September 13, 2025

HIV has been retreating around the world for many years. Good news is everywhere: fewer people are dying from HIV, new infections are dropping, and more HIV-positive people get life-saving medicines. These positive trends have gone up steadily for decades. One big reason for this success is the strong support from the United States. For many years, the US led global efforts to fight HIV/AIDS, especially through programs like PEPFAR (the President’s Emergency Plan For AIDS Relief) and aid from USAID. But things are changing fast. The Trump Administration cut down many foreign assistance programs through USAID. While PEPFAR continued, much of the work it supports is now either stopped or happening at a much smaller scale. This shift raises a serious question: After holding the world’s HIV battlefront for so long, why is the US stepping back? NPR’s reporting from Zambia by Gabrielle Emanuel shows how the cuts might slow progress on the ground. If US support keeps fading, the hard-earned gains against HIV could be in danger. As the global community watches closely, the big worry is: Where will the trend lines go from here? This eye-opening story was produced by Jeffrey Pierre and edited by Courtney Dorning and Rebecca Davis. The executive producer is Sami Yenigun. For more no-ad episodes of Consider This, sign up at Apple Podcasts or plus.npr.org. We love your thoughts — email us at considerthis@npr.org.

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Tags: Hiv, Aids, Pepfar, Usaid, Us foreign aid, Global health,