When U.S. foreign aid changed, AIDS workers in Africa felt it

A significant story is unfolding on the international scene. foreign aid changed, AIDS workers in Africa felt it June 7, 20266:00 AM ET Juana Summers People queue outside the Unjani Clinic in Braamfischerville, Soweto, Johannesburg, South Africa on May 25, 2026. Gulshan Khan for NPR hide caption toggle caption Gulshan Khan for NPR This essay first appeared in the Up First newsletter. It can be hard to remember what the HIV/AIDS epidemic in Africa looked like decades ago: Hospitals across the continent were overwhelmed with young men and women, dying excruciating deaths.

South Africa was at the center of the epidemic. Activist Lucky Mazibuko remembers, vividly. He told me that at the time, the country "was filled with the stench of death.

The Details

" It seemed, he went on to say, that there would be no end to the suffering. "There was no hope, there was basically no light," he told me. "And even if there was a light at the end of the tunnel, it looked like that of an oncoming train.

" The Esselen Clinic, which is situated on the same street as the WITS RHI Women's Health Clinic continues to operate with patients lining up outside on Esselen street, Hillbrow, Johannesburg, South Africa on May 25, 2026. Gulshan Khan for NPR hide caption toggle caption Gulshan Khan for NPR PEPFAR changed everything — across the continent. Sponsor Message President George W.

Bush announced the President's Emergency Plan for AIDS Relief, or PEPFAR, in January 2003. The program is often cited as the most effective public health campaign ever, and is estimated by the State Department to have saved roughly 26 million lives since its inception. And for decades, the program enjoyed widespread bipartisan support.

What Experts Say

But the Trump administration has radically changed the way the U. delivers foreign assistance, making sharp cuts and creating uncertainty about future funding. So as my colleagues and I tracked these developments, we wanted to see first-hand what these sweeping changes could mean for the worldwide fight to combat HIV/AIDS.

A notice informs of the ceasing of the CATALYST study in January 2025 due to USA policy changes and funding cuts, as well as alternate options for HIV prevention and healthcare services outside the WITS RHI Women's Health Clinic in Esselen street, Hillbrow, Johannesburg, South Africa on May 25, 2026. Gulshan Khan for NPR hide caption toggle caption Gulshan Khan for NPR That curiosity is what led us to Soweto Township in South Africa to sit down with Mazibuko. He's an activist and former journalist, who we met at the restaurant he now runs.

Back in 1999, at a time when the disease was still shrouded in stigma and shame, Mazibuko disclosed his own HIV-positive status in a column in South Africa's biggest newspaper. Even at funerals for those who had died after contracting HIV, Mazibuko told me, "people spoke in hushed voices about what the cause of death could have been, even if they knew.

The development has drawn wide international attention, with diplomatic circles watching closely.