(RNS) — I recently watched a war movie in which the threat of “friendly fire” hung over soldiers on the front lines. Those behind the lines would lob shells that took out people on their side, decimating and demoralizing the troops.
For those on the front lines of preventing HIV internationally, defending their work against the Trump administration’s stop-work orders on all American-backed foreign assistance is like dealing with “friendly fire.”
The President’s Emergency Plan for AIDS Relief, or PEPFAR, is among the U.S. government’s most prized investments in global health. HIV/AIDS used to be a death sentence, and Christian health organizations and other faith-based movements struggled to provide care for people who were sick or dying in record numbers.
That all changed with PEPFAR investment. Created in 2003 by then-President George W. Bush, it brought together the best minds in health, who set aside partisan and religious differences to pursue the global good. Reauthorized by Congress five times, it has evolved as its experts have learned.
The result? PEPFAR is credited with saving more than 25 million lives. Millions of babies are born free of HIV; millions of adults have the chance to live productive and long lives; millions of young people are protected from contracting HIV. Experts now say we are within 10 years of bringing HIV under global control.
At Christian Connections for International Health, our network of 124 Christian organizations works in over 90 low- and middle-income countries. Many work on HIV prevention and care in churches, communities and faith-owned health facilities. U.S. investment has strengthened these faith-based health systems, streamlined the flow of medicines and care through faith communities and trained and paid salaries for tens of thousands of health workers who provide HIV/AIDS prevention and treatment as an extension of their compassionate, healing ministries.
I hear firsthand the accounts of success from our partners who lead African Christian health systems. Karen Sichinga, executive director of the Churches Health Association of Zambia, recently told me, “Just in 2022, CHAZ averted HIV infection of 98.6% of exposed babies; supported 7,866 adolescents to stay in school, and educated 37,478 youth on sexuality that reduced teen pregnancies from 4.4% in 2020 to 1.8% in 2022.”
Participants listen during the corporate launch of the partnership for an HIV-free Generation in Muruku slums in Nairobi, Kenya, on Dec. 5, 2008. (Photo by Antony Njuguna/Reuters)
The Christian Health Association of Kenya has cared for 92,750 poor and vulnerable Kenyans in 238 health facilities, supported 8,574 orphans and vulnerable children and prevented mother-to-child transmission for 77,591 women.
No program is perfect; it’s always wise to periodically examine how funding is doled out. But global stop work on all international assistance directed by the Trump administration slams the brakes hard. It came with such power and authority that, literally, it caused global momentum to simply stop.
Medicines. Services. Outreach. Prevention. Supporting religious leaders and health providers to work together. All of it ground to a halt.
As of Tuesday night (Jan. 28), lifesaving drugs can seemingly be delivered again. That’s good, but the on-again, off-again orders only add to the chaos. The entire program is still under review and has yet to be reauthorized by Congress.
We all understand the need many see to shrink the federal budget; some want to stop global spending and keep the money “at home.” Some believe health professionals on the front lines do not deserve investment. At face value, the noble goal of ensuring that U.S. foreign assistance aligns with our aims and is efficient makes sense.
But no one I’ve spoken to among those dealing with the Trump order understands the attitude that came with the directives to stop our aid. I’ll quote:
The United States foreign aid industry and bureaucracy are not aligned with American interests and in many cases antithetical to American values. They serve to destabilize world peace by promoting ideas in foreign countries that are directly inverse to harmonious and stable relations internal to and among countries.
Those of us fighting this battle want to know: How is PEPFAR against the values of America? Innovation and excellence are American values. Mercy and compassion for those who suffer are American values. Justice for those who are vulnerable is an American value. Accountability for results. Rewarding self-determination. Strengthening society’s institutions. Building stronger trading partners. Engaging people of faith to put their faith to work. What’s un-American here?
Slamming the brakes on PEPFAR may be disastrous not only in the short run but the long term as well: HIV comes roaring back when you halt care, and it becomes treatment-resistant if you stop and start care.
Reversing directions on HIV imperils countless people in the future. Millions of immunocompromised people will struggle with new diseases. We could return to a future where businesses have to hire four people for one job, schools don’t have teachers and 10-year-olds raise their young siblings in parentless homes.
HIV was once an emergency that came out of nowhere to threaten people around the world and at home. With containment in sight, let’s not allow it to become an emergency of our own making.
(Doug Fountain is executive director of Christian Connections for International Health. The views expressed in this commentary do not necessarily reflect those of RNS.)