Trump is cancelling a Republican project to wipe out Aids – putting millions of lives at risk

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Michael Jennings, SOAS, University of London

Enormous progress has been made in tackling the global HIV epidemics over the past two decades. The number of people dying from HIV-related causes has fallen by 51% since 2010; and the number of annual new infections has fallen from 2.1 million new infections in 2010 to 1.3 million in 2023 (a drop of 39%).

This is the impact of the roll out of massive global programmes for prevention and treatment in this period. In 2003, around 400,000 people living in low and middle-income countries were able to access the life-saving anti-retroviral therapy drugs to manage the virus. Today it stands at more than 25 million people.

A large part of this success is due to the role of the President’s Emergency Plan for AIDS Relief (Pepfar), established by George W. Bush in 2003. Pepfar now accounts for around 70% of the total funding for the global response to HIV. And it has been a rare example of successful bipartisan support within the US.

Or at least it was, until the Trump administration included Pepfar in its attack on US aid spending in January. HIV spending under Pepfar was included in the initial freeze on aid grants imposed by executive order. And on February 27, news broke that the US secretary of state, Marco Rubio, had signed off on cuts affecting more than 90% of USAid grants, including the ending of US global HIV funding. Pepfar-funded programmes in South Africa were terminated with immediate effect; and UNAids was sent a letter confirming that the US was stopping its funding to the organisation.

Although details on what, if any, Pepfar programmes might survive in some form have not yet been forthcoming, the programme has been gutted in its current form, and few now hold out hope for anything significant remaining.

It has been a remarkable fall for an organisation that at the end of 2024 was funding the treatment of more than 20 million people (including over 560,000 children) across 55 countries; supporting over 90% of the use of pre-exposure phrophylaxis to prevent new infections; funding the testing of 83.8 million people in 2024 (up from 71 million the previous year); and was directly supporting 342,000 health workers across the world.

The importance of Pepfar as a tool of global soft power, the bipartisan support, and the relative uncontroversial focus of its activities, had led many to assume it would survive the administration’s swingeing reductions of aid. This was not to be the case.

In hindsight, that bipartisan support had started to weaken as early as two years ago. In 2023, in the face of growing Republican hostility to the programme, former president, George W. Bush, warned Congress not to drop its support for Pepfar. In March 2024, its mandate and funding was renewed, but for 12 months rather than the usual five years. Criticism increased in the days before Trump took power in January of this year when Pepfar notified Congress (as it was bound to) that four nurses funded through Pepfar in Mozambique had performed abortions (entirely legally). Funding had been suspended and an investigation launched, but enraged Republicans insisted on an additional inquiry.

George W. Bush talks about 20 years of the Pepfar programme.

Trump is expected to reinstate the controversial Mexico City policy. Abortion issues were already an area of heightened sensitivity and contributed to renewed calls from some Republicans for an end to Pepfar. The executive order removing funding from the World Health Organization was another indication of the direction of travel, and a signal that not even relatively uncontroversial support for health funding (where the impact of aid can be seen most clearly) was safe.

Whatever the reasons and politics of Pepfar’s decline, the ending of US support for global HIV programmes is a disaster for those in low and middle-income countries. In South Africa, for instance, Pepfar supports around 17% of the budget of the world’s biggest HIV programme. Around 8 million people live with HIV, and around 5.5 million people are being treated, most of whom are supported by Pepfar funds. The immediate challenge is now to fund ongoing treatment in the weeks and months to come before an alternative secure source of funding can be found.

But even if new funding can be found, the knock-on impact will be serious. The disruption caused by the initial freeze was immense. And the crisis in addressing HIV will also impact wider health issues, especially TB, sexual and reproductive health care. A report published prior to the confirmation of Pepfar’s destruction, suggested ending US support could lead to an additional 565,000 new infections and 601,000 more deaths over the next decade.

In countries where the US funding for HIV programmes is a higher proportion – and for many low and middle-income countries, Pepfar accounts for about two-thirds of the HIV prevention and treatment budget – it will be even harder to plug the funding gap. The former head of UNAids, Peter Piot, has raised the prospect of countries like Zimbabwe and Zambia running out of anti-HIV drugs.

Treatment programmes in in Lesotho, Eswatini and Tanzania have already had to close. Amongst the 350,000 people affected are more than 10,000 pregnant women living with HIV who require treatment to prevent passing on the virus to their unborn child.

The tragedy of the end of Pepfar is that it was one of the clear success stories in how aid can support and transform lives and countries. It played a major role in turning the tide of the epidemic back. The programme was also instrumental in enabling those with the virus to lead full, active lives and contributed to major reductions in the numbers of people newly infected. With a stroke of a pen, that progress has not just been threatened, but reversed.

Rebuilding a global HIV response less dependent on any single donor is essential. But at a time when big donors are stepping back, rather than stepping up in response to the US aid cuts, prospects for filling the gaps quickly to minimise the harm look very dim.

Michael Jennings, Professor in Global Development, SOAS, University of London

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Continue ReadingTrump is cancelling a Republican project to wipe out Aids – putting millions of lives at risk

Invading Iraq is what we did instead of tackling climate change

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Original article well said by Adam Ramsay republished from openDemocracy under a Creative Commons Attribution-NonCommercial 4.0 International licence.

OPINION: Instead of launching a war, the US and UK could have weaned us off the fossil fuels that pay for the brutal regimes of dictators

Traitor Tony Blair receives the Congressional Gold Medal of Honour from George 'Dubya' Bush
Traitor Tony Blair receives the Congressional Gold Medal of Honour from George ‘Dubya’ Bush

Twenty years ago today, [20 March] war was once again unleashed on Baghdad. In the UK – and much of the rest of the world – people sat in front of their TVs watching the skies above the ancient city flash with flame as buildings were rendered to rubble, the limbs and lives inside crushed.

The real victims of George Bush and Tony Blair’s shock and awe were, of course, the people of Iraq. Estimates of violent deaths range from a hundred thousand to a million. That doesn’t include the arms and legs that were lost, the families devastated, the melted minds and broken souls, trauma that will shatter down generations. It doesn’t include anyone killed in the conflict since then: there are still British and US troops in the country. It doesn’t include the poverty resulting from crushed infrastructure, the hopes abandoned and the potential immolated.

And that’s just the 2003 war: Britain has bombed Iraq in seven of the last 11 decades.

But in far gentler ways, the war was to shape the lives of those watching through their TVs, too. The invasion of Iraq – along with the other post-9/11 wars – was a road our governments chose irrevocably to drive us down. And we, too, have been changed by the journey.

The financial cost of the Iraq war to the US government, up to 2020, is estimated at $2trn. The post-9/11 wars together cost the US around $8trn, a quarter of its debt of $31trn. Much of the money was borrowed from foreign governments, in a debt boom which, some economists have argued, played a key role in the 2008 crash.

It was in this period, in particular, that China bought up billions of dollars of US government debt. Just before Barack Obama was elected in 2008, Beijing had overtaken Tokyo as the world’s largest holder of US Treasury bonds. Today, America’s neoconservatives are obsessed with China’s power over the US. What they rarely mention is that this was delivered by their wars in Iraq, Afghanistan and Pakistan.

Britain’s financial contribution was more meagre – in 2015 the UK government estimated it had spent £8.1bn on the invasion of Iraq, and around £21bn on Afghanistan. But these are hardly figures to be sniffed at.

Also significant, in both cases, is where this money went: the Iraq war saw a revolution in the outsourcing of violence. In 2003, when the war began, the UK foreign office spent £12.6m on private security firms. By 2015, just one contract – paying G4S to guard Britain’s embassy in Afghanistan – was worth £100m.

Over the course of the wars, the UK became the world centre for private military contractors – or, to use the old fashioned word, mercenaries. While many of these are private army units, others offer more specialist skills: retired senior British spooks now offer intelligence advice to central-Asian dictators and, as we found out with Cambridge Analytica during the Brexit vote, psychological operations teams who honed their skills in Iraq soon realised how much money they could make trialling their wares on the domestic population.

This vast expansion of the military industrial complex in both the US and UK hasn’t just done direct damage to our politics and economy – affecting the living standards of hundreds of millions of people across the world. It has also distorted our society, steered investment into militarised technology when research is desperately needed to address the climate and biodiversity crises.

Similarly, the war changed British politics. First, and perhaps most profoundly, because it was waged on a lie, perhaps the most notorious lie in modern Britain, that Saddam Hussein had weapons of mass destruction.

Acres of text have been written about the rapid decline in public trust in politicians in the UK in recent years. Very few grapple with the basic point – that, within the memory of most voters, a prime minister looked us in the eye, and told us that he had to lead us into war, based on a threat that turned out to be fictional. There are lots of reasons people increasingly don’t trust politicians – and therefore trust democracy less and less. But the Iraq war is a long way up the list.

Obama – who had opposed the war – managed to rally some of that breakdown of trust into a positive movement (whatever you think of his presidency, the movement behind it was positive). So did the SNP in Scotland.

But often, it went the other way. If the war hadn’t happened, would Cleggmania have swung the 2010 election from Gordon Brown to David Cameron? Probably not. And this, of course, led to the second great lie of modern British politics, the one about tuition fees and austerity.

Without the invasion, would Donald Trump have won in 2016? Would Brexit have happened?

There is a generation of us – now approaching our 40s – who were coming into political consciousness as Iraq was bombed. Many of us marched against the war, many more were horrified by it. The generation before us – Gen X – were amazingly unpolitical. Coming of age in the 1990s, at the end of history, very few got involved in social movements or joined political parties.

When I was involved in student politics in the years following Bush and Blair’s invasion, student unions across the UK were smashing turnout records. Soon, those enraged by the war found Make Poverty History, the climate crisis, the financial crisis and austerity. A generation of political organisers grew up through climate camps and Occupy and became a leading force behind Bernie Sanders and Jeremy Corbyn, helping organise a magnificent younger cohort of Gen-Zers which arrived after us.

But I shouldn’t end on a positive note. The disaster predicted by the millions across the world who marched against the war has played out. Hundreds of thousands have died. The Middle East continues to be dominated by dictators.

This war was justified on the grounds that Saddam was a threat to the world. But while his weapons of mass destruction were invented, scientists were already warning us about a very real risk; already telling us that we had a few short decades to address the climate crisis.

Rather than launching a war that would give the West access to some of the world’s largest oil reserves, the US and UK could have channelled their vast resources into weaning us off the fossil fuels that pay for the brutal regimes of dictators. Instead, we incinerated that money, and the world, with it.

Original article well said by Adam Ramsay republished from openDemocracy under a Creative Commons Attribution-NonCommercial 4.0 International licence.

Continue ReadingInvading Iraq is what we did instead of tackling climate change

Twenty years after: the lessons of Iraq for today’s world

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Stop the War protest march 15 February 2003 London

https://morningstaronline.co.uk/article/e/twenty-years-after-lessons-iraq-todays-world

TWENTY years ago tomorrow two million marched for peace in the biggest protest in British history.

The London demonstration formed just one of scores of marches against the US’s stated plan to invade Iraq which maybe mobilised 30 million people worldwide.

Despite a barrage of lies and war propaganda echoed by the BBC and most major newspapers, polls showed a solid majority of the British people were against the war.

But the government went ahead nonetheless. This was the crime of the century: not the first of the wars of aggression that the US and its allies embarked on during Washington’s “unipolar moment” after the collapse of the Soviet Union, but the largest and most consequential.

It was also the most blatantly unprovoked. Unlike Yugoslavia or Libya, where Nato effectively took sides in a local conflict to advance its destructive agenda, the Iraq crisis was entirely fabricated. The US and British governments knew their case against Iraq was based on lies.

https://morningstaronline.co.uk/article/e/twenty-years-after-lessons-iraq-todays-world

‘A beautiful outpouring of rage’: did Britain’s biggest ever protest change the world?

Continue ReadingTwenty years after: the lessons of Iraq for today’s world

The Highway to (Climate) Hell

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The Highway to Hell was a short poem published by me to oppose the USUK-Iraq War 2003.

THE HIGHWAY TO HELL

I respect all religions
And belief-systems worldwide

But
I have no time
for those b******s

That claim to be Christians
That claim Divine guidance
On the Highway to Hell

dt

26/7/23 https://en.wikipedia.org/wiki/Highway_of_Death

The wikipedia page appears incomplete. I understood that large earth-moving machines were used to kill retreating Iraqi soldiers through burying them alive but there’s no mention of it.

Continue ReadingThe Highway to (Climate) Hell