What does PEPFAR’s future look like in the Trump administration?
Consider This from NPR
NPR
4.2 • 6.2K Ratings
🗓️ 20 April 2026
⏱️ 9 minutes
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Summary
But the Trump administration has made major changes to the way the U.S. distributes foreign aid, disrupting HIV care — and leaving many health workers uncertain about the future of PEPFAR.
What do those changes to foreign assistance mean for the fight against HIV and AIDS around the world?
Host Juana Summers speaks with Dr. Deborah Birx, who once was the U.S. global AIDS coordinator in charge of PEPFAR.
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| 0:00.0 | 2.4 million. That is the number of Africans estimated to have died from AIDS in the year 2002 alone. |
| 0:07.9 | It was even worse than what they described. I mean, you cannot imagine 20% of a village dying again in their 30s and 40s. |
| 0:16.5 | That's Dr. Deborah Birx. Most recently, she worked on the coronavirus pandemic and the Trump administration. |
| 0:22.6 | But for decades, she fought a different virus. As a young HIV vaccine researcher in the 80s and 90s, |
| 0:29.8 | she saw the toll of the AIDS crisis firsthand in East Africa. And then, in 2003, as hundreds of |
| 0:36.8 | thousands of Africans were dying and hundreds of thousands of African children were being orphaned, then President George W. Bush announced a program to help combat the epidemic. |
| 0:46.3 | Out of the blue, I hear the state of a union with President Bush saying we're going to do something. |
| 0:52.7 | And to meet a severe and urgent crisis abroad tonight, I propose the emergency plan for age relief. |
| 0:58.6 | A work of mercy beyond all current international efforts to help the people of Africa. |
| 1:03.7 | I was so proud in that moment that someone saw the crisis. |
| 1:07.7 | The president believed that we could do things that I really thought were impossible. |
| 1:12.9 | Soon, Deborah Birx turned to implementing the president's emergency plan for AIDS relief or |
| 1:17.9 | PEPFAR. Today, PEPFAR has saved nearly 26 million lives, according to the State Department. |
| 1:24.0 | But the Trump administration has made major changes to the way the U.S. |
| 1:28.5 | distributes foreign aid, disrupting HIV care, and leaving many health workers uncertain about the |
| 1:34.7 | future of PEPFAR. Consider this. What do the Trump administration's changes to foreign assistance |
| 1:40.1 | mean for the fight against HIV and AIDS around the world? |
| 1:47.0 | Thank you. means for the fight against HIV and AIDS around the world. From NPR, I'm Juana Summers. |
| 1:58.7 | It's consider this from NPR. |
| 2:04.8 | Dr. Deborah Birx came to oversee the U.S. efforts to fight the the global AIDS pandemic from 2014 to 2021. Dr. Berks, who is now a senior fellow at the George |
| 2:11.9 | W. Bush Policy Institute, joined me to talk about the worldwide fight against HIV and AIDS |
| 2:17.2 | and where that fight stands today. |
... |
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