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Trump’s global health strategy could mark a turning point in the AIDS battle

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World AIDS Day is a time to remember all those who have passed away from the HIV virus, and a time to recognize and reaffirm our nation’s historic and heroic lifesaving efforts to end the preventable and treatable disease.

Nearly a quarter-century ago, with wide bipartisan support, our nation launched the most aggressive global HIV/AIDS program in the world — PEPFAR. Since then, PEPFAR has been credited with saving over 26 million lives in some of the poorest countries in the world, mainly in sub-Saharan Africa, with the highest HIV/AIDS rates. 

PEPFAR has also advanced US interests around the world, demonstrating the values and ideals our country represents, at the same time, combating instability and preventing failed states.

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In the first administration, as an appointee under President Donald Trump, I served at the US Department of State as the Congressional Liaison Officer at PEPFAR. In 2018, in coordination and consultation with the White House, I helped to ensure the reauthorization of the program through the Republican-controlled House and Senate and ultimately signed into law by President Trump. 

At that time, PEPFAR also adapted a more localized approach on the ground which led to greater efficiencies, making the US taxpayer dollar go even further in saving lives. This localized implementation was commended by Project 2025 and urged as a model for future global development efforts and programs.

In the past year there has been both cause for concern and cause for celebration. An initial foreign aid pause and review was quickly amended to ensure that PEPFAR could continue operations, but this combined with the dismantling of USAID, one of the implementing agencies of PEPFAR, led to worries and there was disruption of services on the ground and damage done to PEPFAR’s ability to fully operate.(you can source UNAIDS new WAD report here) 

But under President Trump, Secretary Rubio, and Senior State Department official Jeremy Lewin, and in coordination with the Gilead Sciences, a US private sector biopharmaceutical company, our nation is now dispensing a new miracle twice a year drug that works to both prevent the spread of HIV/AIDS and act as an antiretroviral that treats those infected. 

It is a massive moment in the fight against global HIV/AIDS that now gives us the ability to end AIDS by 2030. In fact, President Trump has stated his goal of ending mother-to-child transmission of HIV/AIDS within the next 3 years. 

PEPFAR is only one part of the holy trinity of global health, which also includes the Global Fund to Fight AIDS, TB and Malaria, and the United Nations Joint Program for HIV/AIDS (UNAIDS). Last week, Jeremey Lewin announced a $4.6 billion USD pledge from the US to the Global Fund — a commitment that will be leveraged 2-1 with other countries and donors. 

In his comments, Jeremy stated “The best days of American healthcare leadership are yet ahead. The State Department recently unveiled our new ‘American First’ global health strategy, which affirms our commitment to global health but enacts much-needed reforms.”

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But the third branch of the holy trinity, UNAIDS, a small, but critical, organization that plays a crucial role in ensuring accountability, coordination, and oversight while collecting key data, is still in need of full funding. Of the billions committed to saving lives, UNAIDS is in need of $50 million USD in order to maintain critical operations to ensure every single US dollar (and other domestic country resources) is invested as effectively and efficiently as possible. While this funding is small in comparison, it is vital to make sure all other efforts are maximized, and I urge Congress and the Administration to urgently dispense with funding. 

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Progress is now being made in the fight against global AIDS in new and novel ways, with the private sector playing a leading role too. And more can be done. President Trump has already been the first president to call for an end to AIDS in America and beyond at his 2019 State of the Union Address. And when President Trump speaks, the world listens. At the upcoming US hosted World Cup and Olympics, our nation can champion the message of ending AIDS, a possibility that President Trump has now enabled and can trumpet to the world. 

Rhetoric must match reality, and if this administration can make the commitments that produce outcomes of millions of more lives saved, then the Nobel Peace Prize will be more than warranted, it will be but a footnote to the living legacy of President Trump.

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