The gutting of USAID is an action with grave consequences. Restore Humanity, the organization I founded in 2006, has never received a dime of federal international development funding, but I have seen USAID programs at work myself in the past two decades of working in Africa. Most notably through the PEPFAR program that provides HIV testing, treatment, prevention, and care all over the world. As of last year, it provided life-saving medicine for 20.6 million people, 566,000 of whom are children.
Some of those children currently reside in our JCO Children's Home. Some have grown up and are now RH Scholars, but they still depend on that life-saving medicine. We have staff members whose lives depend on this medicine, and family members of our kiddos as well. The expectant and new mothers at the maternity ward that we helped build 10 years ago at the local health clinic depend on this medication, not only for them, but to also stop HIV from being transmitted to their babies. This medicine is antiretroviral therapy (ART) and it can reduce the risk of HIV transmission from mother to baby to less than 1%. Given the state of things just two decades ago when I first went to Africa, that seems nothing short of miraculous.
In 2005 I volunteered in South Africa, where the HIV/AIDS rate was around 20%. Almost 1 in 5 people had what was essentially a death sentence. Most of my work there was done alongside the amazing hospice nurses who cared for and provided comfort to people facing this harsh reality. This was a challenging experience, to say the least, but the hardest part for me was the home visits. Home visits were for patients who were coming to their end imminently and almost every patient I visited was dying from AIDS. Even more alarming was the age of the patients who were dying. One would generally expect that the majority, if not all, of hospice patients would be older and elderly. That was not the case here. Seeing so many other young people facing certain death had a profound impact on me.
In 2007 I again witnessed the devastation caused by HIV/AIDS, this time in Kenya. In the village of Sirembe, where we do most of our work, it was as if an entire generation of people had been wiped out. Grandparents were caring for their grandchildren because all the parents of those children had died of AIDS. This is why there were so many orphans and vulnerable children in the area where our programs are located. We have always welcomed and loved the kids who join our RH Global Family through the JCO Children's Home as if they were our own flesh and blood, but the primary reason why the vast majority of these children ever found themselves without a home and family (before joining ours) is that their parents were casualties of the HIV/AIDS epidemic. Please keep this context in mind as you consider the rest of what I have to say.
People my age and older will remember how terrifying the AIDS epidemic was in the 80's and 90's. Back then, contracting this disease was an unambiguous death sentence and often entailed a level of suffering no one should have to endure. Fortunately, today this is not necessarily the case. Modern medicine has developed treatments so that people who have AIDS can now live relatively normal lives—but with the all-important caveat that they take the right medications in the right combination in the right amounts at precisely the right time every single day. Each person's regimen can be quite different and must be individually prescribed and continually monitored under the supervision of a competent medical professional.
This life-saving medicine is cost-prohibitive to the overwhelming majority of people in the developing world, but it is important to note that PEPFAR provides more than the medication itself. It also provides for the testing and adjusting of medications so critical for children who are HIV+. Children with HIV have to take their medicine with food every 12 hours on the dot, every single day. They also have to go to the clinic every month to check their viral load and see if any adjustments need to be made. Each one of our kids who is HIV+ has experienced periods when they were sleeping through school or getting sick easily and we would work closely with the nurses at the clinic to get their dosage readjusted. And ALL of that is also covered by the PEPFAR program. This noble expression of compassionate humanitarian foreign aid and American greatness has transformed lives in the developing world. And yet in recent years, I have occasionally heard people comment about how HIV/AIDS really isn't that big of a problem anymore. In reality, it is still a huge problem on a global scale—but it is no longer necessarily a death sentence.
Sirembe has changed so much in the past 18 years, and many of the positive changes Restore Humanity has actively participated in. However, one of the starkest differences I've noticed is that no one dies of AIDS anymore. It was so common in 2007, but once PEPFAR was established, dying from AIDS was a thing of the past. There is even far less of a stigma to having the disease because it is no longer a death sentence and, as long as you take the medication regularly, you are much less likely to pass it on to your partner or your unborn child. This was the stage we had finally reached until the program was canceled abruptly. This life-saving work has been stopped and millions of people will die if it is not restarted. And PEPFAR is just one of the programs that USAID is responsible for.
People may not realize that USAID also works to contain dangerous diseases when they pop up around the world. During the Ebola outbreak in West Africa in 2014, USAID's work was critical to containing the outbreak and preventing it from becoming a full-scale pandemic.
As I type these words, there is a current Ebola outbreak in Uganda's capital, Kampala–which is only 3 or 4 hours away from our JCO Children's Home. Ebola is highly contagious and has a high fatality rate–41%-70%. The freeze on funding and recalling of all USAID workers has made a bad situation so much worse. The USAID team in situations like this would be helping to provide manpower and funding to check people at airports and border crossings to ensure that Ebola didn't spread further. This critical work is now not getting done. In the ever-shrinking world that we live in, it would just take one infected person to get on a plane and carry it across the world to our shores for it to be very clear, very quickly, why it is in “America's interest” to contain Ebola—and any other deadly highly communicable pathogen.
On February 5th, the US government issued a travel warning for Uganda, so they recognize there is a problem and yet have removed the resources needed to fight Ebola's spread. If Covid taught us anything, it is that our world is much more connected than we realized. We no longer live in a world where we can ignore a contagious disease outbreak on the other side of the world because it could be on our doorstep tomorrow. This is true of the HIV/AIDS epidemic and it is also true for Ebola. These programs and many more at USAID are saving the lives of people across the globe which also ends up saving the lives of people right here at home.
To recap, the PEPFAR program was started by President Bush in 2003 and has saved over 26 million lives. Among other interventions, it has enabled 7.8 million babies to be born HIV-free. That in itself is worth celebrating! Since 2010 it has drastically reduced new HIV infections among young people worldwide. Before the funding freeze, the program supported more than 20 million people with antiretroviral treatment, including 566,000 children. For me the argument is simple, PEPFAR is an incredibly effective program. It saves millions of lives and could allow us to see the end of this horrible epidemic. If PEPFAR ends, millions of people, including newborns and children of all ages will certainly die. Full stop.
No matter where you stand on the political spectrum or what you think America's place in the world is or should be, this program is something that we can all be proud of. The PEPFAR program has saved and continues to save millions of lives every single year–the lives of children, mothers, babies, and loved ones, through testing, prevention, and life-saving medicine (ART). While there may be programs within USAID that need reworking or are overly bureaucratic, this is a program that actually works and actually saves lives and, without it, millions of people will die. When thinking about this program in terms of being in America's interest, there are a few things to consider. First, there are many people in the US who also directly benefit from the medicine and testing. Also, as I mentioned before, we live in an ever-shrinking world and every single person in it would benefit from HIV/AIDS becoming less of a threat and even one day possibly eradicated. If the freezing of this program continues, people will die, but also people will have higher viral loads that result in more infections (including to babies) and the starting and stopping of medicine could create strains of HIV that are drug-resistant. This will make the world more dangerous for everyone and the people most at risk are young people.
Forever etched in my memory is the day in 2005 that I spent sitting at the bedside of a 25-year-old woman dying of AIDS in South Africa. She was surrounded by hospice nurses who had cared for her so well and various Xhosa women from her community singing beautiful songs and praying with all of their might to give her what comfort they could in her final moments. While it was a beautiful thing to see the outpouring of love and support for her, it also struck me as completely senseless—insane even, that a 25-year-old was dying in this way. I was also a 25-year-old woman and couldn't help but think that if the circumstances of her birth had been a bit more fortunate, then instead of being a hospice patient, perhaps she'd be the one volunteering to assist these caring nurses and—more to the point—that if the circumstances of my birth had been a bit less fortunate, then perhaps I'd be the patient being prayed for. This was only 20 years ago, but it was an all too common occurrence for young people to die of AIDS—young women in particular—because, while the medicine that could save their lives had already been discovered and mass-produced, it was not yet accessible to the communities that were the most devastated by this disease. PEPFAR, administered by USAID, provided that missing link.
So what can we do? We can reach out to our members or Congress and let them know that we want USAID and PEPFAR to continue. Fivecalls.org makes it very easy! I have been told that calling is the most effective way to get your message across. Last week a judge temporarily blocked USAID workers being put on paid leave and there is a hearing on Wednesday about the plans to destroy USAID. If we can make our voices heard in the next day or two it might make a difference!
You can also donate to Restore Humanity and/or other international organizations that you love. We all need all of the support we can get right now and we try to ensure our people are ok and that our programs continue. Thank you all for all of the support.