Goats and Soda: NPR

Engage Men’s Health, a nonprofit organization in South Africa, offers tests and medicine to prevent and manage HIV at three clinics throughout the country – all for free.

That is, they did until Monday. It is then the clinic financed by the US initiative Pepfar says it received orders from the US government to stop all work immediately. It is now closed so far, according to messages on its site and social media.

This development is the consequence of the Trump administration’s action on Friday, ordering a stop work for all global health financing, including the pepar-the US president’s emergency plan for AIDS-laying.

This action had an instant influence.

Clinics have “stopped distributing medicine and PepFar Central information systems were shut down,” Atul GawandeAssistant Administrator of Global Health at USAID under Biden Administration, NPR told in an E email.

At least 220,000 patients around the world visit the network of PepFar-supported clinics daily, according to a fact sheet from Amfound, Foundation for AIDS Research, a premiere lawyer organization for people with HIV and AIDS.

About 20 million people around the world depend on these programs for medicine.

Many patients take a three to six month supply of medication. The medians keep the virus in chess for those who are HIV-positive and protect HIV-negative people from infection. Those who were able to receive medicine in early December run out in early February, Deborah Birxtold a senior fellow at the Bush Institute and former Global AIDS coordinator, to NPR.

“What I hope is true and only the program can know that (is it) the majority of patients would have medication through the end of February,” Birx said. “It’s really critical for us to work together right now” to restore this access to medicine, she said.

If a person who is HIV positive does not take these medications, the virus can multiply, leading to illness and spreading to other people through intimate contact. And this development can also lead to mutations in the virus, which potentially makes it more transmission or resistant to medication to were previously effective in keeping it in control.

A clinic serving the transsexual community in Johannesburg, South Africa, published a message about X, announcing patients that it would be closed so far because of the stop-work order. (The organization running the clinic subsequently deleted all their social media accounts and mentions of the clinic on its website.)

“Visit the clinic on January 28 before 4pm to collect your medication,” the clinic wrote hours before closing its doors indefinitely.

That kind of shutdown is done at PepFar-supported clinics all over Africa south of Sahara, Asia Russell, CEO of HIV Access Organization Health Gaptold NPR. She has seen messages from staff to patients saying, “Our clinics are closing. You need to come in today to get a supply of medicine.”

The clinics say in statements that they had to close because of the stop-work order issued by the United States. For example, all USAID partners in Tanzania were ordered to “immediately stop, cease and/or suspend any work done,” according to a memo from USAID obtained by NPR.

“They have to stop the work, otherwise they will contradict the stop-work order and a disciplinary act will be taken,” Russell said. “Everyone is destroyed by this.”

Contractors at PepFar, both within the US and abroad, were also dismissed, which means that some of the staff who run the health centers funded by the initiative no longer have jobs. In addition, data systems for the program, which track everything from working with local programs to countryside commitments to combating HIV, were dismantled on Monday.

A ‘hitherto unseen’ order

It is not unusual for a new administration to order a review of existing programs or even to pause new expenses, Matthew KavanaghDirector of Georgetown University’s Center for Global Health Policy & Politics, NPR said in an E email. “But Stop-Work order that closes life-bearing medical treatment is both unprecedented and reckless.”

“There is no good reason for this,” he said. “This is a dangerous feature.”

Senior Pepfar -Officers have submitted a waiver to the State Department of Medicine to continue to be paid out, Russell said.

It is not clear what the system is for treating these exceptions and how long it takes – but it is critical for this to happen as soon as possible, she told NPR.

“Secretary Rubio’s exception authority must be used immediately for the entire PepFar program,” she said.

The Ministry of State confirmed stops for foreign assistance to NPR in an E email on Sunday, but has not responded to further investigations.

Deferencing of contractors

The stop-work action is not the only shake affecting pepar and health programs that address HIV. Senior employees in USAID were placed without Monday on administrative leave. And all contractors in USAID Global Health Bureau, which make up half of the agency’s workforce, were also told to stop working, said a source against USAID requesting anonymity because they were not authorized to talk to the press. These contractors work within the United States and internationally.

The contractors working on Pepfar were “fully dismissed, not furouged,” the source told NPR.

Family Health International ) has been canceled. “A USAID -Officer shared a copy of this memo with NPR.

All PepFar’s data systems were dismantled on Monday, Russell confirmed. These systems track everything that happens across the massive $ 6.5 billion program, which is mainly monitored by USAID, but also by the Ministry of State and the US Center for Disease Control and Prevention.

Fatma Tanis from NPR contributed to this story.

Melody Schreiber is a journalist and editor of what we did not expect: personal stories of premature birth. Follow her on Bluesky @melodyschreiber.com.