Since its inception in 2003, PEPFAR [U.S. President’s Emergency Plan for AIDS Relief] has helped provide anti-HIV medicine to more than 20 million people, prevented transmission of the virus to 5.5 million babies who have mothers living with the virus, and saved an estimated 25 million lives. Started by former Republican President George W. Bush, it has largely enjoyed bipartisan support ….
As part of what the Trump administration calls an America First Global Health Strategy, it changed how countries receive PEPFAR funds. In the past, USAID and other U.S. agencies negotiated annual PEPFAR plans in conjunction with countries and NGOs. Instead, Rubio’s State Department asked each country to submit a memorandum of understanding (MOU) ….
Zimbabwe and Zambia have refused to sign MOUs because the United States is demanding access to resources such as minerals … in return for funding. … Jirair Ratevosian, a global health researcher at Duke University who worked as PEPFAR’s chief of staff in 2022 and 2023, [said] “Trying to negotiate these MOUs like it’s a nuclear standoff … doesn’t lead to good public health outcomes. This is not the Strait of Hormuz here. This is about HIV control.”
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