Death Sentence: The real cost of Trump’s aid cuts on HIV

The Independent

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00:00He's feeling a headache, chest pain, abdominal pain, even joint pain.

00:18Now he don't have drugs and there's nowhere to get the drugs.

00:22Are you worried that he might die soon?

00:25Yes.

00:27USA headquarters in Washington, D.C. was closed today.

00:32Assistance for the PEPFAR program has also been put on hold.

00:35The United States government is not a charity.

00:37It's been run by a bunch of radical lunatics and we're getting them out.

00:41What's happening right now is dangerous for the United States and humanity.

00:57We here? Let's go.

01:11Today we are joining Grace, a volunteer health worker, as he goes on his daily rounds of these remote villages in Uganda.

01:19For years he has checked on HIV patients, coordinating their life-saving treatment with charities.

01:27So for now I have five people who don't have drugs at all.

01:31HIV drugs?

01:32They don't have enough drugs.

01:34Everything changed in January when during his first week in office, Donald Trump abruptly slashed funds to the US's global HIV programs.

01:44That was devastating here.

01:4770% of Uganda's HIV response relies on USAID. Money that is now gone.

01:59James, his niece Beatrice and her 11-year-old daughter are all HIV positive.

02:06In the future, his brother has pushed on the right side.

02:30Monica, a mother of five, is not only worried about her own life, but that of her 14-year-old

02:48son, who is also HIV positive, and off his medication.

02:54Both of them managed to borrow some drugs from Monica's sister, who is also HIV positive.

03:01But even that has now run out.

03:24I don't know how to do it.

03:31I don't know how to do it.

03:34I don't know how to do it.

03:39I, Donald John Trump, do solemnly swear...

03:50In a shocking move during the first few hours of his presidency, Donald Trump signed an executive

03:56order that froze almost all foreign assistance for 90 days.

04:01We've also effectively ended the left-wing scam known as USAID, the agency's...

04:06That included PEPFAR, the US's global HIV AIDS response program.

04:12PEPFAR was first introduced by Republican President George W. Bush in 2003.

04:19Seldom has history offered a greater opportunity to do so much for so many.

04:25It is regarded as one of the world's most successful health initiatives ever, and has been integral

04:32to putting the world on track to end the AIDS pandemic by 2030.

04:37Because of the US, there are about 20 million people across the world that are on life-saving

04:45treatment.

04:46So a pause or a freeze in that funding is devastating.

04:51If PEPFAR were permanently discontinued, there would be an additional 4 million AIDS-related deaths,

04:59an additional 6 million new HIV infections by 2029.

05:06Because what you're saying is you were on track for this crisis essentially to be over by 2030.

05:14But you're now talking about there being an additional...

05:16We're talking about an additional 2,300 new infections every single day.

05:23There's no way that we can get to the end of AIDS.

05:27With these number of new infections, we cannot turn off the tab.

05:31The US State Department says a waiver is in place for life-saving care.

05:37But on the ground in Uganda, AIDS clinics say no money is getting through.

05:47Family Hope supports 5,000 HIV patients, including children.

05:52They had to temporarily close for two months and only recently reopened with a skeleton staff.

05:59We apologize for that, but now we are open two days.

06:05My health workers are working on voluntary.

06:08They are not being paid.

06:10For us here, we are 100% funded by USID.

06:15Wow.

06:16So you lost all your money overnight?

06:18All the money.

06:19All the money went.

06:20For how long will the current supplies that you actually have?

06:23For the next two months.

06:24But that's in jeopardy because you don't know if the supply will come.

06:27Yeah, in case it doesn't come, then it means we have to close.

06:31This worries their most vulnerable patients, like 19-year-old Alex.

06:37What was it like, that moment when you learned that all the funding was cut?

06:44Feeling like I wanted to drown myself because all my whole life I was getting my medicine

06:50at Family Hope.

06:51I first walked this whole city, just thinking, where can I get my medicine?

06:57Alex is speaking to us anonymously because of the stigma around HIV-AIDS.

07:02He is worried this is only going to increase as infections rise.

07:08It's really hard being a victim of HIV.

07:11It's like being a suspect of murder.

07:14That crowd just pointing at you, calling you a walking dead because having HIV,

07:18it feels like we're just a walking dead.

07:21So they call you the walking dead if you have HIV?

07:25I have HIV.

07:26So for you, these funding cuts means no medicine, which means no future?

07:32No future.

07:37Gaps in treatment are a major concern for the staff, who warn of a surge in infections

07:42and also drug-resistant HIV strains.

07:45When you take your drugs well, you stay healthy.

07:49But now when they default, because the drugs are not there,

07:52it means they are going to get opportunistic infections like TB.

07:56It means the virus in their body will replicate.

07:59And we shall have more drug-resistant clients outside there.

08:03They will also be taking the same virus that is already strained from Uganda to U.S.

08:07and the trend will continue.

08:09So let's be humane.

08:11Let us consider to reverse that decision.

08:14I know it's possible.

08:16I know it's possible.

08:20The most vulnerable will bear the brunt.

08:24Rose contracted HIV from her violent alcoholic husband who raped her.

08:30He later died from the disease, leaving her a penniless single mother of five.

08:36Sex work was the only way to feed her children.

09:01Rose worries without her medication, she risks spreading HIV,

09:05especially as her symptoms have worsened.

09:16What is your biggest fear right now?

09:18She is a good person.

09:19And she has been a good person.

09:20She has been a good person.

09:21She is a good person.

09:22She is a good person, and she is a good person.

09:23She is a bad person.

09:24She is a bad person.

09:25She is a good person.

09:26But it's not just patients and medics who are confused about the future of PEPFER.

09:30for. Even the officials once in charge of these projects are in the dark. We tried to

09:37visit the offices of USAID in Jinja. Most of the staff had been sent home. The rest

09:44were not permitted to speak to us because of the 90-day freeze.

09:47So the sense I get is that the situation is super unclear. No one knows what's going to

09:54happen, either at the end of the 90-day freeze or in the coming months and years.

10:01On board Air Force One, the Independent asked President Trump himself about the fact that

10:07HIV treatment is not getting to people despite the waiver being in place.

10:12...I'm saying to my colleagues that they're still not getting medicines, and the U.N.A.

10:18Well, that shouldn't be happening, but the other thing, other countries should be helping

10:22us with that. And I'm a big fan of getting that solved. But, you know, we're the only

10:28country. Where is France? Where is Germany? Where are these other countries? Nobody does

10:33anything but the United States. And we spent, you know, billions and billions of dollars.

10:39So they should be helping also. But, as you know, we did a waiver. You know that, right?

10:43Right.

10:44Well, I can't help that, because if we did a waiver, then you have to get your people to

10:49act properly in the waiver. But I do ask, why are we the only country doing it?

10:54The president is not engaged on this. It's just not on his radar. The State Department

11:00says they're going to continue to run PEPFAR. But will it be the same large, widely successful

11:09program that existed before Elon Musk took a meat ax to USAID?

11:18This is the chainsaw for bureaucracy.

11:22No. The mechanisms for carrying out the program, those networks are atrophying with the demise

11:29of USAID. And it's not clear how the administration intends to rebuild that capability.

11:42The fear is a return to the grim days of babies born with HIV, of mass infections and death,

11:50and even of a surge in children orphaned because of this pandemic.

12:02It's not clear how it is. It's not clear how it is. It's not clear how it is.

12:18Haja is HIV-positive, pregnant, and struggling to find medication for herself, but also to prevent

12:26transmission to her unborn baby. The UN warns that if the programs are discontinued, there could be as

12:33many as a million additional babies born with HIV over the next five years.

12:40If you don't get these drugs, what will happen for you and also for your unborn child?

12:56And this is another potential outcome predicted by the UN, that by 2030, there could be an additional

13:223.4 million children orphaned by HIV-AIDS. That is already a reality for Promise, who we join as she

13:32does her rounds, checking on her HIV-positive patients in this Zimbabwe village. Like Grace in Uganda,

13:41Promise is also a volunteer health worker whose patients have run out of medicine, with a deadly effect.

13:52Then we want to show off it. Both children lost their parents to HIV-AIDS because they couldn't find

13:59or afford their medicines. Can I ask about that little boy? What's your name?

14:04My name is Nisa. Okay.

14:08My name is Nisa.

14:10My name is Nisa.

14:12My name is Nisa.

14:16My name is Nisa.

14:18My name is Nisa.

14:20My name is Nisa.

14:22My name is Nisa.

14:24My name is Nisa.

14:26My name is Nisa.

14:28My name is Nisa.

14:30My name is Nisa.

14:32My name is Nisa.

14:34My name is Nisa.

14:36My name is Nisa.

14:38My name is Nisa.

14:40My name is Nisa.

14:42My name is Nisa.

14:44With the abrupt halt of an aid, this has meant that the most vulnerable

15:12have been able to get hold of medication and there is no backup plan and there are no

15:16safety nets.

15:17We just met two children whose parents died because they had no access to medication.

15:22And that's just the tip of the iceberg.

15:25There will be more deaths.

15:26There will be a surge in infections, which is painting a very bleak picture of the future.

15:37Can you explain why people in the UK, in the US should care?

15:43HIV and AIDS is still a global pandemic.

15:49I've often said that there is no wall that can be built tall enough or no net that can

15:55be thrown that is wide enough that can prevent HIV from coming into different borders.

16:02HIV and AIDS knows no boundaries.

16:09I don't have drugs to give him, I don't have food, I don't have other necessities to him,

16:18so I'm almost helpless to him, he may die, any time he may die.

16:35I don't think it's possible to go back to what was.

16:39We have to collectively figure out how to move forward in the new reality.

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