trials where contact persons provided additional information, seven trials were affected before participants were enrolled or after data analysis was complete; one trial reported minor patient safety issues.
- The trials were conducted across five continents, predominantly in Africa (13 countries) and in Asia (nine countries).
- The study sites most frequently mentioned across all trials were South Africa (9 times); Kenya and the United States (6 times each); and Uganda, Zambia, and Zimbabwe (4 times each).
Due to the stop-work order, said Nina Zeldes, a health researcher at Public Citizen's Health Research Group, "researchers were unable to safeguard the welfare of participants and uphold their ethical obligations."
Public Citizen said that "the sudden, medically uncalled-for suspension of the clinical trials was a serious violation of research ethics, potentially jeopardizing the health of trial participants and the integrity of the trials."
The Center for Global Development also published an analysis Tuesday of estimates that have stated the White House's proposal of cutting global health and humanitarian aid funding by two-thirds would put 1 million lives at risk.
Researchers Charles Kenny and Justin Sandefur found that it was "implausible" that cuts to U.S. foreign assistance would only impact so-called "waste" and would preserve lifesaving assistance, as the administration has claimed.
"Using our estimates of costs per life saved for U.S. global health and humanitarian assistance based on available empirical evidence, we can calculate the potential number of lives at risk from such cuts," wrote Kenny and Sandefur. "The calculation suggests the cuts could lead to 675,000 additional deaths from HIV, and a combined 285,000 deaths from malaria and tuberculosis."
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UNRWA Chief Accuses Israel of Torturing Staff as US Backs Ban on Agency at World Court
Nearly 300 UNRWA workers have been killed in Israeli attacks since October 2023, and dozens of other agency staffers have alleged torture during Israel Defense Forces detention.
Apr 30, 2025
As the International Court of Justice this week weighs an Israeli ban on a United Nations agency that provides lifesaving aid in Gaza, the program's leader called out attacks on its workers while the United States defended Israel—the recipient of billions of dollars in U.S. military assistance.
The ICJ is holding a week of hearings in The Hague, Netherlands following the U.N. General Assembly's December passage of a Norwegian-led resolution asking the tribunal, which is also known as the World Court, for an advisory opinion on Israel's legal obligation to "ensure and facilitate the unhindered provision of urgently needed supplies essential to the survival of the Palestinian civilian population."
Among the 38 nations and three regional blocs scheduled to address the 15 ICJ judges, only the United States and Hungary have so far defended Israel, whose forces have killed nearly 300 United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) workers during their nearly 19-month annihilation of Gaza.
"An occupational power retains a margin of appreciation concerning which relief schemes to permit," U.S. State Department legal adviser Joshua Simmons argued before the court Wednesday, referring to Israel's 58-year occupation of Palestine, which the ICJ ruled an illegal form of apartheid in a June 2024 advisory opinion.
"Even if an organization offering relief is an impartial humanitarian organization, and even if it is a major actor, occupation law does not compel an occupational power to allow and facilitate that specific actor's relief operations," Simmons continued, noting "serious concerns about UNRWA's impartiality, including information that Hamas has used UNRWA facilities and that UNRWA staff participated in the October 7th terrorist attack against Israel" in 2023.
"Given these concerns, it is clear that Israel has no obligation to permit UNRWA specifically to provide humanitarian assistance," Simmons added. "UNRWA is not the only option for providing humanitarian assistance in Gaza."
In what UNRWA Commissioner-General Philippe Lazzarini described at the time as an act of "reverse due process," the agency fired nine employees in February 2024 following Israeli allegations that they were involved in the Hamas-led attack on Israel in which more than 1,100 Israelis were killed and 251 Israeli and foreign survivors were kidnapped.
Lazzarini admitted to terminating the staffers without due process or an adequate investigation of Israel's claims. A subsequent probe by the U.N. Office of Oversight Services "was not able to independently authenticate information used by Israel to support the allegations."
On Tuesday, Lazzarini reminded the world that "over 50 UNRWA staff—among them teachers, doctors, social workers—have been detained and abused" by Israeli forces since October 2023.
"They have been treated in the most shocking and inhumane way," he continued. "They reported being beaten up and used as human shields. They were subjected to sleep deprivation, humiliation, threats of harm to them and their families, and attacks by dogs. Many were subjected to forced confessions."
Those forced confessions spurred numerous nations including the United States to cut off funding to UNRWA. Almost all of the countries have since restored funding as Israel's claims have been debunked or questioned over a lack of evidence.
The U.S.—which has not restored funding for UNRWA—earlier this week abandoned its long-standing position that the body is immune from lawsuits, opening the door for cases by October 7 survivors and victims' relatives stemming from dubious claims of agency involvement in the attack.
In addition to accusing Israeli troops of torturing its staffers, UNRWA has also documented tortures allegedly suffered by Palestinians imprisoned by Israel, including interrupted drowning—also known as waterboarding—being shot in the knees with nail guns, sexual abuse of both men and women, and being sodomized with electric batons. The Israel Defense Forces is investigating dozens of in-custody deaths, many of them at the notorious Sde Teiman base in the Negev Desert.
While Israel's physical assault on Gaza has killed hundreds of UNRWA workers, its diplomatic war on the U.N. has seen the agency banned from operating in Palestine and U.N. Secretary-General António Guterres declared "persona non grata" in Israel after he included Israel on his 2024 "list of shame" of countries and armed groups that kill and injure children during wartime.
The U.S.-backed 572-day war waged by the far-right government of Israeli Prime Minister Benjamin Netanyahu—who is a fugitive from the International Criminal Court—has left more than 184,000 Palestinians dead, maimed, or missing in Gaza, according to the Gaza Health Ministry. Nearly all of the embattled enclave's more than 2 million people have been forcibly displaced and Israel's "complete siege" of the coastal strip has fueled widespread starvation and illness.
This week's ICJ hearing comes amid the tribunal's ongoing genocide case against Israel, which was brought by South Africa and is backed by dozens of nations either individually or via regional blocs. The court has issued three provisional orders in the case, all of which Israel has been accused of flouting.
Responding to the U.S. intervention in this week's ICJ hearings, Palestinian Ambassador to the Netherlands Ammar Hijazi told Middle East Eye that "everybody knows that Israel is using humanitarian aid as a weapon of war and is starving the population in Gaza because of that."
U.N. agencies and international humanitarian groups have warned in recent days of the imminent risk of renewed famine in Gaza as food stocks run out.
“ #Gaza: children are starving. The Government of Israel continues to block the entry of food and other basics. A manmade and politically motivated starvation. Nearly 2 months of siege. Calls to bring in supplies are going unheeded.” — UNRWA Commissioner-General Philippe Lazzarini
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— UNRWA ( @unrwa.org) April 27, 2025 at 1:39 AM
"The U.S. intervention is very narrow in its scope, when it highlights the rights of an occupying power but ignores the so many layers of duties of that occupying power that Israel is in violation of," Hijazi added.
Among the countries defending UNRWA during Wednesday's ICJ session were Indonesia and Russia, which is currently waging a war against Ukraine. Indonesian Foreign Minister Sugiono affirmed "the Palestinian people's right to self-determination," while Maksim Musikhin, legal director of Russia's Foreign Ministry, argued that "international law should be respected by Israel" and that UNRWA deserves a Nobel Peace Prize.
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Critics Decry Rubio's 'Deeply Unserious' State Department Overhaul Plan
One observer called the proposal "nothing less than an assault on American diplomacy."
Apr 23, 2025
Secretary of State Marco Rubio's plan to streamline what he called the "bloated" State Department by slashing staff and closing or consolidating bureaus was widely criticized Tuesday as a dangerous retreat from diplomacy and soft power that would weaken U.S. standing abroad and boost adversaries.
"In its current form, the department is bloated, bureaucratic, and unable to perform its essential diplomatic mission in this new era of great power competition," Rubio said in a statement. "Over the past 15 years, the department's footprint has had unprecedented growth and costs have soared."
"But far from seeing a return on investment, taxpayers have seen less effective and efficient diplomacy," he added. "The sprawling bureaucracy created a system more beholden to radical political ideology than advancing America's core national interests. That is why today I am announcing a comprehensive reorganization plan that will bring the department into the 21st century."
Marco Rubio says the State Department has been “beholden to radical political ideology.” Also known as democracy.
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— Mark Jacob ( @markjacob.bsky.social) April 22, 2025 at 9:45 AM
Rubio's proposal includes a 15% department-wide staff reduction, the elimination of 132 of the agency's 734 bureaus and offices, and the consolidation of many others, according to reports. Bureaus and programs expected to be eliminated or merged include the Office of Global Women's Issues; the war crimes and civilian protection divisions; and the agency's diversity, equity, and inclusion efforts, which have been banned throughout the executive branch. The position of special climate envoy will also be eliminated.
The Office of Civilian Security, Democracy, and Human Rights is slated to be replaced by a new division for the coordination for foreign assistance and humanitarian affairs that will assume responsibilities once shouldered by the embattled U.S. Agency for International Development. Already under siege by Elon Musk's Department of Government Efficiency, USAID is reeling from Rubio's announcement last month that the vast majority of its programs would be canceled.
Christopher Le Mon, a former senior department official during the Biden administration, told The New York Times Tuesday that the plan's human rights scaleback "sends a clear signal that the Trump administration cares less about fundamental freedoms than it does about cutting deals with autocrats and tyrants."
In a Substack post published Tuesday, Rubio accused the Bureau of Democracy, Human Rights, and Labor of becoming "a platform for left-wing activists to wage vendettas against 'anti-woke' leaders" and the Bureau of Population, Refugees, and Migration of funneling "millions of taxpayer dollars to international organizations and NGOs that facilitated mass migration around the world, including the invasion on our southern border."
Responding to this, Brandon Wu, director of policy and campaigns at ActionAid USA, said that "Secretary Rubio's rant against the Bureau of Democracy, Human Rights, and Labor as the carrier of a leftist agenda lays the administration's intentions bare: Their decimation of the State Department is part of an unhinged crusade against perceived 'woke' policies and practices, not a coherent plan for reform."
"The idea that any part of the State Department was supporting an 'invasion' of the U.S. southern border is similarly ludicrous," Wu added. "The proposed staff reductions at the State Department, when taken in conjunction with the dismantling of USAID, will hamper the diplomatic engagement with the rest of the world. This is a deeply unserious proposal that will not make the U.S. safer or stronger."
"Trump has said he wants to be a president who ends wars, but moves like this will make that much more difficult."
Dylan Williams, vice president for government affairs at the Center for International Policy, a Washington, D.C.-based think tank, called Rubio's plan "nothing less than an assault on American diplomacy" that will "further decimate U.S. influence and standing in the world, undermining our fundamental security and other critical interests."
"Coupled with the administration's intention to dramatically increase military spending, this decimation of the State Department also serves as a clear indication that it is prioritizing militarism over diplomacy," Williams said. "Donald Trump has said he wants to be a president who ends wars, but moves like this will make that much more difficult."
Democratic lawmakers also condemned Rubio's proposal, with Sen. Jeanne Shaheen (D-N.H.), the ranking member of the Senate Foreign Relations Committee, asserting that "any changes to the State Department and USAID must be carefully weighed with the real costs to American security and leadership."
"As I and many of my Democratic colleagues have made clear, we welcome reforms where needed—but they must be done with care," she continued. "Elon Musk and his team have engaged in a slash-and-burn campaign targeting federal employees, terminating critical programs at State and USAID, undermining our allies, and diminishing American leadership in the world."
"A strong and mission-ready State Department advances American national security interests, opens up new markets for American workers and companies, and promotes global peace and stability," Shaheen added. "It remains to be seen how the administration's latest proposals will achieve that goal."
Rep. Gregory Meeks (D-N.Y.), the ranking member of the House Foreign Affairs Committee, warned that Rubio's proposed reorganization "would leave the State Department ill-equipped to advance U.S. national security interests."
"The vital work left on Secretary Rubio's cutting-room floor represents significant pillars of our foreign policy long supported by Democrats and Republicans alike, including former Sen. Rubio—not 'radical ideologies' as he now claims," Meeks added. "Retreating from this work will further erode our national security and undermine our influence on the world stage."
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