It is now a unique moment to reduce funding for HIV – Mother Jones

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Rebecca Denison was waiting have a short life. She had acquired HIV as a student in the 80s, She said to the public At a conference on infectious diseases in San Francisco earlier this month, and obtained an official diagnosis in 1990. “At the time,” she said, “it was heard that we were all going to die.” In six years, all of this has changed. A New generation of drugs Called protease inhibitors, when combined with other drugs, made the virus practically undetectable in people with HIV, which gave them a much greater chance to live in old age.

“Your work saved my life,” said Denison, now a defender of HIV -positive women, in The Room.

She is not alone. Over the past three decades, the development of preventive drugs as well as better tests and treatments have reduced new annual infections to HIV by a narcotic 60% worldwide. Now a strategy of Take medication before meeting with HIV—Pre -exposition prophylaxis, or preparation – can reduce the risk of transmission during intercourse 99%.

Then, last year, scientists revealed Another critical development: In a clinical trial of more than 5,000 girls and young women in Africa, a shooting twice annual called Lenacapavir, administered as preparation, blocked HIV infection for 100% Out of more than 2,000 participants who had received it. Shortly after, in a study of 3,000 multi-gendarmes in seven countries, 99.9% Participants who obtained the Lenacapavir did not acquire HIV. A drug that worked well (and required an injection once every six months, no less) had never been seen before.

“I was soaring,” recalls Anna Katomski, a former program analyst at the American International Development Agency (USAID), recalls when she saw the results presented for the first time at a conference. Lenacapavir is not a vaccine; Such a thing has Elusion scientists for decades. But as Science Put it in an article appointing the drug its 2024 “Breakthrough of the year,“It may be the” best next thing “- a lasting, injectable and very effective preventive.” There was just such a feeling of optimism, “said Katomski, adding:” It’s like “Oh my God”, we could have this tool that can really end HIV. “”

But now, it’s at risk. As Denison warned him in his speech at the conference in San Francisco, Robert F. Kennedy Jr., who once said that HIV was caused by “gay lifestyle” and “poppers», Now directs the Ministry of Health and Social Services; Thousands of government workers, including Katomski, have seen their job dismiss or reduced funding; And the so-called “Ministry of Effectiveness of the Government”, led by the technological billionaire Elon Musk, closed Usaid, a decision that civil servants say The country’s ability to combat malaria, polio, tuberculosis, HIV / AIDS and other diseases will be hindered. The claws do not stop there: last week, the Wall Street Journal reported That the Trump administration plans to reduce funds to centers for Disease Control and Prevention (CDC) for the prevention of domestic HIV.

Particularly disturbing HIV researchers are the threat to PEPFAR – the US President’s Emergency Plan for AIDS relief – a program created in 2003 by Republican President George W. Bush to provide HIV in the world, widely delivered by USAID. On January 20, President Donald Trump published an executive decree “Revalle and realign ”the country’s foreign aid policies And called for a 90 -day examination of related programs. Shortly after, the Trump administration ordered the closure of operations to USAID, including work on Pepfar. The administration has since been overthrown, deletion Allow certain Pepfar programs to continue, including preparation for pregnant and breastfeeding women, but not for Other “key populations” such as LGBTQI and sex workers, explains Nidhi Bouri, the former deputy assistant administrator of world health at USAID. Foreign aid is currently being examined until April 19, the future of Pepfar is not clear.

This is a program which, throughout its over 20 years, has saved an estimated 26 million lives. “It is the greatest act of humanity in the history of the fight against infectious diseases that the world has ever known,” said former Pepfar chief John Nkengasong recently said Science review.

So what would it mean to move away from this great act of humanity? In short, said Monica Gandhi, who heads the University of California to San Francisco Bay Area Center for Aids Research, it would be a “disaster”. Without renewing American aid, the Executive Director of Uusids Winnie Byanyima told the Associated Press Last month, the world was able to see more than six times more infections against HIV by 2029 and an increase of ten times from death to more than six million. Literally, it is death by a thousand cuts.

Gandhi is also concerned about the Possibility of HIV resistance to drugs. As she explains, the effective treatment of HIV requires combined and combined antiretroviral drugs. Without reliable access to clinics and help, she warns, people can try to stretch their supply of pills, take medication less often or share with family members. “If you do this kind of rationing, which he leads to resistance to drugs.”

And Pepfar is not the only RISH HIV program. Several high -level studies have also closed in response to Trump’s order. A set of essays known as the Matrix study, A $ 125 million company funded by USAID was designed to assess new HIV prevention products for women, including a dissolved vaginal film, a dissolved vaginal insert and a vaginal ring intended to prevent pregnancy and HIV transmission. Catherine CHAPPELL, assistant professor and OB / GYN at the University of Pittsburgh, who helped direct the trial for the vaginal ring, said that Trump’s order meant that her phase I clinical trial was suddenly put an end to the collection of medium data. “We had participants in South Africa who still had these rings (placebo) in their vaginas,” she says. Chappell is concerned about the fact that the abolition of the study in the middle of the relationship of “irreparably damaged” researchers with the community. “It is simply contrary to ethics,” she says.

Similarly, Katomski, the former USAID analyst, had been in the process of analyzing the Mosaic study, a three -part test intended to assess various forms of preparation (oral, injectable and vaginal ring) among women and girls. When the study ceased, Katomski and his colleagues and the dissemination of data also made partners and participants. “It is not only such a violation of ethics codes that we follow as researchers,” she says, “but also from a scientific point of view, it’s just such a waste of dollars of taxpayers.” Before losing its job at USAID, Katomski’s research division was considering testing for Lenacapavir, the “revolutionary” medicine of 2024. “All this has just been cut,” she said.

We do not know how, exactly, this recent change in priorities happened. Over the past 20 years, Pepfar has experienced a large and bipartite bipartite support. In a 2023 OP-ED published in The hillA group of senators, including Lindsey Graham (RS.C.), one of Trump’s most vocal supporters, urged the reauthorization of the Pepfar, writing: “We must again together to reautorize the Pepfar and work to end the aid as a public health threat by 2030. Now is the time to withdraw the world what American leaders have put our minds and hearts. Even former senator Marco Rubio, now Trump’s secretary of state – who Supervision of the purge of Usaid—Practing the agency’s work on “more than two dozen opportunities” over the years, According to the site to verify politicians“From the relief of hurricanes to the fight against infectious diseases to refugees.”

In short, after decades of research, science has delivered the most effective HIV drugs that the world has ever seen – and the United States launch their hands and abandon the efforts to share them with those who need it most. It is not only a moral failure, say the experts, it also goes against the personal interest of the country. For decades, officials have seen the prevention of foreign diseases as a form of “soft power” – it generates confidence within the global community, while guaranteeing fewer infections abroad and finally at home. “When you prevent the transmission of diseases, whether HIV, be it tuberculosis, be it malaria, in an area of ​​the world,” says Katomski, “this prevents this disease from returning to the United States.”

All this to say, it is now a unique moment to move away from research and HIV help. As an anthony Fauci, the former chief of the National Institute of Infectious Allergies and Diseases, said to the participants of the conference via the video In San Francisco, “we can end the world HIV epidemic. We have the resources to do so. ”

“It’s not time to withdraw,” he said, “because history will judge us hard if we waste the opportunity before us.”