KENYA’S GIRLS NAVIGATE HIV RISK WITHOUT U.S. SUPPORT. Report by Victoria Amunga for Devex

KISUMU COUNTY, Kenya — Nineteen-year-old Sharon Akoth remembers the moment her ambition to become a doctor felt possible.

In 2021, she enrolled in the U.S.-funded DREAMS program, an initiative aimed at supporting adolescent girls and young women at high risk of HIV. Orphaned at age 12, Akoth had struggled to stay in school and relied on relatives in Kibos, a small town in Kenya’s Kisumu County, to cover school fees and meals. Frequent inability to pay for required supplies, such as books and uniforms, often forced her out of class. The DREAMS program, she said, changed that.

“It's through the DREAMS program that they gave me a school uniform, shoes, and they provided me with food, which I took home,” Akoth said.

She began looking forward to the weekends, when dozens of girls from her community gathered at the local social hall for DREAMS mentorship sessions. There, Akoth learned about sexual health, relationships, and how to protect herself from gender-based violence — topics her late mother never had the chance to discuss with her.

“I used to meet my peers during the forums … we would talk a lot. They were like family to me,” she said, noting that the program would also regularly distribute menstrual hygiene products because few of the girls could afford to buy them on their own.

Her routine ended abruptly in December 2024. After returning from their holiday break, Akoth and her peers were called into a January meeting where their trainer announced the sessions would not continue.

Akoth is among millions of girls and young women affected after the U.S. government halted its PEPFAR-funded DREAMS program across 15 countries, including 10 in sub-Saharan Africa. The initiative had reached more than 2 million adolescent girls and young women, focusing on HIV prevention, sexual and reproductive health and rights, protection from physical and sexual violence, education, and economic empowerment.

In Washington, D.C., the DREAMS termination was framed as a pragmatic trade-off: treatment and HIV testing could continue, officials argued, even if prevention programs were scaled back, according to a former State Department employee familiar with the conversations who requested anonymity out of concern for professional repercussions.

For Akoth, the loss extended far beyond canceled gatherings. Without the program, she dropped out of school and was forced to have sex with men to financially survive. She met a man, hoping he would help her buy sanitary towels and continue her education, but she became pregnant. When he learned of the pregnancy, she said, he left.

An architecture of prevention

DREAMS — short for Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe — functioned as a comprehensive support system for girls who were otherwise navigating risk largely on their own, said Nairobi-based women’s and children’s health advocate Maurine Murenga, founder of the Lean on Me Foundation a nonprofit that supports women living with HIV and those affected by tuberculosis.

Through small peer groups known as “sister cycles,” girls received mental health support, mentorship, and age-appropriate guidance on sexual health and HIV prevention, often from slightly older peers who had already navigated similar challenges.

Launched in 2014 with an initial commitment of $385 million, the DREAMS initiative was funded through PEPFAR — also known as the U.S. President’s Emergency Plan for AIDS Relief — in partnership with the Gates Foundation, Girl Effect, Gilead Sciences, Johnson & Johnson, and ViiV Healthcare. PEPFAR had invested over $1.6 billion in DREAMS goals since its inception, according to a 2022 report to the U.S. Congress.

It was an initiative credited for its success in driving reductions of 25% or more in new HIV diagnoses among adolescent girls and young women across nearly all of its geographic regions. The gains were especially significant in sub-Saharan Africa, where women and girls accounted for 62% of all new HIV infections in the region in 2023.

In Kisumu, 23-year-old Queenter Auma is still holding onto hope that the DREAMS program will return. Born HIV-positive, she depended on the initiative for consistent access to medication, counseling, and accompaniment to clinics, which helped shield her from stigma. She joined DREAMS after learning about the opportunity from representatives who went door to door in her village.

“I was living with my single mother, and she encouraged me to join the program,” Auma said. “They supported us in getting antiretrovirals. They helped me in paying [for school].''

The loss of the program has increased vulnerability for girls like Akoth and Auma, Murenga said. Beyond counseling and mentorship, the program was designed to address the structural factors that increased girls’ vulnerability to unplanned pregnancy and HIV — particularly poverty and school dropout — by helping keep girls in classrooms and supporting basic economic stability for those who had already dropped out.

Kenya recorded a 19% increase in new HIV infections in 2024, including an increase in Kisumu, where both Akoth and Auma reside. This trend will only worsen, Murenga said, with the termination of initiatives like DREAMS. Kenya does not yet have the capacity to sustain programs of the same scale without foreign assistance, leaving adolescent girls and young women exposed to HIV and teenage pregnancy.

What often goes unspoken, Murenga added, is that these trends translate into children acquiring HIV from their mothers. Based on data from Lean On Me, many of the children still contracting HIV are born to teenage mothers who were newly infected.

“A 14-year-old still doesn't know how to take care of herself,” she said. “And then you shock them with the HIV infection? They don't even know what to do about the HIV infection. They're still dealing with this pregnancy.”

Filling the void

There is no movement within the U.S. government to revive the DREAMS program, according to the former State Department employee. Yet several of the administration’s stated priorities — including expanding access to new HIV treatments such as long-acting antiretroviral lenacapavir and reducing mother-to-child transmission — are unlikely to be met without the prevention and support systems DREAMS once provided.

“You’re not going to reach your HIV-related targets or policy goals if you ignore that certain populations are more vulnerable than other populations, or the cultural norms that play into that,” the employee told Devex.

To address the gap in Kenya, the National AIDS and STIs Control Program, or NASCOP, under the country’s Ministry of Health, has launched an effort to train health care workers to provide adolescent-friendly sexual and reproductive health services. NASCOP program manager Elizabeth Nailantei said the focus has been on building provider capacity, with trainers now trained in 26 counties, including in Kisumu, where Akoth and Auma live.

Nailantei acknowledged that the effort falls far short of replacing DREAMS. NASCOP won’t be able to fill the void left by the abruptly defunded social programming and economic support, for example, but “we can empower the health providers to be able to offer those [adolescent and young people]-friendly services that they were not offering before,” she said. This includes things such as free counseling services, the provision of contraceptives, and creating safe spaces so that vulnerable populations at risk of stigmatization don’t have to queue with the rest of the public for services.

Several health professionals familiar with the program said it has always been an expensive model that would be difficult for countries to replicate or sustain with domestic resources alone.

Emily Bass, a public health advocate and coauthor of a Physicians for Human Rights report, told Devex that while comprehensive HIV prevention for adolescent girls and young women remains essential for long-term success, the program has not yet been replaced in countries such as Uganda and Tanzania.

“It is urgent to work with impacted communities to identify and fund gaps with programs that reduce HIV risk for people who do not have HIV and ensure long, healthy, stigma-free lives for people who do,’’ she said.

With the exit of the DREAMS program, girls who once relied on its support are trying to move forward without it, even as they hope it will return. Right now, survival depends on informal or low-paid work. Akoth, now a mother, earns a small income at a local bicycle repair shop, a sharp departure from her ambition to become a doctor.

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U.S. AFRICA COMMAND REVIEWS 2026 PRIORITIES. Digital Press Briefing from U.S. Department of State

AFRICOM is the U.S. military command focused on Africa. Its mission is to “counter transnational threats and malign actors, strengthens security forces and responds to crises in order to advance U.S. national interests and promote regional security, stability and prosperity.” AFRICOM uses the full military forces of the U.S. and partners with local nations as well as allies in Europe. Leadership recently held a digital press briefing with journalists to explain priorities and activities for the coming year. This briefing will give you insights to the strategy and commitments the U.S. government is making to the nations and people of Africa and how building security and stability can lead to economic development.

Below is the transcript of the session:

Feb 5, 2026

MODERATOR:  Good afternoon.  My name is Phillip Assis, and I am the director of the U.S. State Department’s Africa Regional Media Hub.  It is my pleasure to welcome journalists from across Africa and beyond to today’s press briefing, which is our first of 2026.  We are privileged to be joined today by General Dagvin R.M. Anderson, who is the seventh commander of U.S. Africa Command, otherwise known as AFRICOM.  General Anderson has been the commander of AFRICOM since August of 2025, and he joins us today from the AFRICOM headquarters.

General Anderson is also joined today by Sergeant Major Garric Banfield, who is the Command Senior Enlisted Leader of AFRICOM.  Sergeant Major Banfield will also give remarks.

Today’s briefing is on the record, and you may quote our guests by name and title.  We will begin today’s briefing with opening remarks by General Anderson, followed by Sergeant Major Banfield, and then turn to your questions.  We have received many questions in advance, and we’ll unfortunately not have a chance to respond to all of them.

And with that, I am pleased to turn the floor over to General Anderson.

GENERAL ANDERSON:  Thanks, Phillip, I appreciate it.  Sergeant Major Garric Banfield and I are here today and happy to talk to folks from across the continent about the issues here regarding Africa and our mutual security interests.

First of all, I’d just like to say I am happy to be back working in Africa.  I am the new commander here at AFRICOM.  I’ve been here for about five months, but I am not new to Africa or working on the continent, having been the Special Operations Command for Africa a few years ago just down the hill here at Kelley Barracks.  So it’s, for me, very happy to be back engaging with the partners and being able to hear views from a different perspective.

And so one of those things to start real quick, I had the opportunity – literally we just – the sergeant major and I just got back from a trip to East Africa.  We visited Ethiopia, Kenya, and Djibouti with the Deputy Secretary of State Christopher Landau.  It was a great opportunity to do a combined visit with our State Department leadership, but also to come out and hear from our partners in the region and also discuss areas of mutual interest.  One of the things – we had a great opportunity; it was a great visit.  I got to go to the Black Lion Air Show in Ethiopia, and it was the 90th anniversary of that air force – older than our own Air Force in the United States.  It was a great opportunity to talk about our long history of working together, where Colonel John Robinson came to Ethiopia in 1935 to help them establish their air force during a time of crisis, and then after the war stayed to develop – help them establish Ethiopian Airlines, obviously a great symbol of Ethiopia but a great symbol of the African continent as well.

And it’s just interesting to me as we look forward – and the reason I was traveling with the deputy secretary – of looking at where economic investment and development coincide with security and stability.  And I just thought, historically, that was a great example of where a U.S. engagement for security then turned into an investment in economic and development security for the future of Ethiopia.  And so this is not a new history for us, but it is something we’re starting to explore more of.  And after that – this confluence of economics and security.

And then, after that, we went to Kenya, where I had the great opportunity to accompany the deputy secretary down to Manda Bay and a groundbreaking ceremony for the new runway that both the U.S. and Kenya are investing in.  Again, part of the security investment that is in Lamu County that is the head of or the start of an economic corridor as well.  So again, the confluence of economics and security and where those come together.

And then had the opportunity also to go to the African Union, where we discussed these same issues.  It was received very well from the chairman of the African Union as well as the economics council, looking at where these come together.  But more importantly, we had the – the sergeant major and I had the opportunity to lay a wreath at the memorial wall at the African Union, and it was just a powerful reminder of the sacrifice all of us have put into maintaining peace and stability around the world through these missions, especially on the African continent, and the importance of doing this together, and that it’s not one nation or one effort, but it’s the combined effort to address these serious threats that we all face.

I’ll pause there and I’ll let the sergeant major say a couple of words.

SERGEANT MAJOR BANFIELD:  Yeah, hello, this is Sergeant Major Garric Banfield.  I’m newly joining the AFRICOM team.  I’ve been here about two and a half months, but I have prior Africa experience, so formerly served at – just like General Anderson, at Special Operations Command Africa, and I’m excited and honored to be rejoining the team here.

I’m sort of in my campaign-of-learning phase at a new level.  My last assignment, we focused on special operations, and in this position, we’re focusing on the entire security apparatus with all services and our partner nations.  I’m happily engaged with our partners’ enlisted leaders, such as Sergeant Major Omari Haji from Kenya, and I’m learning a lot from him.  I’m excited to see what the U.S. forces can – how we can partner with African nations to find out what the security concerns are and assist with those, and I’m also excited about what we can learn from our African partners.

GENERAL ANDERSON:  And, Phillip, I guess I talked a lot about our last trip.  Just I had a couple points real quick also.  It was very clear, having come back to this theater, watching the threat of terrorism grow across the continent, working quite a bit in the west as well, looking at how we can help address those common issues, but also looking for opportunities.  And so while that terrorist threat with ISIS and al-Qaida continues to grow, also looking at how we can work with key partners to address the changing character of war.  And so I’ve been to Morocco and Tunisia already twice, and looking – working with them on opportunities to develop their centers of excellence as they look to help train partners from across the continent and be a force multiplier in this counterterrorism effort.

And I’ve also been to West Africa and talked to folks along the coast, the Gulf of Guinea, both about the maritime security and cooperation opportunities, but also how they’re looking at the growing threat of terrorism.

And so I’ve been to multiple countries; I’ve visited 11 countries thus far, been back several times and had the opportunity to engage and listen to what the partners have to say and to learn where we can best work together to address this common threat.  And very clearly as we look at this, how to – as we see the changing character of war, how do we bring innovation to the continent, how do we look at emerging technologies to address these threats – I think an area that the United States excels at and can help develop.

I also, like we said, talked about the economic and security confluence, and what is it we can help bring to economic development, looking at trade opportunities that have a security confluence or a security implication, and then looking at how do we share information and understanding and address these threats together.  Because security leads to stability; that stability creates opportunities for investment; and that investment creates prosperity for both African partners as well as the United States.

And so looking at the holistic part of this, our role as a convener, our role as the foundation of security for the United States and some of our African partners – how do we bring this together to be more effective.

And with that, Phillip, I’ll pause.

MODERATOR:  Great, thank you.  That’s actually a really interesting overview, and some of that history I wasn’t aware of.  Actually the question – we’ll go now to our questions, and actually I think some of our questions will touch on the themes that you just discussed.

So our first comes from Mr. Geoffrey York of The Globe and Mail in South Africa, who asks:  “Can you please update us on the current status of your 2026 exercises?”

GENERAL ANDERSON:  Sure, I’d be happy to talk about those.  We’ve got several.  And again, as these work against transnational or regional threats, all our exercises are focused on being multilateral and bringing multiple countries together not just from Africa but from Europe, South America, the Middle East, even some Indo-Pacific countries, as we have a common interest in addressing these threats, particularly the terrorist threat but also the growing narcotics threat and smuggling.

So with that, our largest exercise is in Morocco, and called African Lion.  We are looking for that in May.  We’re excited this year as the United States approaches its 250th birthday that Morocco has been with us every step of the way as the first country to have recognized us as a nation.  And so to be able to have this exercise here I think is important, and to continue to be able to bring innovation as well.

And so African Lion brings 19 African countries together with six European and then some from South America and the Middle East as well.  It’s done in three spokes.  We’ve got a spoke in Tunisia, another one in Ghana, and in Senegal – again, looking at that regional component, not just a single nation.

We also have the Cutlass Express series going on in Mozambique – 14 countries, five European, two Indo-Pacific countries, bringing eight different maritime operations centers across East Africa together.  I’ve also got my deputy commander is out in Mauritius right now as part of the Cutlass Express series, engaging as part of the exercise.

Also we’ve got Justified Accord held out of Kenya this year.  We’ve got five African countries and three European countries participating along with concentrated spokes in Tanzania and Djibouti.  And I’ll let the sergeant major comment briefly on Flintlock and some of the efforts we’re doing there.

SERGEANT MAJOR BANFIELD:  Yeah, Flintlock is the special operations component exercise, which this year will be hubbed out of Côte d’Ivoire with a spoke in Libya.  That exercise will bring together 26 African nations, 15 European partners, and two from the Indo-Pacific, and one South American partner.  It’ll be a multinational exercise focused on counterterrorism.  One thing that’s unique this year is that spoke in Libya, which will be led by Italian mentors; we’ll bring together both east and west Libyans at the tactical level.

The – one of the – the most valuable things that we get out of these multinational operations – exercises is multi – learning about each other.  Multinational operations are extremely complex, as we’ve seen over the last 20 years of doing those.  It’s something that we have to exercise regularly to build interoperability amongst partners.

MODERATOR:  Great, thank you for that.  Our next question comes from Mr. Kanishkh Kanodia of The Economist in the United Kingdom:  “What steps and efforts has AFRICOM taken for counterterrorism with African partner countries?”

GENERAL ANDERSON:  Yeah, thanks for the question.  Again, just to highlight, we – the sergeant major and I just visited East Africa, where we talked to the leadership in Ethiopia, Kenya, and Djibouti, looking at how we address al-Shabaab in particular but also ISIS and the growing connection of the Houthis into that region.

And how we can address that – everyone concurred that it has to be done together.  And so we’re looking at ways to work with our partners across the region to increase the opportunities to apply pressure to these terrorist groups that are creating disruptions across the region, and actually across the continent.  So how do we work together to focus our efforts, and that was the key discussions I had with both Prime Minister Abiy and President Ruto as well as President Guelleh in Djibouti.  And everyone is keenly interested in looking at opportunities here of how to disrupt these terrorist threats together.

In addition, we’re looking at working in the west.  I think a great example of that is the partnership we’ve had with Nigeria.  I was able to go to the Aqaba Process in Rome last – late last year that was hosted by the prime minister of Italy and the king of Jordan, focused specifically on the terrorist threat in West Africa.  And at that meeting, I was able to meet President Tinubu.  We were able to share some thoughts and agree that we needed to work together on a way forward in the region.  That has led to increased collaboration between our nations, to include a small U.S. team that brings some unique capabilities from the United States in order to augment what Nigeria has been doing for several years.  And I think we’ve had some really good, positive movement there.  My deputy was just there with a high-level delegation from State Department led by Allison Hooker, in order to look at how we can continue to move forward together.

And then again, as I mentioned earlier, both Morocco and Tunisia have been very good partners.  We’ve made a lot of progress there.  Both are looking at centers of excellence that they can establish to continue that counterterrorism framing and effort and provide – be a force multiplier in helping address that threat together so as we continue to invest in those centers of excellence, they can continue to help train partner nations.

MODERATOR:  Great, thank you for that.  We have a third question in from Mr. Euphraim Kubwimana of the Shikiriza newspaper in Burundi, who asks:  “What has AFRICOM accomplished over the last 6 months?”  Or in other words, since you’ve been there, General Anderson.  What has AFRICOM accomplished?

SERGEANT MAJOR BANFIELD:  Yeah, I’ll start this one out.  This is Sergeant Major Banfield.  One thing that I’ve been extremely impressed with since returning here to the AFRICOM team is what I’ve seen as far as innovation.  That’s both introducing existing technologies to our African partners to see where they could use them to improve their security situation, but also what we’ve learned from them and how those are applied, and it’s a two-way relationship here of introducing the technology to them and then learning how those can be applied within the security environment on the African continent from them.

GENERAL ANDERSON:  Yeah, I think for me, from General Anderson here, in the first few months I think one of the best things that have – for me has been able to get out, travel, and engage with the partners and listen to their concerns and listen to how they see the threats and the issues and the opportunities going forward.  And I’ve learned a lot.  And I think that’s been, for me, really helpful to understand what those threats are, to help shine a light on these concerns and illuminate the issues, both with our partners but also as I engage in Europe with the European partners and back in the United States, to create a common understanding of not just the threats but the opportunities that exist in Africa.

So for me, the – probably the biggest accomplishment has just been able to get out and hear from the African partners.  But with that, also I’d just like to also share that we’re looking at how we can deepen the relationships, how we can share information, how we can engage in that understanding.  Recently, as well as last month, in Washington, D.C., I shared a conference across the interagency in the United States where we talked to leadership from the Department of State and the Department of Commerce as well as from the Department of War on how we can better integrate these efforts in order to provide options and opportunities to our partners in Africa.

So how do we actually bring the economic, the information, and the military levers together to be more effective and to address the partners’ needs and understand what they’re looking for and how we can create that operational independence of our partners.  Because ultimately that’s the goal, is to help degrade the threat and provide opportunities for development that allow all of us to prosper together.

MODERATOR:  Great, thank you for that.  Our next question comes from Abdirahman Jeylani of the Arlaadi Media Network in Somalia, and this is a question about Somalia:  “U.S. airstrikes in Somalia increased last year.  Could you explain why this happened and how these strikes have supported your Somali partners?”

GENERAL ANDERSON:  Absolutely.  We see these strikes as critical support to our partners.  I’ll just give one quick example that we have seen.  We, in Puntland, helped support our partner forces there in an offensive up into the Golis Mountains against Daesh.  And that was largely – it’s been largely successful.  It’s collapsed the area that ISIS has been able to operate in.  I was just back in Puntland in November, where we talked with our partners and about the importance of the unique capabilities that the U.S. can bring – the ability to bring ISR training, some resupply, these targeted strikes.  And what they told me – it was very clear.  I mean, I want to be clear.  This was what the partner told us, is that these strikes have allowed them to stay engaged, to shrink the territory held by ISIS, but more importantly, to remain in the Golis Mountains and apply continued pressure to ISIS, quite literally keeping them and ISIS’s leadership underground.

And that is where we’re looking.  What is it – what are the unique capabilities that the United States can bring that enable our partners to be successful?  And that’s where we see the greatest success, and that’s where these strikes have been very helpful, and that’s what we’re hearing from the partners in Somalia.

SERGEANT MAJOR BANFIELD:  Yeah, another area beyond airstrikes that we’re very interested in is maritime domain awareness.  We’re looking for a technical opportunity – technical solutions – that’ll help us increase maritime domain awareness along the border – along the coast of the African continent.  This will help us defeat threats from terrorists but also illicit activity, such as illegal, unauthorized fishing and piracy.  And the intent with that is assist them in improving their security capabilities to protect their shorelines and borders.

GENERAL ANDERSON:  Yeah, and I think that’s an important point because it goes beyond just the strikes.  That tends to be what gets a lot of the news, but as we see the Houthi threat – smuggling weapons into Somalia, supporting Al-Shabaab and the increased cooperation there – we’re looking at ways to increase that domain awareness of our partners so they can protect their borders and help secure those sea lanes and reduce that threat that goes across the Gulf of Aden and the Red Sea.  So I think while the strikes are important and, I think, have done a substantial amount of enabling our partners to be successful, we’re looking beyond just those strikes and how can we address the greater threat, especially as we see greater cooperation of some of these organizations in the region.

MODERATOR:  Great.  Thank you.  I’m afraid we only have time for one more question, and that question goes to Mr. Mamadou Diallo of FIM FM in Guinea, who asks:  “What is the level of threat of insecurity and overall instability in the West African sub-region according to AFRICOM?”

GENERAL ANDERSON:  Yeah, that’s a great question.  We clearly see the growing threat as an issue, both from Daesh and al-Qaida.  And JNIM is clearly affiliated with al-Qaida in the Sahel.  We’re seeing them apply more pressure in those areas, especially across the Sahel, threatening the capitals in the region, spilling down into some of the other countries.  And again, having traveled to several countries there along the Gulf of Guinea, understand the shared concerns that they have as this threat continues to expand.  I’ll say that – again, that this highlights the importance that the Aqaba conference had in Rome a few months ago, where both the prime minister of Italy and the king of Jordan helped focus the interest of folks on this and highlight the importance of addressing this threat.  We will continue to engage with willing partners to address this common threat as we look across the region.

But again, I’d like to highlight the – our partnership with Nigeria is a great example of a very willing and capable partner who requested the unique capabilities that only the U.S. can bring – with some of the ISR, some of the intelligence fusion – to bring that to bear together.  And when we do that, we are much more effective to counter these threats.  And being able to counter these threats together, I think, has been – is critical to our future.  And so while there are many nations that are concerned with this, when we can find a capable, willing partner to work with and we can fuse the unique capabilities that U.S. brings, we have seen success in addressing these threats.

SERGEANT MAJOR BANFIELD:  Yeah, this is Sergeant Major Banfield.  I want to emphasize that we are ready and willing to work with willing partners to get after shared security concerns.  As far as the instability, the threat of instability, instability in stable areas are a hospitable environment for violent extremist organizations and terrorist organizations.  I believe strongly that security – a secure environment leads to a stable environment, and that’s where it branches off from an area that’s hospitable to terrorists and VEO’s and goes towards an area that adds investment and prosperity for both the African nation and the United States.

MODERATOR:  Great.  Before we close, General Anderson and – or Sergeant Major Banfield, are there any final remarks that you wish to make or any points that you wanted to be certain that we cover today?

SERGEANT MAJOR BANFIELD:  No, I’d just like to say again I’m honored and privileged to be back here with the AFRICOM team, and I look forward to working with our African partners the next few years of my tour.

GENERAL ANDERSON:  Yeah, and just a couple things.  Again, I echo Sergeant Major Banfield’s sentiment that it’s great to be back at AFRICOM and great to be back on the continent working with the partners.  As the Special Operations Command Africa commander, I saw some of these issues.  As the AFRICOM commander, I’m being exposed to a broader array – and not just the challenges and the significant challenges that we face ahead, but also the opportunities.  And I think that’s a area where we’re working with the current administration to see how we can leverage some of the economic opportunities and investments that lead and contribute directly to security.

And this is an area that we haven’t, in the past – from the Pentagon’s perspective – looked at as closely, and so this is an area that we are continuing to explore, but I see great opportunity across the continent.  There are areas that we look at that not just investment in a single item or a single thing, but investments in areas such as the Lobito Corridor, where it’s not just a port but it’s the rail, it’s the mining, it’s the infrastructure that goes with it that all contribute to security and economic development.  And what we’re seeing is how we can work these together hand in hand and incrementally make progress.  And I think there’s a huge amount of opportunity across the continent here, and we look forward to exploring that.

I also continue to be very impressed with our partners.  I always appreciate hearing their views and really the opportunities that we have together.  And that’s something that these last five months have been an education for me, highlighting multiple opportunities and trying to focus then now where can we have the most effect with those opportunities, because there’s a myriad of them – where do we get the best return and, from my perspective, on the security impact.  And then we’re in conversations, like I said, in our government in the United States back in Washington, then that is one piece of the calculus that looks at where can we focus some of this investment, where do we focus our security engagements to have that best return.

There are some real opportunities for some of those investments.  We didn’t get to talk about those.  We talked a little bit about Lobito Corridor, about Angola, Mozambique, Libya, other places that have great potential that we can bring security and economics together, because again, that security leads to stability, that stability creates opportunity for investment, and those investments lead to prosperity for all of us.  And that’s part of what we’re looking at.  It’s a new way of looking at things for us here at AFRICOM and we’re excited to talk to our African partners about where they see these opportunities as well.

Phillip, that’s all I got but I appreciate the time and enjoyed the discussion.

MODERATOR:  Thank you.  We did too.  Thank you, General Anderson and Sergeant Major Banfield, for joining us today.  We really appreciate it.  And thank you, journalists from across Africa, for participating in today’s briefing.  I’m sorry we were not able to get to all the many questions that came in.

We will send a transcript and an audio recording of today’s briefing.  We’ll send that to all of you who’ve registered shortly after this call.  If you have any questions about the briefing, please reach out to us at AFMediaHub@state.gov, and also, if you publish any articles or broadcasts based on today’s briefing, we’d appreciate a copy of that as well at the same email address.

And finally, I’d like to invite you to follow us on X.  Our handle is @AfricaMediaHub.  And for our French-speaking participants, please also join us at the handle @USAenFrancais.  Thank you all and I wish you all a nice day.

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TRUMP SIGNS $50 BILLION FOREIGN AID BUDGET. WILL IT BE SPENT? Report by Fatma Tania, NPR

Foreign aid spending is back in the U.S. government's budget, after a year in which the Trump administration cut billions of dollars to global health and humanitarian assistance.

On Tuesday evening, President Trump signed the spending bill that would fund much of the government through September 30.

In that legislation, Congress has allocated $50 billion for foreign aid in 2026 — a 16% cut from 2025. Still, it's a lot more money than the administration had signaled it wants to spend on foreign aid in its proposed budget.

The foreign aid package includes funding for a variety of issues, such as military aid to Egypt, Israel and Taiwan. However, it also includes money for initiatives aimed at supporting democracy, scholarship programs, U.S. embassy operations and health and humanitarian programs around the world.

Susan Collins, R-Maine, chair of the Senate Appropriations Committee, said in a statement that the bill advances the priorities of the American people. "This fiscally responsible package would realign U.S. foreign assistance and make America safer and stronger on the world stage."

Aid groups also welcomed the package, even as they noted the reduction in funding for humanitarian assistance compared to previous years.

"Strong, transparent and effective assistance helps to save lives, prevent conflict and displacement, and creates the conditions for children and families to build safer, healthier futures," said Christy Gleason, Chief Policy Officer for Save the Children, in a statement.

In 2025, the Trump administration dismantled much of America's foreign aid systems, including shutting down the 64-year-old United States Agency for International Development, and sent back billions of dollars that Congress had earmarked for foreign aid in 2025. Those moves were largely approved by a Republican-led congress.

President Trump and other senior administration officials accused the agencyof being rife with waste and fraud and a bastion of the far left. But this bill appears to signal a change of heart in Congress, according to Jonathan Katz, a fellow at the Brookings Institution and a USAID official during the Obama administration and part of Trump's first term.

"The surprising factor is that you see Congress, in a bipartisan fashion, saying 'we want to fund foreign assistance,' from global health to food security to even democracy support, which has been much maligned by the Trump administration," he says.

Katz says there's been concern from both sides of the aisle over how the reduction in funding last year impacted global health and humanitarian aid around the world. Many people lost access to clinics and medicine and food. There's also the fear that a reduction in American aid could lead to the U.S. losing its soft power influence around the world and give rivals — like China — an opportunity to fill the gap, he says.

Some Republicans nodded to those concerns as they explained the goals of the foreign aid funding.

"We counter our foes and stand with our friends. And we reinforce democracy and human rights efforts. Focused security and economic investments keep Americans safe and maintain our global edge," wrote Tom Cole, R-Okla., in a statement issued when the bill first came out.

"I think there's a bit of buyer's remorse when it comes to U.S. engagement globally, meaning the soft power withdrawal of the United States that President Trump's policies have been sort of leading to," Katz says.

But others in the foreign aid community wanted to see a Congress that's more aligned with the administration's new model for foreign aid. The State Department's new America First Global Health Strategy focuses on making one-on-one deals with individual countries, investing in their healthcare systems and requiring those governments to chip in, too, as well as create opportunities for American businesses.

Max Primorac, an analyst with the Heritage Foundation who previously held senior roles at USAID, says Congress has allocated too much overall.

"It's always the problem of overfunding," Primorac says. "[Congress] doesn't seem to be aware that we just don't have money to spend like we did before."

Primorac says the package included some positives for supporters of the administration's views on foreign aid — such as the lack of funding for programs that support gender equality, LGBTQ issues and climate change and less funding overall for United Nations agencies.

But he was surprised at the $9.4 billion allocated for global health programs aimed at curbing diseases like HIV/Aids, malaria and addressing maternal and child health and other issues. It's largely the same level of funding for global health as previous years, he says.

"It's too much money and keeping alive an industry that has been living off of the taxpayer money for far too long," Primorac says.

The Trump administration has been critical of aid groups and NGOs who, in the previous aid model, received the bulk of foreign aid funding to do global health work. Primorac says they spend too much on overhead costs rather than the actual issues. Instead, he says, the administration's new strategy encourages self-sufficiency in low income countries.

"My concern is that [this package] could actually upend the reforms of this administration by creating disincentives for these African states to take more financial ownership and therefore more responsibility if they see that this money has to be spent anyway," Primorac says.

Both Katz and Primorac agree that the passing of this package won't be the end of the debate between Congress and the White House over foreign aid.

"I think we're likely to see an administration that continues to make decisions about spending that it thinks should be the priority versus that which Congress believes should be the priority," Katz says.

Ultimately, the administration could end up asking Congress to take back the funds it allocated, like it did last year, he says.

SOUTH AFRICA LAUNCHES TRIAL OF LOCALLY DEVELOPED HIV VACCINE. Reported by Afrique Du Sud

South Africa has begun the first‑ever human trials of a locally developed HIV vaccine, marking a landmark moment in global health and a potential turning point in the decades-long fight against HIV and AIDS.

The trial, launched in Cape Town at the Desmond Tutu HIV Foundation based at Groote Schuur Hospital, is the first human HIV vaccine study designed and led entirely by African scientists.

Twenty HIV‑negative volunteers have already been enrolled to help researchers assess the vaccine’s safety and its ability to trigger an immune response.

The initiative is being driven by the South African Medical Research Council, the Wits Health Consortium and the Desmond Tutu HIV Foundation under the BRILLIANT Consortium.

Health experts say the trial represents a major scientific and symbolic milestone for a continent that carries the heaviest burden of the epidemic.

South Africa remains the global epicentre of HIV, with an estimated eight million people living with the virus – more than any other country.

Sub‑Saharan Africa as a whole accounted for roughly 25.6 million cases in 2023.

While antiretroviral therapy has transformed HIV into a manageable chronic condition, the region continues to face high infection rates, unequal access to treatment, and persistent stigma.

The scale of the crisis has made the search for a vaccine urgent.

HIV has killed millions and continues to strain health systems worldwide.

More than 39 million people globally are currently living with the virus.

Glenda Grey of Wits University described the launch of the trial as a “critical step in the long journey toward an effective HIV vaccine,” noting that a successful candidate could dramatically reduce new infections and ease the long‑term financial and logistical pressures of lifelong treatment.

The World Health Organisation has praised African‑led vaccine research, arguing that local leadership ensures scientific relevance and strengthens global preparedness.

The breakthrough comes at a challenging moment for South Africa’s HIV response.

Recent cuts to the United States President’s Emergency Plan for AIDS Relief (PEPFAR) have disrupted prevention and treatment programmes, leading to clinic closures, job losses and concerns about rising infections.

Despite these setbacks, the launch of the vaccine trial signals renewed momentum.

If successful, it could reshape global prevention strategies and reinforce Africa’s role not only as the region most affected by HIV, but as a central driver of the scientific solutions needed to end it.

CONGRESS MOVES TO RESTORE FOREIGN AID BUDGET. TRUMP COMMITS TO SIGN BILL. Report by The caring world.

Congress has proposed a $50 billion foreign assistance budget for fiscal year 2026, which is a 16% decrease from the previous year but still exceeds the Trump administration's request. The bill is currently awaiting Senate approval and the President’s signature, which is expected to happen February 2.

The budget includes significant funding for global health programs, with $9.4 billion allocated, which is $5.6 billion above the administration's request. It supports contributions to major health initiatives like the Global Fund and Gavi (the Vaccine Alliance). The bill also aims to maintain U.S. leadership in humanitarian assistance, despite previous cuts and the closure of the U.S. Agency for International Development (USAID).

The FY26 foreign aid budget reflects a compromise that seeks to balance funding priorities while pushing back against proposed cuts from the administration. However, uncertainties remain regarding its final approval and implementation. There are concerns about the operational capacity of foreign aid programs due to staffing reductions and potential funding impoundments by the administration.

It is estimated that 750,000 Africans died because of the budget cuts in 2025. 500,000 of that number are estimated to be children. Much of the infrastructure on the ground in Africa has been dismantled. Rebuilding the delivery system will be difficult.

The Trump administration has put conditions of the funding that eliminate NGO participation and steer money to African governments. Trump has made it clear that he expects governments that receive aid will do business with U.S. companies and U.S. will get preferential treatment in access and development of African national resources like rare earth minerals.

The proposed $50 billion foreign assistance budget includes funding for global health programs, military aid to Egypt and Israel, and initiatives supporting democracy and food security. Specific allocations include $9.4 billion for global health, which addresses diseases like HIV/AIDS and malaria, and additional funds for humanitarian assistance and development programs.

The 2026 foreign assistance budget is set at $50 billion, which is a 16.1% decrease from the $59.7 billion enacted in 2025, but it is significantly higher than the Trump administration's proposed budget of $30.1 billion. This budget reflects a compromise that aims to maintain U.S. leadership in foreign aid despite proposed cuts.

This foreign aid budget is part of the 2026 version of The Big Beautiful Bill which has raised much controversy because it included $75 billion for ICE programs that included $40 billion to build additional facilities to house illegal immigrants as they wait for deportation. Congress agreed to separate the ICE budget from the rest of the 2026 budget to avoid a lengthy government shutdown.

THE CRUEL WORLD ACCORDING TO STEPHEN MILLER. David Klion reporting for The Nation

If the only thing one knew about Stephen Miller was that he was a white man, it might be sufficient to explain his alignment with Donald Trump—after all, 60 percent of that demographic supported Trump against Kamala Harris last fall. But identity is complicated, and every other aspect of Miller’s points to the opposite conclusion. At 39, Miller is a millennial (51 percent of voters age 30 to 44 voted for Harris); he was raised Jewish in a Reform congregation (84 percent of Reform Jews voted for Harris) and grew up in Santa Monica, California (Santa Monica’s precincts ranged from 71 to 86 percent for Harris); he has parents with advanced degrees and himself graduated from top-ranked Duke University (56 percent of college graduates and a likely 75 percent of students at Duke voted for Harris); and he has lived his entire postcollegiate life in the District of Columbia (92 percent of DC voters went for Harris).

Miller has the profile not of a typical Trump supporter but of a garden-variety liberal Democrat. Nevertheless, he is arguably one of the president’s most influential and ideologically fervent loyalists. Having previously served as chief speechwriter and a senior adviser for policy in Trump’s first term, this year he returned to the West Wing as deputy chief of staff for policy and Homeland Security adviser in Trump’s second—roles that mark him as one of the most powerful people in the Trump White House and, by extension, the world. As a January New York Times profile put it, “Mr. Miller was influential in Mr. Trump’s first term but stands to be exponentially more so this time.”

One of the architects of the attempted “Muslim ban” as well as the infamous child-separation policy during Trump’s first term, Miller has now pledged to oversee “the largest deportation operation in American history,” indiscriminately targeting the roughly 11 million undocumented immigrants believed to be living in the United States, with the full coercive power of the executive branch. To whatever extent he is successful, he will transform America demographically, culturally, and economically in ways he has fantasized about since his early teens; in many respects, he already has.

How to make sense of Miller and his trajectory? While he has made his share of public appearances to push his ultra-nativist views, he rarely speaks about his own political evolution. To date, the only authoritative biography of Miller is Hatemonger: Stephen Miller, Donald Trump, and the White Nationalist Agenda, by the reporter Jean Guerrero. Published in 2020, at the height of the Covid-19 pandemic and during a presidential election that saw voters reject Trump, the book was well received by reviewers but arrived at a moment when Miller seemed, mercifully, to be fading in relevance. But the story Guerrero recounts is an urgent one, packed with insights into the kind of personality that self-radicalizes toward the far right in the unlikeliest of circumstances. As we now know, Miller was only just getting started during Trump’s first term. The particular brand of virulent xenophobia he represents is now politically ascendant, and his biography is inescapably central to the history of the present.

Stephen Miller was born in 1985 and raised in the coastal paradise of Santa Monica—a semi-urban enclave of wealthy and mostly white liberals, undergirded by the omnipresent labor of immigrants who are neither white nor wealthy. “Laborers maintain this world,” Guerrero notes, most often laborers from Mexico and Central America. The rest of California in the 1980s and ’90s, however, was neither placid nor uniformly liberal. During Miller’s childhood and adolescence, the state was a hotbed of anti-immigrant sentiment and racial backlash.

Miller was 6 years old when the Los Angeles Police Department’s savage beating of Rodney King set off a wave of protests and riots across the city. California’s Republican governor, Pete Wilson, won reelection on an anti-immigrant platform when Miller was 9, campaigning on Proposition 187 to deny nonemergency services to undocumented immigrants. Right-wing talk radio, spearheaded by but not limited to Rush Limbaugh, took off nationwide during the 1990s and stoked racist and xenophobic sentiment for anyone inclined to listen to it. Santa Monica may have been a haven for well-to-do veterans of the New Left (Tom Hayden and Jane Fonda lived there for decades), but they were thriving amid the cognitive dissonance produced by a functional racial caste system upon which many of them relied and a state that was a harbinger of our ugly political moment.

Miller is a product of some of the same cognitive dissonance. The story of how he came to be born in Santa Monica, as Guerrero reminds us, begins with his ancestors’ immigration to escape antisemitism. Both sides of his family, the Millers and the Glossers, arrived in the United States from Russia’s impoverished Pale of Settlement in the early 20th century. From then on, they both had typically American Jewish social ascents. On the Miller side, one generation’s success selling groceries and rolling cigars in Pittsburgh led to the next generation’s success in law and real estate in Los Angeles; on the Glosser side, a family-owned department store served as a community pillar in Johnstown, Pennsylvania, until it was acquired and liquidated in a leveraged buyout in the 1980s.

Stephen’s father, Michael Miller, a Stanford-educated lawyer, cofounded a firm focused on corporate and real estate law; he also became deeply involved in his father’s real estate business and helped to reconstruct the world-famous Santa Monica Pier. Stephen’s mother, Miriam Glosser, graduated from the Columbia University School of Social Work and worked with troubled teens before eventually pivoting to the family real estate business as well. As a child, Stephen grew up in a $1 million, five-bedroom home in the North of Montana section of Santa Monica, one of the wealthiest neighborhoods in Greater Los Angeles. He had Latin American–born housekeepers who cooked family meals and cleaned up after him and his siblings.
This comfortable lifestyle was disrupted in 1994, when the Millers had a run of terrible luck: A major earthquake inflicted $20 billion in property damage in Southern California, including on a number of properties managed by the family firm. This came at a particularly inopportune moment, as Michael Miller was in the midst of an acrimonious legal battle with his former partners in the law firm he’d started, the upshot of which was that he found himself hundreds of thousands of dollars in debt.

In 1998, when Stephen was 13, the family sold its imposing home and moved to a smaller house by a freeway underpass near the working-class Hispanic neighborhood of Pico, though still in a majority-white middle school district. The area was beginning to gentrify, and the Millers would refinance the house three times over the next four years as their fortunes gradually recovered.

If there is a sociological explanation for Miller’s politics, Guerrero implies, perhaps it lies in this period. In the aftermath of the 2008 housing crisis, many of Miller’s peers found themselves downwardly mobile, locked out of the housing market and denied opportunities that prior generations had taken for granted—experiences that have inclined many millennials toward a more socialistic politics than previous cohorts. But Miller’s brush with downward mobility came much earlier, with his affluent boomer parents experiencing the shock of material insecurity during the 1990s, a decade that is more typically remembered as a period of unprecedented economic prosperity. Though Miller was never anywhere close to working-class, and his family’s finances rebounded in time for him to enjoy the benefits of an elite university education and a parentally subsidized down payment on a DC condo (though recently his parents had another bit of bad luck, as their home was destroyed in the Los Angeles wildfires in January), he did pass through a period of acute economic and status anxiety during a very impressionable age.

But sociology can only explain so much; it is hard to escape the sense that there was something fundamentally malevolent about Miller from the start. Another person in his shoes might have grasped that this anxiety was the product of his parents’ business difficulties and sheer geological misfortune, but the adolescent Miller sought out other culprits. With his economic privilege in seeming jeopardy, he leaned much harder into his privilege as a white, native-born American.

Guerrero spoke with Jason Islas, a working-class Mexican American who was Miller’s friend in middle school and attended his lavish bar mitzvah. Though the two initially bonded over Star Trek, Miller abruptly ditched Islas as a friend the summer after middle school, citing his Latino heritage as a justification. “The conversation was remarkably calm,” Islas told Guerrero. “He expressed hatred for me in a calm, cool, matter-of-fact way.”

In middle school, Miller was already drawn to right-wing subcultures that distinguished him from his peers, purchasing a subscription to Guns & Ammo magazine and finding himself inspired by the writings of Charlton Heston and Wayne LaPierre on the Second Amendment. His father was also moving right, alienated by bad relationships and burned bridges with his liberal Santa Monica cohort, and Stephen seems to have inherited his father’s contrarian streak. By the time he enrolled in the public Santa Monica High School, which Guerrero portrays as neatly internally segregated between professional-class, college-bound whites and working-class Hispanics, he was a full-fledged conservative provocateur.

For Miller, a key entry point to the right was The Larry Elder Show, whose Black host had built a following among right-wing Angelenos for his verbal assaults on political correctness and liberal shibboleths. Miller called in to the show and invited Elder to speak at his high school, and he subsequently became a frequent guest, a precocious teen reactionary holding forth on his high school’s alleged anti-Americanness in the wake of the 9/11 attacks before an audience that spanned Southern California.

Miller’s provocations became more outlandish as he advanced through his teens. He cultivated a mid-century gangster affect: He listened to Frank Sinatra, enjoyed gambling, and styled himself after Ace Rothstein, the Robert De Niro character in Casino. He was known for arguing with teachers, hijacking school events, and winning attention with his outrageous antics. In both high school and college, he would be repeatedly observed throwing trash on the floor and then insisting that the custodial staff pick it up. (“Am I the only one here who is sick and tired of being told to pick up my trash when we have plenty of janitors who are paid to do it for us?” he is quoted as saying at one point.) A number of students and faculty found this behavior appalling, but Miller’s shameless transgressiveness at least got him a lot of attention.

His willingness to upset liberals and thrive on their outrage put Miller on the radar of David Horowitz, the nationally notorious firebrand whose red diaper upbringing and early career involvement with the Black Panthers were followed by an abrupt rightward turn beginning in the 1970s. By the early 2000s, Horowitz had become a leading conservative ideologue who specialized in identifying and recruiting young talent. After discovering Miller on The Larry Elder Show, Horowitz went on to serve as something of a career guru to him. He helped Miller craft an image as an outspoken champion of free speech at a hostile liberal high school, which Miller exploited to secure a photo spread in the Los Angeles Times. This publicity, Guerrero speculates, might also have helped Miller gain admission to Duke University despite an antagonistic relationship with his high school administration.

In 2003, Miller entered Duke, where he continued the shtick he’d developed at Santa Monica High: the performative littering, the trolling classroom monologues, the Larry Elder Show appearances lambasting the university administration for its supposed leftism, and the fruitful relationship with Horowitz. He quickly established a Duke chapter of Horowitz’s Students for Academic Freedom, which he used to assail the Palestine Solidarity Movement, to attack feminism and multiculturalism, and to champion the white members of the Duke lacrosse team who were accused (falsely, it turned out) of raping a Black stripper in 2006. This last incident, which drew sustained national attention, gave Miller the opportunity to appear on The O’Reilly Factor and Nancy Grace while he was still an undergrad.

Miller’s TV appearances proved to be the perfect launchpad for a career in Republican politics after graduation. Horowitz helped, too, introducing Miller to Representative Michelle Bachmann, from whose office Miller quickly rose to serve as press secretary for Alabama Senator Jeff Sessions. It was in this job that Miller met Steve Bannon, then affiliated with the emerging right-wing tabloid site Breitbart; Bannon, a longtime Los Angeles resident, recognized Miller from his Larry Elder spots. Breitbart and an increasingly extensive network of alternative right-wing media outlets enabled Miller, working with Sessions, to play a central role in the successful effort to kill the Obama administration’s effort at bipartisan immigration reform in 2014.

By this point, Miller had become much more deeply immersed in the literature and online forums of the extreme right and was taking direct inspiration from Jean Raspail’s novel The Camp of the Saints, with its dystopian vision of a horde of nonwhite migrants invading the West. Soon he also began to develop ties with leading right-wing media figures like Ann Coulter, Laura Ingraham, Tucker Carlson, and the anti-immigration think tanker Mark Krikorian.

Perhaps the most vocal advocate against immigration in that media space was one Donald Trump, who had leveraged his celebrity to become the leading exponent of the “birther” conspiracy theory during the Obama years, impressing Miller greatly in the process. “Our whole country is rotting, like a third world country,” Trump told Breitbart in the wake of the Obama immigration bill’s defeat, prompting Miller to e-mail his friends that “Trump gets it…. I wish he’d run for president.” When Trump began his long-shot campaign the following year, Miller, barely 30, joined up, and the two quickly hit it off. Where more traditional young Republicans might have spent their early careers preparing to work for a more conventional Republican candidate like Jeb Bush or Chris Christie, Miller had presciently spent his preparing for a candidate like Trump. And with Trump’s victory came opportunities to do the kinds of things that his more seasoned peers might never have proposed.

Literally from Day 1, Miller set the tone for Trump’s first presidency: “This American carnage stops right here and stops right now,” the most memorable line in Trump’s 2017 inaugural address, came from Miller’s pen. A wave of executive orders empowering Immigration and Customs Enforcement, targeting sanctuary cities, ordering the construction of a border wall, and suspending immigration from seven Muslim-majority countries soon followed, all of them pushed and heavily shaped by Miller. It was Miller who made the once-obscure Salvadoran gang MS-13 
an obsession of the Trump administration, and Miller who emerged as one of the top internal advocates for the family separation policy that became a national scandal in 2018.

In addition to the president himself, Miller built a close relationship with Jared Kushner and Ivanka Trump, ensuring a level of family trust that protected him from the turnover for which the Trump administration became infamous. If xenophobia was the policy through line for most of Miller’s efforts, competent bureaucratic maneuvering and absolute loyalty to Trump were what empowered him to execute his agenda. Miller’s fingerprints are likewise all over the early initiatives of Trump’s second term, including turning legal refugees away from the United States, suspending foreign aid, launching ICE raids on major cities, and leaning on the major tech companies to ban diversity initiatives.

The world according to Stephen Miller is a cruel and callous one, in which America is strictly for unhyphenated Americans and those here “illegally” must be forcibly returned to the “failed states” where they were born. To Miller, the crumbling American heartland is being preyed on not by rapacious capital but by an invading army of gangsters, thugs, and terrorists waved in by coastal liberal elites—in other words, by exactly the kind of people he has always lived among.

Part of why Guerrero was able to speak with so many of Miller’s acquaintances—including his estranged uncle David Glosser, who has compared his nephew to the Nazis—is that Miller is so unrepresentative of the world he grew up in. Interviewees throughout Hatemonger regularly express shame and horror rather than pride at Miller’s steady climb to the heights of political power; one gets the sense that speaking to the media is a form of penance for some of them.

At the same time, Miller’s rise wasn’t exactly a fluke. It was facilitated not only by his family’s baseline wealth and privilege and the social capital they afforded, but by Miller’s demonstrated talent for hacking the weaknesses of liberal elite culture itself. Miller is an extreme case, yet anyone who grew up in similar communities or attended similar schools can recognize him as a very particular type of guy. His hateful tirades weren’t popular at Santa Monica High or at Duke, but they consistently drew attention; students and faculty often pushed back hard against his constant trolling, but in doing so they played right into his hands. Teachers who wanted to encourage open debate and free speech gave him a platform regardless of whether he was arguing in good faith; mainstream and liberal media outlets continued to promote him in the name of provocation and ideological diversity. Like Trump himself, Miller intuitively grasped that being hated in elite liberal environments was better than being ignored, and that embracing the language and tactics of conservative media offered a means for a strange and argumentative kid to stand out from a crowd of generic achievers and to fast-track his way to influence.

This isn’t to say that Miller’s act is entirely cynical. It’s clear that beneath all the performative cruelty and amoral careerism, there’s an authentic core of seething, visceral, unquenchable hatred that defies any easy explanation. It’s true, as Guerrero documents, that such bigotry circulated widely in Southern California and elsewhere in the 1990s, and it’s true that far-right voices on talk radio and later on the Internet continually grew in influence as Miller came of age, but none of that by itself explains why Miller is the way he is.

Despite his obvious intelligence and his elite pedigree, Miller didn’t arrive at his views via serious reading—his is not the classical conservatism of Edmund Burke, the libertarianism of Friedrich Hayek, the neoconservatism of Irving Kristol, or the paleoconservatism of Samuel Francis—and he’s never presented himself as an intellectual in his own right in the manner of, say, his White House colleague Michael Anton. His ideas are not just monstrous and reactionary but banal and simplistic; he lacks the imagination that is a prerequisite for empathy. But in a way, this makes him the ideal conservative for the Trump era: His ideology is not refined, abstracted, or euphemized away from its real object. He’s told us exactly what he intends to do.

CHINA AND THE AFRICAN UNION HOLD STRATEGIC DIALOGUE. Post from Friends of Socialist China.

On January 8, 2026 local time, Member of the Political Bureau of the CPC Central Committee and Foreign Minister Wang Yi and Chairperson of the African Union (AU) Commission Mahmoud Ali Youssouf jointly held the ninth China-AU Strategic Dialogue at the AU headquarters in Addis Ababa.

Wang Yi said that the AU is the “locomotive” driving African unity and cooperation, playing an important and unique role in China-Africa relations. President Xi Jinping has sent congratulatory messages to the AU Summits for 13 consecutive years, which fully demonstrates China’s high regard for developing relations with the AU. This year marks the 70th anniversary of the start of diplomatic relations between China and Africa, and also the 36th consecutive year for Africa to be the destination of the Chinese Foreign Minister’s first overseas trip in a new year. This diplomatic tradition reflects the continuity of China-Africa friendship, the stability of China’s policy toward Africa, and the solidarity of developing countries. The unity and concerted efforts of over 2.8 billion people in China and Africa will enable them to overcome any difficulties and challenges, accelerate their pace toward modernization, and contribute to a more just, equitable, harmonious and stable world.

Wang Yi said that both China and Africa are at a critical stage of development and are facing new and broad opportunities for cooperation. China is willing to leverage its own development to provide support for the vast number of developing countries, including those in Africa, to achieve modernization together and jointly safeguard the interests of the Global South. The Forum on China-Africa Cooperation (FOCAC) has played an important role in the common development of China and Africa, blazing a path of win-win cooperation between China and Africa. Both sides should continue to make good use of this platform to deepen practical cooperation and jointly tell the story of China-Africa cooperation well. Both sides should continuously enhance the strategic, exemplary, and practical nature of China-AU relations and ensure that the AU plays a better leading role in the overall China-Africa relations. China firmly supports the AU in uniting and leading African countries to uphold independence and defend the right of African countries to pursue independent development. China supports the African people in seeking African solutions for African problems and pursuing development paths suited to their own national conditions. China also supports the AU in playing a leading role in regional affairs.

Wang Yi said that the AU promptly and actively responded to and supported the Global Governance Initiative proposed by President Xi Jinping, reflecting the high alignment of ideas between both sides and their shared aspiration to shape international fairness and justice. China is ready to continue strengthening dialogue and communication with the AU on the four global initiatives, support Africa in playing a greater role on the international stage, jointly practice true multilateralism, and make the global governance system more just and equitable.

Mahmoud Ali Youssouf said that China is a partner that Africa can fully trust and rely on. The fact that the Chinese foreign ministers have made Africa the destination of their first overseas visit in a new year for 36 consecutive years fully reflects China’s strategic emphasis on Africa. Africa-China friendship, based on mutual respect and a shared vision for peace and development, has become a model of cooperation in the Global South. The AU appreciates China’s long-standing partnership with Africa across various fields and its selfless support for Africa’s development. The AU highly commends the fruitful outcomes of the FOCAC and the tangible benefits it has brought to the people of Africa and China. The AU adheres to the one-China principle, firmly supports China in safeguarding its core interests on the Taiwan question, and opposes any attempt to split China. The AU is willing to work with China to continue strengthening Africa-China cooperation through mechanisms such as FOCAC to deliver greater benefits to the people of both sides.

Mahmoud Ali Youssouf said that the AU congratulates China on successfully hosting the Commemoration of the 80th Anniversary of the Victory of the Chinese People’s War of Resistance Against Japanese Aggression and the World Anti-Fascist War. At a time when power politics and bullying are on the rise and multilateralism is under attack, Africa and China are at a critical moment to remember history, look to the future, and defend sovereignty. It is even more necessary for Africa and China to deepen their partnership. The AU highly appreciates the four global initiatives put forth by President Xi Jinping and is willing to join hands with China to safeguard the common interests of the Global South and promote global fairness, justice, peace and development.

U.S. CUTS HEALTH AID AND TIES IT TO FUNDING PLEDGES BY AFRICAN GOVERNMENTS. Stephanie Nolen for The NY Times.

The State Department is negotiating agreements with countries across the developing world to provide billions of dollars in health aid, an effort intended to replace the system of global health assistance that had for decades been offered through the now-dismantled U.S. Agency for International Development.

Over the past month the U.S. has signed agreements with 16 African countries to provide more than $11 billion in health aid over the next five years, and is negotiating dozens more deals with governments in Asia and Latin America as well as Africa.

The new commitments represent a steep drop in the health aid that the United States contributed before President Trump ordered a review of foreign assistance on his first day in office last year. According to an analysis by the nonprofit Partners in Health, health funding under the agreements would drop by 69 percent to Rwanda, 61 percent to Madagascar, 42 percent to Liberia and 34 percent to Eswatini, where a quarter of adults live with H.I.V.

Nevertheless, the deals are being welcomed by governments and some analysts in Africa as a significant shift that could increase country autonomy and make health systems stronger and less reliant on international largess. Others, however, say the agreements were negotiated with countries that had no leverage and demand conditions that are unattainable, especially in places where people are most in need of help.

The deals are guided by the administration’s global health strategy, announced in September, which emphasizes health spending that it says serves to make the United States safer and more prosperous. In Zambia, where negotiations are stalled, Washington is seeking to tie access to U.S. health funding — on which Zambia relies heavily to run a huge H.I.V. treatment program — to the signing of a separate deal for U.S. access to the country’s vast mineral resources. The proposed deal cuts Zambia’s health funding from the United States by more than 50 percent.

Jeremy Lewin, acting under secretary of state for foreign assistance, humanitarian affairs and religious freedom, said the agreements are the first phase of a reimagining of a failing and dysfunctional foreign aid system.

“That system was failing American taxpayers who were going to fund this in perpetuity,” Mr. Lewin said in an interview with The New York Times. “It was failing countries who didn’t have control over their own health sovereignty and their own health destinies. And it was failing patients, because ultimately we can only reach so many people with our foreign assistance funding and the thing that’s going to produce the best health outcomes for people in these countries is going to be for their national governments to build the capacity to take care of those populations.”

The overall large drop in the funding deals contrasts sharply with a push from Congress, where the House voted overwhelmingly on Wednesday to maintain funding for global health near the level it was in past years. The Senate will take up the bill later this month; the legislation proposes $9.4 billion in global health funding for the 2026 fiscal year, more than twice the $3.8 billion the administration had said it intends to spend.

The administration’s new mode of providing health aid differs significantly from the previous funding model. Now U.S. support is being conditioned on a cofinancing commitment from the partner country — Washington will give Nigeria about $2 billion over five years, for example, if the Nigerian government increases its current health budget by $3 billion in that period. In many cases, the new commitments that governments are making represent a large hike in their health spending — and it’s not clear, in countries with faltering economies and huge debt burdens, where those funds will come from.

“We will be punished sorely if the terms of the agreement aren’t met,” said Gift Trapence, who chairs a network of H.I.V. organizations in Malawi. “Yet Malawi is already struggling to finance its health system.” U.S. funding to Malawi will be cut by 35 percent.

The agreements frame the U.S. support as a direct exchange with the African governments, reducing or eliminating the role of nongovernmental organizations. Mr. Lewin and others at the State Department have been harshly critical of the large aid organizations — known as “implementing partners” — that the United States contracted to do much of the global health work it funded in the past.

Under that system, U.S.A.I.D. contracted those organizations to deliver goods and services in partner countries, sometimes working with the local health ministry, while other times acting independently. Trump administration officials have repeatedly characterized those organizations as a development mafia, saying they charged exorbitant overhead fees and were more preoccupied with ensuring their own survival than with helping countries end their reliance on foreign aid.

Under the new deals, more funds will go directly to governments to deliver services, and when they need the support of partners, they will choose them with the United States and have clarity about their budgets. The lack of transparency around those budgets, and the ability of implementing partners to set heath agendas, have been points of frustration for recipient governments in the past.

“There’s nothing not to like here,” said Ebenezer Obadare, a Nigerian analyst of African politics at the Council on Foreign Relations. “If there is any part of this that does not work for any African government, they are entitled to walk away.”

But Dr. Musoba Kitui, the Nairobi, Kenya-based regional director for a health rights advocacy group, said it was absurd to suggest that this was a fair negotiation between nations. After the United States abruptly froze funding to Kenya a year ago, “the health system was on its knees, and that vulnerability made it very likely that the state would sign on to any conditions, just to get some money into the Ministry of Health,” he said. Kenya’s funding from the United States will decline by 20 percent.

The deals have been negotiated under intense time pressure and with limited transparency. In Cameroon, the heads of key government health departments were unsure talks were even taking place until they learned a deal had been signed. In Kenya, the deal was negotiated with the Kenyan Treasury, and senior figures in the health ministry did not know its content until it was signed.

The compacts mean governments should be able to better integrate their health systems instead of having H.I.V. services run through one channel of U.S. funding, and malaria services another, said Dr. Kitui, who works with Ipas Africa Alliance. But what’s lost is the kind of solidarity that U.S.A.I.D. used to provide for marginalized communities — for women and girls, for people living in informal settlements or rural areas whose needs are often neglected by government. U.S.A.I.D. funded projects that provided health care to queer communities in places such as Uganda where homosexual activity is criminalized or persecuted.

Dr. Kitui said there is deep concern that the new deal could restrict abortion access, overriding national policies on reproductive health. A 1973 U.S. law prohibits the use of American foreign assistance funds to pay for abortion as a method of family planning, or to motivate or coerce any person to practice abortion. While abortion in Kenya is legal only when deemed necessary for the life or health of the pregnant woman, in practice medical personnel interpret this broadly and include the ways mental health can be undermined by an unwanted pregnancy.

Now, though, any aspect of the Kenyan health system that is getting U.S. funding support — such as the national medication supply chain — would theoretically be prohibited from supporting abortion, such as by stocking medications.

The new agreements will do more government-to-government transfer in countries where there is perceived to be greater transparency, and will continue to rely on “implementing partners” in places where accountability is weaker, Mr. Lewin said. The “implementing partner” model was developed in part because of concern about high levels of corruption in some developing countries’ governments, and fear of theft or waste of resources that were U.S. taxpayer contributions.

“We don’t see any way to make sure how this money is being used,” said Olivia Ngou, the director of Impact Santé Afrique, a health advocacy organization in Cameroon — a country with high corruption and an opaque, autocratic government.

U.S. SIGNS AID DEALS WITH AFRICAN COUNTRIES, WITH STRINGS ATTACHED. By Mogomotsi Magome And Michelle Gumede, Johannesburg AP

The U.S. government has signed health deals with at least nine African countries, part of its new approach to global health funding, with agreements that reflect the Trump administration’s interests and priorities and are geared toward providing less aid and more mutual benefits.

The agreements signed so far, with Kenya, Nigeria and Rwanda among others, are the first under the new global health framework, which makes aid dependent on negotiations between the recipient country and the U.S.

Some of the countries that have signed deals either have been hit by U.S. aid cuts or have separate agreements with the Trump administration to accept and host third-country deportees, although officials have denied any linkage.

The Trump administration says the new “America First” global health funding agreements are meant to increase self-sufficiency and eliminate what it says are ideology and waste from international assistance. The deals replace a patchwork of previous health agreements under the now-dismantled United States Agency for International Development.

U.S. aid cuts have crippled health systems across the developing world, including in Africa, where many countries relied on the funding for crucial programs, including those responding to outbreaks of disease.

The new approach to global health aligns with President Donald Trump’s pattern of dealing with other nations transactionally, using direct talks with foreign governments to promote his agenda abroad. It builds on his sharp turn from traditional U.S. foreign assistance, which supporters say furthered American interests by stabilizing other countries and economies and building alliances.

The deals mark a sharp departure from how the U.S. has provided health care funding over the years and mirrors the Trump administration’s interests.

South Africa, which has lost most of its U.S. funding — including $400 million in annual support — due in part to its disputes with the U.S., has not signed a health deal, despite having one of the world’s highest HIV prevalence rates.

Nigeria, Africa’s most populous country, reached a deal but with an emphasis on Christian-based health facilities, although it has a slight majority Muslim population. Rwanda and Uganda, which each have deportation deals with the U.S., have announced the health pacts.

Cameroon, Eswatini, Lesotho, Liberia and Mozambique also are among those that have signed health deals with the U.S.

According to the Center for Global Development, a Washington think tank, the deals “combine U.S. funding reductions, ambitious co-financing expectations, and a shift toward direct government-to-government assistance.”

The deals represent a reduction in total U.S. health spending for each country, the center said, with annual U.S. financial support down 49% compared with 2024.

A faith-based deal in Nigeria, a lifeline for several others

Under its deal, Nigeria, a major beneficiary of USAID funds, would get support that has a “strong emphasis” on Christian faith-based health care providers.

The U.S. provided approximately $2.3 billion in health assistance to Nigeria between 2021 and 2025, mostly through USAID, official data shows. The new five-year agreement will see U.S. support at over $2 billion, while Nigeria is expected to raise $2.9 billion to boost its health care programs.

The agreement “was negotiated in connection with reforms the Nigerian government has made to prioritize protecting Christian populations from violence and includes significant dedicated funding to support Christian health care facilities,” the State Department said in a statement.

The department said “the president and secretary of state retain the right to pause or terminate any programs which do not align with the national interest,” urging Nigeria to ensure “that it combats extremist religious violence against vulnerable Christian populations.”

For several other countries, the new deals could be a lifeline after U.S. aid cuts crippled their health care systems and left them racing to fill the gaps.

Under its deal, Mozambique will get U.S. support of over $1.8 billion for HIV and malaria programs. Lesotho, one of the poorest countries in the world, clinched a deal worth over $232 million.

In the tiny kingdom of Eswatini, the U.S. committed to provide up to $205 million to support public health data systems, disease surveillance and outbreak response, while the country agreed to increase domestic health expenditures by $37 million.

South Africa is noticeably absent from the list of signatories following tensions with the Trump administration.

Trump has said he will cut all financial assistance to South Africa over his widely rejected claims that it is violently persecuting its Afrikaner white minority.

The dismantling of USAID resulted in the loss of over $436 million in yearly financing for HIV treatment and prevention in South Africa, putting the program and thousands of jobs in the health care industry at risk.

Agreements made with African countries that agree to accept U.S. deportees.

At least four of the countries that have reached deals previously agreed to receive third-country deportees from the U.S., a controversial immigration policy that has been a trademark of the Trump administration.

The State Department has denied any linkage between the health care compacts and agreements regarding accepting third-country asylum seekers or third-country deportees from the United States. However, officials have said that political considerations unrelated to health issues may be part of the negotiations.

Rwanda, one of the countries with a deportation deal with the U.S., signed a $228 million health pact requiring the U.S. to support it with $158 million.

Uganda, another such country, signed a health deal worth nearly $2.3 billion in which the U.S. will provide up to $1.7 billion. Also Eswatini, which has started receiving flights with deported prisoners from the U.S.

TRUMP GUTTED AIDS HEALTH CARE AT THE WORST POSSIBLE TIME. By Steven W. Thrasher and Afeef Nessouli for The Intercept.

On World AIDS Day 2025, humanity should be celebrating that there is a new shot available which offers six months of protection against the transmission of HIV, the virus which has already infected approximately 40 million living people and taken the lives of 44 million more.

Instead, public health workers are reeling from how President Donald Trump has helped HIV to circulate in more humans this year than last. The lethal ways the current U.S. health policy is harming the health and wealth of LGBTQ+ people worldwide will be felt for years, if not decades.

That’s because on the first day of his second term, Trump issued a stop-work order for all foreign aid and several orders that jeopardized the health outcomes of minority groups within the U.S.

The cuts were far-reaching yet highly specific. They reduced resources for short- and long-term health research conducted by the Centers for Disease Control and Prevention, universities, and community groups in the U.S. and around the world. Through the so-called Department of Government Efficiency’s gutting of the United States Agency for International Development, or USAID, the administration curtailed or ended funding for programs like the President’s Emergency Plan For AIDS Relief, also known as PEPFAR.

These cuts disparately harmed several distinct but often overlapping populations: LGBTQ+ people, immigrants, sex workers, and people living with HIV/AIDS. They were swift, halting scientific trials and critical services within days (or even mere hours) of their posting on January 20, 2025. And they were significant, contributing to acute medical crises, hunger, homelessness, or even death.

In the U.S., cuts to federal spending resulted in the cancellation of over $125 million in National Institutes of Health grants for LGBTQ-focused health research.

Across the globe, cuts to USAID are disrupting life-saving services and forced community organizations to close across the globe. In South Africa, transgender people immediately lost access to gender-affirming care, leading to forced detransitioning, body dysmorphia, depression, and even suicide. In Lebanon, USAID cuts are causing job losses among humanitarian aid workers, impacting medical care and disrupting development programs. In Uganda, people living with HIV have lost access to condoms, lubricants, medication, and even to the food that USAID once provided to people living with the virus (as those who are starving simply cannot take antiretroviral medication).

While there are lethal exceptions, often, the effects of these cuts are unfolding gradually over time. HIV is a slow-acting virus, and the deadliness of halting its prevention and treatment now will take years or even more than a decade to manifest.

But it’s possible to take a toll of the damage nearly 11 months later today on World AIDS Day, to better understand the damage done and the suffering and death still to come. By early 2025, Politico reported that the administration canceled 86 percent of all USAID awards. One analysis found that 71 percent of HIV-related activities globally were terminated, including several HIV treatment awards and most HIV prevention programs. Overall, there has been a huge drop in the number of people starting antiretroviral medication and a decrease in viral load testing, which is crucial for monitoring the virus and preventing transmission. Without the infrastructure of monitoring, documentation, and care, HIV is transmitting unchecked in the dark.

And it’s also possible to get a pattern of HIV’s rise by talking to people doing the work on the ground (or who recently returned from it), people living with HIV, and people who are both. In the United States, Europe, Africa, and the Middle East, Trump’s cuts are not merely harming these populations by reducing or eliminating services they receive; it is also harming them by taking away their jobs.

For instance, at one large university hospital we visited in the Midwestern United States, every single trans Black outreach worker — who had been integral in addressing high rates of HIV among Black LGBTQ+ Americans — had lost their job by May. In Europe, we found HIV nongovernmental organizations struggling not just with cuts from USAID, but cuts also dictated from Brussels and their own governments, as EU countries shifted money away from immigrants and foreign aid and toward NATO and Frontex, the ICE of the European Union.

In Lebanon, the executive director of an organization that helps some 600 people per month access HIV services and other care — including financial aid or case management for queer people experiencing violence — said they can no longer plan beyond eight months.

At a clinic in Uganda for “key populations” (the euphemism for LGBTQ+ people in a country where “aggravated homosexuality” is a capital offense), a medical assistant said the staff was cut from 15 to just four. When told that staff at a similar organization in South Africa had also been reduced to just four people — but from an original staff of 86 — one of the workers in Uganda could only laugh: “Wow, I thought we had it bad.”

OCT 30: AID CUTS ARE DEVASTATING HEALTH SERVICES IN AFRICA. Report by The Economist.

“It’s heartbreaking,” says Velontafa Jackia, a doctor based in Sambava, in the north-east of Madagascar. Until this year she was part of a project funded by the United States Agency for International Development (usaid) that helped send health workers to even the remotest parts of the impoverished island. But since the funding stopped, fewer patients have been seen. Ms Jackia lists the effects: more birth complications, more maternal deaths, more malarial deaths and “lots of outbreaks”. She sighs: “We’ve been reliant too much on aid and now it’s gone.”

Nine months after Donald Trump’s administration began dismantling usaid the effects are being felt across sub-Saharan Africa, where America supplied more than two-thirds of the bilateral aid for public health. The Trump administration says the largesse created a “culture of dependency”. Its America First Global Health Strategy, published in September, says recipient governments must do more of the work and pay for more of it themselves. This is a good idea in theory, but in practice many people are going to die as aid is reduced.

America became the “indispensable nation” for African public health, notes Jeremy Nel, a South African doctor specialising in hiv. In 21 African countries its aid equalled at least 20% of government health spending; in eight it was over 50%; and in three countries (Somalia, South Sudan and Malawi) it exceeded government spending (see chart). America was also the largest single donor to global bodies like the Global Fund to Fight aids, Tuberculosis and Malaria, and un agencies like Unicef (which helps children), the World Health Organisation (who) and the World Food Programme (wfp).

These contributions have “collapsed”, notes Charles Kenny of the Centre for Global Development (cgd), a think tank. According to estimates of disbursals for the 2025 fiscal year (which runs from October to September), wfp received $326m v $4.3bn in the previous fiscal year. Also cut were funds for the who ($133m v $553m), the Global Fund ($1.3bn v $2.3bn) and Unicef ($265m v $1.1bn).

The fate of bilateral aid—ie, money not spent via international groups—is harder to gauge. Typically this aid was disbursed via thousands of contracts with third parties, usually ngos, who then implemented programmes in the relevant country. As of August 1st, 86% of usaidcontracts (and 77% of those related to health) had been terminated. Since some of the largest contracts remain in place, the percentage drop in funding is less dramatic. Mr Kenny estimates that there will be a 38% drop in aid spending in 2025 from 2024.

Foreign aid could be constrained for many years; 2024 and 2025 will probably mark two years of consecutive bilateral aid cuts by the four largest donors (America, Britain, France and Germany) for the first time since the oecd, a club of mainly rich countries, started collecting data. Britain is cutting its aid spending from 0.5% of gross national income to 0.3% by 2027. Mr Trump’s proposed budget for 2026 has a two-thirds cut in bilateral health funding relative to 2025, and no money for the who, gavi (a vaccine funder) or the Global Fund.

The impact of aid cuts on Africans’ health is obscured by the fact that the data systems used to track disease were paid for by American aid—and have largely been shut down. But two sources of information suggest reasons to worry. The first are analysts’ estimates that take the relationship between previous aid spending and the deaths that it averted, then in effect undo it to estimate the additional mortality. Mr Kenny and Justin Sandefur, another economist, reckon that Mr Trump’s recent budget proposals would put as many as 1m lives at risk, mostly from more untreated cases of hiv, tuberculosis and malaria.

The State Department, which has absorbed some of usaid’s functions, has said it would maintain “life-saving” work. This includes antiretroviral drugs for hiv and salaries for health workers who administer them as part of pepfar, America’s flagship anti-aids programme. But another analysis for cgd found that contracts for these elements affecting 2.3m people had still been cancelled. In addition, cuts to preventive programmes put hundreds of thousands at risk of new hiv infections.

State has said it will provide “bridging” funding for countries until they strike new bilateral deals with America, but there is little sign of the money. And many of the ngos best placed to spend it have closed down operations. Meanwhile, the European governments that many Africans hoped might help fill gaps are, at least in some cases, doing the opposite.

The second source of information comes from on-the-ground reports of chaos across Africa. In South Africa, where pepfar paid for only a minority of anti-hiv programmes, clinics have been receiving “hivmigrants” from neighbouring Eswatini, Lesotho, Mozambique and Zimbabwe, unable to find drugs in their countries. “We are going backwards,” says Olive Shisana, a South African epidemiologist, who cites estimates by the un that there could be more than 6m new hiv infections and 4m more deaths from aids by 2030 than would otherwise be the case.

In Madagascar people who used to work for American-funded projects worry about a looming crisis in the island’s south. The area is subject to regular drought and mass hunger. But the supply of emergency food is “a tenth of what it was” last year, says a senior humanitarian figure.

Across Africa, refugee camps are vulnerable. In Kiryandongo, in Uganda, America paid for about 60% of the wfp budget. Ronald Onen, from South Sudan, says that in April he was told he no longer qualified for food rations. “You can imagine the problems, the stress, this has caused,” he says.

In July hundreds of South Sudanese refugees with sticks and machetes attacked a compound housing newcomers who had fled the war in Sudan—and supplies. Over a hundred were injured and one killed. One mother said the attackers stole food, including the dinner her children were about to eat, which was part of their food aid.

Similarly troubling reports come from north-eastern Nigeria, where America footed the bill for 60% of humanitarian costs. ngos say they are turning away famished children. In Somalia the wfp says it must cut the number getting food aid from 1.1m in August to 350,000, less than a tenth of those the agency says require help.

Basic preventive health care has suffered too. In early October cgdnoticed a rise in cholera in Angola, Congo, Sudan and South Sudan. In each case there was a reduction in American funding for “wash” projects—water, sanitation and hygiene.

African policymakers are paying lip service to the idea that the crisis offers an opportunity. “We cannot build healthier populations purely on the generosity of other nations,” said Muhammad Ali Pate, the Nigerian health minister, in August. But the ngos and local officials dealing with the fallout are gloomier. Seramila Teddy, who governs the Madagascan province where Dr Jackia works, says he has no money to dispatch health workers to remote areas. South Africa’s government has said it will replace the lost pepfar funding, but ngos say no cash has arrived.

A silent crisis could be dangerously convenient for both sides. America does not want to be blamed for contributing to the deaths of Africans; African governments do not want to look weak and incompetent. All the while, the signs are growing that America First also means Africa last. ■

FOREIGN AID IS MOSTLY GONE. IT COULD BE REPLACED BY SOMETHING BETTER. Opinion by Rajiv Shah, President of the Rockefeller Foundation.

Mr. Shah is former leader of U.S.A.I.D. and the author of “Big Bets: How Large-Scale Change Really Happens.” This opinion was originally printed in N.Y. Times.

Over the past year, wealthy countries around the world have undermined a decades-old consensus that human dignity is universal and that nations have a responsibility to further it. The shuttering of the United States Agency for International Development, which I led for five years, is just one piece of a broader, tragic retreat from a system of foreign aid that helped cure the sick, feed the hungry and empower the poor.

Countries, including the United States, Canada, Britain and Germany, have slashed billions in assistance. Research published by The Lancet estimates that more than 14 million people could die as a result of American aid cuts alone — 4.5 million of them children younger than 5. This is a moral failure that will make the whole world less safe, less secure and less prosperous.

Amid the tragedy, it is tempting to defend what we know. Fortunately, leaders in Africa, Asia, Latin America and elsewhere are building something new. They are taking ownership of their countries’ own development, figuring out ways to leverage new technology and, most important, encouraging private investment — long the single biggest challenge for development projects. Their initiatives are modeling a way to lift up the vulnerable that will be more sustainable in the 21st century.

Eighty or so years ago, powerful nations came together around the concept of universal dignity, codifying that idea into institutions like the United Nations, the World Health Organization and the World Bank. This system helped usher in an era of extraordinary progress: transforming AIDS into a manageable condition, saving millions of children from dying of preventable causes and helping to cut hunger in low-income countries by more than 60 percent from 1970 to 2015. It also benefited donor countries by fighting diseases like Ebola abroad to protect lives at home and turning poorer countries into trade partners that created jobs.

Yet while the system did enormous good, it also faltered as the world changed. That model was funded and thus directed by wealthy countries and centralized in large institutions. Over time, donor support and public support for international institutions proved inadequate, yet aid projects remained dependent on them. The work also increased as overlapping yet siloed initiatives proliferated in large part because the best way to find funding was rallying excitement about each new idea.

In recent years, the African country of Malawi received about 55 percent of its health funding from an estimated 166 external sources. To keep the money flowing in, Malawi had to write at least 50 strategic plans to secure financing.

Recipient governments and domestic resources were also often bypassed by donor nations and NGOs. Meanwhile, the effects of climate change created new challenges for which the system was unprepared. The data makes that clear: Ten years after the United Nations member states committed to comprehensive goals on human well-being, including ending extreme poverty and malnutrition, only about 18 percent of the targets are on track.

As that system was defunded over the past year, a new way to advance human dignity has been revealed in initiatives across the world. It is increasingly led by developing countries, not donors. It prioritizes underlying issues, like electricity access, that improve economic growth and life in many ways rather than just one. It leverages new technology: A.I. chatbots that teach farmers new methods, battery storage systems to enable use of clean energy, and drug therapies that reduce the number of dosages as they increase the length of coverage. This model uses philanthropic capital to get started, entices private investments and commits countries themselves to long-term investment.

In January, I joined more than two dozen African leaders who came together in Dar es Salaam, Tanzania, to commit to connecting 300 million people on the continent to electricity by 2030. This effort exemplifies the new model: It’s driven by African countries’ commitments to reform and to provide the electricity essential to modern jobs, health, education and nutrition. This is possible because of new technologies, such as localized grids that create electricity and internet connectivity for remote communities. Above all, this effort is focused on making commercial investment less risky, thereby mobilizing private-sector capital to drive sustainability.

Last month about 80 nations spanning sub-Saharan Africa, Southeast Asia, Western Europe and Latin America met in Brazil to advance one of the most effective ways to save kids from hunger: school meals. About 466 million children benefit from school meal programs. These meals also improve students’ learning and attendance (particularly girls) while creating jobs for local cooks and food suppliers and generating predictable demandfor local farmers.

One dollar invested in school meals can yield up to $35 in economic returns. In recognition of this remarkable potential, global funding for school meals doubled from 2020 to 2024 — with 99 percent coming from national budgets. When a country provides its own safety net, it creates a bulwark against droughts, climate stress and other shocks that otherwise cause famine.

And last month, as world leaders gathered in New York at the United Nations, African leaders, including Ghana’s president, John Mahama, met to commit to redesigning their health systems to be less dependent on external aid. By necessity, Mr. Mahama and other leaders are committing to paying for more of it themselves and attracting more private investment. Combine this political will with new technology — integrated data systems, A.I. support to help community health workers identify patterns and treatments, and long-lasting new drugs, such as the H.I.V. treatment lenacapavir — and the possibilities are significant.

Of course, this model faces challenges. Leaders have to want to do the right thing and stay on guard against corruption and inefficiency. Amid rash budget cuts, the field of global development has lost valuable expertise. And these nations are trying to take on more responsibility even as many face crippling debt crises. To help these countries make this modern model succeed, donors should forgive debt and target available — and even expanded — aid accordingly.

A new poll by the Rockefeller Foundation of more than 36,000 people in 34 countries gives reason to think that’s possible. Though only slight majorities said they trusted long-running international institutions such as the U.N., support for their sort of work — like international collaboration in feeding the hungry and preventing disease — was above 90 percent. The reason? Support for global cooperation is deeply linked not to a system but to results; up to 75 percent would support initiatives if they proved to be effective.

As needs increase around the world, that poll showed that Americans and many others still want to advance human dignity. We just want to do it well. These leaders are showing us how, and the world should help them.

THE TAX ON BEING A GIRL. Opinion by Nicholas Kristof in NY Times.

President Trump’s cuts to humanitarian assistance abroad have hurt all kinds of people. But from what I see on the ground, those suffering the most are women and girls — and that will leave all of us, including men and boys, worse off.

Sometimes the cuts don’t directly target girls, but when families are stressed it is girls who pay the highest price. In a Congolese refugee settlement I visited in southwestern Uganda, Rwamwanja, aid cuts led to reduced food assistance and to the layoffs of 88 teachers; the result was that thousands of students dropped out of school in the last few months, and the great majority of the dropouts were girls.

“Only about one-quarter of our schoolchildren are girls now,” David Mugenyi, the settlement’s commandant, told me. Until a few months ago, it was close to 50-50, he said.

He explained that 70 percent of families in the settlement lost their food assistance around May, and when households are economically pinched, they pull their daughters out of school to fetch firewood and water, to mind younger siblings, to work in the fields or to sell vegetables in the market.

To travel through these impoverished villages east of the Congolese border in the aftermath of aid cuts is to see a kaleidoscope of pain shared by all but felt most acutely by women.

Karungi Kevin, 46, survived sexual assault in the Democratic Republic of Congo that left her with serious health complications. She fled in February to Uganda, where cuts in health services have left her struggling to get care. Women’s health programs have been particularly hurt by funding cuts.

As medical care evaporates, it is moms who die in childbirth. As food disappears and babies cry from hunger, some overwhelmed husbands abandon their wives and children. As social order unravels, it is mostly girls who are raped — and then are scorned for having been raped. And when times are desperate, it is girls like Alice Mugisha who are married off against their will.

“I cried when my dad told me to get married,” Alice told me. “But when the food aid got cut off, he said I had to marry.” So three weeks before I arrived, she married.

I gingerly asked how she was doing.

“I’m happy,” she told me dully, although she seemed near tears. She hadn’t eaten in 24 hours and had little hope that her husband would return from the fields that evening with something to eat.

Alice didn’t know her birth date but thought she might be 17 or 15. So I drove to her family home to check refugee documents that might indicate her age. That remains uncertain: Her father, Francis Twagira, showed me a not-very-reliable document suggesting she was 18 or 19.

I asked him why he had married Alice against her wishes. He was regretful but unapologetic.

“It was important for her to get married because we were broke,” Twagira said, adding that he had received a bride price from the husband’s family of $140. “If aid was still coming, Alice would remain with us.”

He then pointed to a younger daughter, Muhawe, who the documents say is either 12 or 13.

“If the situation continues like this, I will have to marry Muhawe off as well,” he said.

I tried to ask Muhawe what she thought of that, but she was too terrified to say anything at all.

As I’ve noted many times, there are reasons of self-interest to be alarmed about Trump’s aid cuts. Diseases are global, so if we lose health surveillance abroad we are more vulnerable to epidemics at home. Failed states produce waves of migration that eventually reach us. Humanitarian assistance is a tool of foreign policy: We confront China with submarines but also with humanitarian assistance programs meant to cultivate soft power.

But to me the most powerful argument is ethical: If we can easily and cheaply save children’s lives, we should do so. And after decades of providing assistance that people rely on and that saves an estimated 3.3 million lives a year, we shouldn’t suddenly pull the rug out from under them with no time to adjust.

Men and boys are hurt as well by the collapse in medical assistance, but women seem to be particularly suffering because of a crisis in reproductive health care — and already one of the most dangerous things a girl can do in places like this is to reach puberty or, even more perilous, become pregnant.

In one health center, I came across a 14-year-old girl, Shamim, who was pregnant, expecting in October, and as a result had dropped out of school. I asked about her boyfriend, but it turned out there wasn’t one.

“I was raped,” she explained. “He used force.”

Shamim said that the sharp curtailment of aid had increased crime of all kinds, from theft of food to assault. She used to be safe with others in school or at home, but with the shortages everyone was toiling in the fields and she was alone at home when a man in his 20s found her.

“I didn’t know about sex,” she said softly. “I didn’t know how babies are made.”

There has always been rape and other crime, so I don’t want to overdo the link to curtailing aid. But there does seems something to the idea that desperation has eroded the social fabric and left girls particularly vulnerable. In one village, I found a 9-year-old girl, Provia, who had been left alone for a week in the family hut to care for her 3-year-old brother, Paul, because their mother was at the hospital with their severely malnourished infant brother.

The Trump administration has been particularly hostile to reproductive health. It not only defunded the U.N. Population Fund, a leading supplier of contraceptives and major force for reducing maternal mortality, but also slashed funding for family planning and even has said it will incinerate almost $10 million worth of I.U.D.s, implants and birth control pills. The Guttmacher Institute estimates that each $10 million reduction in spending on international family planning leads to an additional 362,000 unplanned pregnancies and 718 maternal deaths.

Family planning is now becoming harder to find, patients and doctors told me, and when women become pregnant they can’t always get an H.I.V. test — which is necessary to prevent transmission of the virus to babies.

Antiretroviral drugs, often provided by the United States at a cost of 12 cents per day per person, are now also becoming more scarce. Judith Mbabazi, 47, told me that she had tested positive for H.I.V. in March, but still was unable to obtain treatment.

“I was told that I couldn’t get medicines because there’s a shortage and they have to prioritize those who’ve been in care longer,” she said. She began weeping. “My life is in danger,” she said, “and I want to be able to take care of my children and see my grandchildren one day.”

In addition, cervical cancer kills a growing number of women — roughly as many as maternal mortality — and is a horrific and painful ailment. It is sometimes diagnosed by the stink of rotting flesh.

One of the exciting steps forward in global health has been a growing effort to eliminate cervical cancer with vaccinations through GAVI, the Vaccine Alliance, and with screenings. Pap smears are not widely available in poor countries, but an inexpensive alternative is a “vinegar test” in which vinegar is brushed on the cervix, revealing precancerous lesions that can be frozen off with a simple device. This lifesaving care is offered by MSI Reproductive Choices and many other caregivers — but with the United States cutting off support for both GAVI vaccinations and for reproductive health, more women may be destined to suffer excruciating deaths from cervical cancer.

Women in developing countries already often face unimaginable burdens. “Appeasement marriages” in Mozambique to settle quarrels. Breast ironing in Cameroon, maiming girls so that they will be less vulnerable to assault. Extreme genital mutilation in Sudan and Somalia. Murders of young wives in India over dowry disagreements. Acid attacks in Pakistan. Obstetric fistulas, human trafficking, denial of education, anemia (because of menstruation and poor diets) endured by some 30 percent of women of reproductive age worldwide. And a child marriage somewhere in the world about once every three seconds.

Over the last quarter-century there have been growing efforts to invest in educating and empowering girls, for reasons of justice but also because educated girls are the building blocks of more prosperous and peaceful societies. Yet now there seems a retreat from that vision. The cost will be more women dying unnecessarily, but men and boys will also be losers.

These women are not helpless. Never forget that impoverished women in these circumstances show extraordinary grit. With a bit of assistance, they are capable of superhuman accomplishments, lifting up themselves and their communities.

I thought of that when I met a Congolese refugee named Anna Arakaza, 23, outside her hut in a refugee settlement. She was sitting on the ground with her 4-year-old son, and I gradually realized that she was unable to stand or walk. She explained that she had had a sickness at the age of 10 that cost the use of her legs; she didn’t know what the sickness was.

In April of this year, the M23 militia rampaged through her village, killing her parents and taking away her husband, who hasn’t been seen since. Five of the soldiers gang-raped her, she told me, and one stabbed her in the leg. They also robbed her of her wheelchair.

“So I decided to flee,” she explained — by crawling.

Sometimes she got motorcycle rides, but for much of the 100-mile journey she crawled, her son beside her. Now that she has arrived in Uganda, the U.N. refugee agency is helping her, but budget cuts mean that it no longer has funding for wheelchairs or other support for disabled people like Arakaza. (Readers can help here.)

Arakaza is still in pain from the stabbing, and sometimes she is incontinent. But I look at her and see not just the suffering but also above all her fortitude. She saved her son and, against all odds, found a path to safety. Imagine what women of her determination and pluck could do with education, resources and help as simple as a wheelchair.

U.S. PLEDGES BREAKTHROUGH AIDS DRUG FOR 2 MILLION. 20 MILLION NEED IT. Press Release from UNAIDS.

GENEVA, 5 September 2025—UNAIDS welcomes the announcement by the US State Department that the President’s Emergency Plan for AIDS Relief (PEPFAR) will be supporting an initiative by the Global Fund to Fight AIDS, TB and Malaria to provide lenacapavir to up to 2 million people in countries with high burdens of HIV.

Lenacapavir, an American-based innovation, is one of the most promising new HIV prevention tools that has emerged in the HIV response, offering protection against HIV with just twice-yearly injections. The breakthrough medicine will save thousands of lives if made widely available for all people and populations at risk of HIV including young women and adolescent girls as well as sex workers, people who inject drugs, and men who have sex with men in high burden countries and geographies.

"This deal offers hope that many more people around the world who are at risk of HIV will have access to this revolutionary HIV medicine. More global work will be needed to increase scale and rapidly make lenacapavir available, affordable and accessible in all low and middle-income countries. But at this critical moment, the United States’ backing of this breakthrough medicine is an important signal to the world that by investing in the HIV response we can stop new infections,” said Winnie Byanyima, Executive Director of UNAIDS.

An initial roll-out of 2 million is an important start toward a broader ambition and i t is important that lenacapavir be available to all people in need, not only to some. UNAIDS estimates that 20 million people will need to be reached with antiretroviral-based prevention such as lenacapavir as part of efforts to achieve the 2030 global HIV prevention targets. UNAIDS also estimates that for every US$ 1 invested in HIV prevention, US$ 7 will be saved in treatment and care costs later.

The price for lenacapavir in France, Norway, Spain and the United States in late 2024 exceeded US$ 28 000 per person per year. For this initiative, manufacturer Gilead has pledged to supply the medicine at no profit. Research published earlier this year showed that lenacapavir can be made and sold for just US$ 40 per person per year, falling to US$ 25 with sufficient scale.

To successfully expand access to lenacapavir, community engagement will be essential. To advance progress in the roll-out, populations most impacted by HIV must play a central role in its delivery and people most at risk of HIV must have access.

UNAIDS will continue to support countries and partners in driving the response to HIV forward to ensure that everyone, everywhere has access to the HIV services they need and that AIDS is ended as a public health threat by 2030.

U.S. RELEASES “AMERICA FIRST GLOBAL HEALTH STRATEGY.” U.S. Department of State official communication.

To the American People:

The United States is the world’s health leader. More innovative drugs and medical devices

are developed in the United States than anywhere else in the world. If you are sick, there is

nowhere you would rather be cared for than in the United States.

Over the past several decades, we have extended our health leadership globally. We have

helped contain thousands of infectious disease outbreaks around the world, stopping

numerous potential pandemics in their tracks before they could reach our shores. Our

health foreign assistance programs, most notably the President’s Emergency Plan for AIDS

Relief (PEPFAR), have saved over 26 million lives and prevented 7.8 million babies from

being born with HIV / AIDS. There is much to be proud of.

But there are also many problems – our foreign assistance programs are deeply broken.

Our health foreign assistance programs in particular have become inefficient and wasteful,

too often creating parallel healthcare delivery systems and a culture of dependency among

recipient countries. Many of the NGOs who support these programs have committed many

times to helping transition the work to local governments, but little progress has been made.

This is often not because of a lack of willingness on behalf of recipient countries but rather

because of our broken foreign aid system and the perverse incentives that encourage NGOs

to self-perpetuate.

We must keep what is good about our health foreign assistance programs while rapidly

fixing what is broken – and this strategy lays out a plan to do just that. We detail an America

First Global Health Strategy that uses global health diplomacy and foreign assistance

to make America safer, stronger, and more prosperous. We lay out a vision to end the

inefficiencies, waste, and dependency of our current system. In its place, we cast a positive

vision for a future where we stop outbreaks before they reach our shores, enter strong

bilateral agreements that promote our national interests while saving millions of lives, and

help promote and export American health innovation around the world.

We will continue to be the world’s health leader and the most generous nation in the world,

but we will do so in a way that directly benefits the American people and directly promotes

our national interest. We look forward to making this vision a reality in the months and

years ahead.

Sincerely,

Marco Rubio

United States Secretary of State

Executive Summary

The United States is the world’s global health leader. Over the last 25 years, the United

States’ global health programs have prevented thousands of infectious disease outbreaks

from reaching American shores, saved over 26 million lives, and prevented 7.8 million babies

from being born with HIV / AIDS.

However, our global health programs have become inefficient and wasteful. Today, less than

40% of health foreign assistance funding goes to frontline supplies and healthcare workers.

This includes approximately 25% of funds that are used for the purchase of commodities

(e.g., diagnostics, drugs) and approximately 15% of funds that are used to employ over

270,000 frontline healthcare workers (e.g., mostly nurses and community health workers).

The remaining 60% of funding is spent on technical assistance, program management, and

other forms of overhead.

This inefficiency has built up over time for a number of reasons. In the early days of the

HIV / AIDS response, there was minimal health delivery capacity in many of the most

affected countries. As a result, the United States often chose to invest in directly building

health delivery capabilities, often minimally connected to national health systems. While

this strategy was successful in dramatically improving health outcomes, it has also too

often resulted in parallel procurement systems, parallel supply chains, program-specific

healthcare workers, and program-specific data systems.

This problem has only been exacerbated by the significant amount of funding Congress has

continued to dedicate to global health programs in recent years, which has provided little

incentive to change. The problem is further exacerbated by NGOs who are the recipient of

much of this funding (especially for technical assistance and program management) who

have perverse incentives to self-perpetuate rather than work towards turning functions over

to local governments. As a result, even though the last three presidential administrations

have developed strategies to transition global health programs to increased local ownership,

very little progress has been made. It is time for that to change.

In the following pages, we lay out a positive and forward-looking vision for United States

leadership in global health – an America First Global Health Strategy. We lay out a plan

that will prioritize the interests of Americans and make America safer, stronger, and more

prosperous. And as we do so, we will help save millions of lives around the world and assist

foreign countries in developing resilient and durable health systems.

SAFER. We will keep Americans safe by continuing to support a global surveillance system

that can detect an outbreak within seven days. We will accomplish this through bilateral

relationships with countries that include having a U.S. government staff presence on the

ground where possible, with a larger number of staff dedicated to geographies with the

highest risk of an outbreak. When there is an outbreak, we will be prepared to work with

local governments to respond promptly. We will be prepared to surge resources to ensure

the outbreak is contained, travelers are appropriately screened, and – to the maximum

2025 America First Global Health Strategy | 4

extent possible – the outbreak does not reach American shores or harm Americans living

abroad.

STRONGER. Our global health foreign assistance program is not just aid – it is a strategic

mechanism to further our bilateral interests around the world. Moving forward, we will

utilize our health foreign assistance to advance U.S. priorities and move countries towards

resilient and durable local health systems. We will do this thoughtfully, by entering multi-year

bilateral agreements with recipient countries that lay out clear goals and action plans.

These bilateral agreements will ensure funding for 100% of all frontline commodity

purchases and 100% of all frontline healthcare workers who directly deliver services to

patients. We will also partner with each country to ensure there are data systems in place

that can both monitor potential outbreaks and broader health outcomes. We will ensure

these systems are integrated into the long-term health information systems of a country

so that we can monitor outbreaks and health outcomes well into the future. We will also

work to rapidly transition technical assistance from supporting individual clinical sites

to supporting governments in taking over key functions. This will include more govern-

ment-to-government assistance as well as leveraging the private sector and faith-based

organizations. Finally, we will ask governments to co-invest in these efforts and work with

the United States to align on performance benchmarks that will be required for releasing

future U.S. health foreign assistance funding.

We aim to complete bilateral agreements with recipient countries receiving the vast

majority of U.S. health foreign assistance by December 31, 2025 with the goal of beginning

to implement these new agreements by April 2026.

MORE PROSPEROUS. We will first and foremost make America more prosperous by

helping contain outbreaks at their source, protecting American lives and the American

economy. We will also leverage our foreign assistance to promote American companies

and American innovations abroad, including continuing to procure goods from American

companies as part of our foreign assistance programs. We will also leverage our bilateral

relationships with countries to promote American health innovations and products more

broadly globally, helping ensure that American innovation becomes a cornerstone of health

systems around the world.

READ AMERICA FIRST GLOBAL HEALTH STRATEGY

LET’S THINK THROUGH A 1% SUPER WEALTH TAX TO FUND CRITICAL SOCIAL AND HUMANITARIAN PROGRAMS. White Paper from The caring world.

As President Trump seeks to control spending on Congressional approved budgets for social services and humanitarian aid, the American people need to investigate and seriously consider alternative funding for programs and agencies that impact human life in this country and in foreign nations that we have helped for decades. We are looking at a 1% super wealth tax on the richest of richest Americans that could raise in excess of $70 million per year. The rationale is that these richest of richest have made their fortunes because of the U.S. economy. Many have made billions doing business with the U.S. government. Also the lifestyles and business operations of this group has a much greater effect on the environment and climate change that the average American. What follows is an executive summary followed by a more detailed white paper.

Executive Summary: A 1% U.S. Billionaire Wealth Tax to Close the Humanitarian Aid Gap

Objective. Create a dedicated, stable revenue stream to permanently eliminate the current $9 billion shortfall in U.S. humanitarian aid by enacting a narrowly targeted 1% annual tax on the net wealth of U.S. billionaires.

Scale. As of 2025, America has roughly 900+ billionaires. Their combined wealth surpassed $7 trillion in June 2025 (based on Forbes data compiled by Americans for Tax Fairness). A 1% levy on that base yields about $70 billion per year—nearly 8× the identified shortfall, even before behavioral or market adjustments. ForbesAmericans For Tax Fairness

Use of funds. Establish a Humanitarian Aid Stability Fund (HASF) at Treasury that:

• Automatically transfers the first $9 billion each fiscal year to USAID/State humanitarian accounts (IDO/Humanitarian Assistance, Migration and Refugee Assistance, Global Health, etc.).

• Smooths volatility via a rolling three-year reserve so appropriations remain steady through market cycles.

Administration & design. The tax applies to U.S. tax residents with net worth ≥ $1 billion, defined as worldwide assets minus liabilities. Public assets are mark-to-market; private assets follow standardized valuation safe harbors with third-party reporting and audit. Anti-evasion tools include information reporting, penalties for under-valuation, and an exit taxto discourage tax-motivated expatriations (modeled on prior proposals). OECDElizabeth Warren's Senate Website

Legality. The Supreme Court’s 2024 decision in Moore v. United States upheld a tax on undistributed, realized business income and explicitly did not resolve whether “realization” is constitutionally required for all income taxes, leaving space for alternative designs (e.g., minimum-tax approaches, mark-to-market) and for a direct wealth tax debate in Congress. Multiple legal analyses argue a properly drafted federal wealth tax is constitutional. Supreme CourtPoliticoRoosevelt InstituteGeorgetown Law Scholarship

Revenue reality check. Even under conservative assumptions—−20% market drawdown and 15% avoidance/non-collection—a 1% levy still nets about $50–60 billion/year, leaving ample headroom to fully backstop the $9 billion aid gap. (Baseline: ~$70 billion.) Global work for the G20 suggests a 2% minimum levy on billionaires could raise $200–$250 billion/year—scale that underscores feasibility. Americans For Tax FairnessGabriel Zucman | Professor of economics

Why 1%. International evidence shows that low-rate, broad-base designs minimize distortions and are administratively manageable—particularly with modern information reporting. The OECD’s design guidance and European experience inform the safe-harbor valuation, reporting, and audit playbook proposed here. OECDTax Foundation

White Paper: Designing a 1% Billionaire Wealth Tax to Permanently Fund U.S. Humanitarian Aid

1) Policy Goal & Rationale

• Goal: Permanently close a recurring $9 billion humanitarian aid funding gap without touching middle-class taxes or annual appropriations battles.

• Mechanism: 1% annual tax on the net wealth of U.S. billionaires (≥ $1 billion), with proceeds dedicated to a new Humanitarian Aid Stability Fund (HASF).

Scale & sufficiency. U.S. billionaire wealth topped $7 trillion in 2025; 1% produces ~$70 billion gross annually. Even with conservative haircuts, net collections handily exceed needs, ensuring predictability in aid budgets and allowing a reserve to buffer market swings. Americans For Tax Fairness

2) Tax Base, Rate, and Threshold

• Threshold: Net worth ≥ $1 billion (averaged over two consecutive year-ends to reduce cliff effects).

• Rate: 1.0% on net wealth above $1 billion.

• Base: Worldwide net wealth (all asset classes) less bona fide liabilities.

• Included: Public equities and bonds; private business equity; carried interests; derivatives (net); cash; real estate; alternatives (PE/VC funds, hedge funds); art/collectibles; trusts and foundations where the taxpayer retains beneficial interest or control.

• Excluded: Personal-use household goods under a de minimis threshold; defined-benefit pension rights already taxed at entity level.

• Residency: U.S. citizens and long-term residents; treaty provisions respected.

International context. Only a handful of OECD countries levy recurrent net wealth taxes today; the OECD provides detailed design guidance, which this proposal follows (broad base, low rate, robust reporting). OECDTax Foundation

3) Valuation & Information Reporting

• Publicly traded assets: Daily mark-to-market; end-year valuation for liability, with average-of-quarter option to dampen volatility.

• Private business equity: Safe harbors: (i) last arm’s-length financing valuation, (ii) formula based on EBITDA and industry multiples, or (iii) NAV for investment entities; taxpayers may elect the highest to deter under-valuation.

• Real estate: Assessed using appraisal safe harbors (recent transaction; standardized capitalization rate tables).

• Alternatives, art, and collectibles: Certified appraisals or fund manager NAVs; penalties for lowballing.

• Reporting: Create Form 1099-W ecosystem (brokers, banks, custodians, funds, registries) with automatic information exchange; leverage post-FATCA frameworks and beneficial-ownership registries. OECD

4) Administration, Compliance & Anti-Avoidance

• IRS Wealth Tax Unit: Specialized valuation teams; ≥ 30% audit rate within the covered population during rollout, then risk-based selection.

• Under-valuation penalties: Accuracy-related (20%); gross misstatement (40%); civil fraud (75%).

• Trusts & pass-throughs: Look-through rules to beneficial owners; attribution rules for family/entity webs.

• Cross-border: Matching with CRS/FATCA data; penalties for non-filing; cooperation agreements.

• Expatriation deterrent: An exit tax assessed on net wealth above the threshold for covered expatriates (modeled on prior federal proposals at ~40%), which evidence suggests materially reduces avoidance via migration. Elizabeth Warren's Senate WebsiteEconometrics Laboratory

5) Alternative Legal Framings (If Desired)

While a direct net wealth tax is a straightforward instrument, lawmakers can also consider:

• A billionaires minimum tax pegged to a percent of wealth (e.g., “effective tax = max[regular income/capital-gains tax, 1% of wealth]”), which can be administered through income-tax machinery and reduce constitutional risk.

• A mark-to-market regime for ultra-high-wealth taxpayers’ tradable assets with a deferral charge on non-tradables—approaches debated around Moore and in Senate proposals. Moore left the “realization” question open, preserving congressional flexibility to design such instruments. Supreme CourtPenn Wharton Budget Model

Multiple constitutional analyses (Roosevelt Institute, leading academics) argue a well-drafted federal wealth tax can pass muster; Moore did not foreclose these paths. Roosevelt InstituteGeorgetown Law Scholarship

6) Revenue, Volatility, and Sensitivity

• Baseline: ~$7 trillion × 1% = $70 billion.

• Conservative case A (market −20%): $56–60 billion (depending on base composition).

• Conservative case B (−15% enforcement haircut): ~$59.5 billion.

• Double-stress (−20% markets & −15% haircut): ~$47–51 billion.

Global modeling for the G20 suggests a 2% billionaires minimum tax would raise $200–$250 billion annually worldwide—consistent with the scale implied by U.S. estimates. Gabriel Zucman | Professor of economics

7) Humanitarian Aid Stability Fund (HASF): Guardrails & Governance

• Structure: Treasury account with statutory first-call transfer of $9 billion each FY to USAID/State humanitarian lines (sub-allocations set by Appropriations).

• Stabilizer: Three-year rolling reserve target of $12–18 billion to cover downturns.

• Transparency: Quarterly public reports (collections, fund balance, transfers); GAO audits; Inspector General oversight.

• No crowd-out clause: Wealth-tax funds supplement, not supplant, base humanitarian appropriations.

8) Economic Effects & International Experience

• At 1%, with a narrow base (billionaires only) and modern information reporting, expected distortions are modest. OECD work emphasizes that design (reporting, valuation, base breadth) is the driver of administrative success, not merely the label “wealth tax.” OECD

• Europe’s mixed history reflects high rates and narrow/porous bases; today’s surviving models (e.g., Switzerland, Spain, Norway) show operational feasibility—useful lessons, not templates. Tax Foundation

9) Interactions with Philanthropy & Capital Formation

• Philanthropy: Charitable transfers reduce wealth and thus liability organically—no new deduction needed. To align incentives with the policy’s purpose, Congress may cap a non-refundable credit up to 25% of annual wealth-tax liability for verifiable, arm’s-length contributions to qualified humanitarian organizations; cap prevents wholesale erosion of the base.

• Investment: For founders with illiquid stakes, offer deferral with interest (e.g., AFR+200 bp) secured by liens/escrow; mandatory pre-payment on liquidity events.

10) Implementation Timeline

• Year 0–1 (Setup): Stand-up IRS Wealth Tax Unit; finalize valuation safe harbors; build 1099-W reporting; issue regs and FAQs.

• Year 1 (Assessment): First valuation date at year-end; initial filing due the following Oct. 15 with electronic asset statements.

• Year 2 (Collection): Begin HASF transfers monthly (pro-rated) once collections commence; backstop with a one-time seed transfer from general revenues repayable from first-year receipts.

11) Legislative Outline (Sketch)

1. Definitions & Scope (covered taxpayers; residency; aggregation rules).

2. Tax Imposition & Rate (1% over $1 billion; two-year averaging).

3. Valuation (public mark-to-market; private safe harbors; elections; substantiation).

4. Information Reporting (1099-W; third-party penalties; cross-border exchange).

5. Anti-Avoidance (trust/look-through; related-party rules; GAAR-style catch-all).

6. Expatriation (exit-tax mechanics; security interests).

7. Administration & Enforcement (audits; penalties; interest; appeals).

8. HASF (automatic transfers; reserve mechanics; transparency; no-crowd-out).

9. Sunset/Review Clause (five-year independent evaluation).

12) Risks & Mitigations

• Market volatility: Three-year averaging and HASF reserve smooth revenues.

• Valuation disputes: Safe harbors + third-party reporting + penalty regime.

• Migration/avoidance: Exit tax, look-through rules, FATCA/CRS-style data. Elizabeth Warren's Senate Website

• Litigation: Alternative legal framings (minimum tax / mark-to-market on tradables with deferral charges) offer fallback paths while Moore leaves room for congressional design. Supreme Court

Key Sources (select)

• Billionaires & wealth totals (2025): Forbes; Americans for Tax Fairness analysis of Forbes data (U.S. billionaire wealth >$7 T; ~900 U.S. billionaires). ForbesAmericans For Tax Fairness

• Global revenue scale (2% minimum): Zucman, G20 report (2024). Gabriel Zucman | Professor of economics

• Design/administration: OECD wealth-tax design report. OECD

• Legal landscape: Moore v. United States (2024); Roosevelt Institute constitutional brief; academic commentary. Supreme CourtRoosevelt InstituteGeorgetown Law Scholarship

FINANCING HUMANITARIAN STABILITY: A 1% BILLIONAIRE SURTAX AND THE HUMANITARIAN AID RESERVE FUND. White Paper created with AI.

Executive Summary

This paper proposes a targeted, sustainable financing mechanism to cover the U.S. humanitarian aid shortfall of $9B annually. By combining a 1% surtax on billionaire income with a 1% surtax on billionaire stock gains, revenues would flow into a Humanitarian Aid Reserve Fund (HARF). The fund stabilizes aid flows, guarantees predictable baselines, and creates capacity for extraordinary crisis response.

1. Context and Problem

• Humanitarian aid is underfunded, with a $9B gap in U.S. contributions.

• Volatile appropriations undermine planning and reduce effectiveness.

• Billionaires have seen extraordinary wealth growth: U.S. billionaire wealth totals $5.5T (2024). A small surtax could fill the shortfall without burdening ordinary taxpayers.

2. The Proposed Revenue Mechanism

A. 1% Surtax on Billionaire Income (AGI)

• Applies to taxpayers with net worth > $1B.

• Adds 1% to all taxable income (AGI).

• Revenue: $3–6B/year, based on estimated aggregate billionaire AGI ($300–600B).

B. 1% Surtax on Billionaire Stock Gains

• Public stock: mark-to-market annually using brokerage reporting.

• Private stock: taxed at realization, with interest charge to neutralize deferral.

• Revenue:

• Typical year: ~$4B,

• Boom year: up to $10B,

• Weak year: $0 (covered by reserves).

C. Combined Yield

• Typical year: $7–10B,

• Boom year: $13–16B,

• Weak year: $3–6B.

3. The Humanitarian Aid Reserve Fund (HARF)

Structure

• Receives all surtax receipts.

• Pays out $9B annually as a guaranteed baseline for humanitarian programs.

Rules

• Surpluses: 70% to reserves, 30% to extraordinary crises.

• Shortfalls: reserves fill gaps. If reserves fall below 1 year’s need, surtax rises automatically by +0.25% for up to 2 years.

• Investments: U.S. Treasuries only.

• Oversight: Board of Trustees (USAID, State, CDC + 3 NGOs). Public quarterly reports, GAO audits biennially.

Example Flows

• Normal year ($10B revenue): $9B baseline, $0.7B reserves, $0.3B crises.

• Boom year ($15B revenue): $9B baseline, $4.2B reserves, $1.8B crises.

• Weak year ($5B revenue): $9B baseline, $4B from reserves.

4. Advantages

• Predictable: $9B guaranteed each year regardless of market cycles.

• Fair: Contributions come from billionaires, whose wealth has soared.

• Efficient: Uses existing IRS reporting for income and stocks.

• Legal: Structured as an income surtax (avoids direct tax/wealth tax challenges).

• Flexible: Builds capacity for extraordinary crises without new appropriations.

5. Risks and Mitigation

• Revenue volatility: Addressed by reserves + automatic surtax bump.

• Valuation complexity: Limited to public assets for annual mark-to-market; private taxed at realization.

• Political resistance: Framed as humanitarian solidarity, not redistribution.

• Legal challenge: Narrowly framed as income taxation to withstand scrutiny.

6. Conclusion

The U.S. can secure predictable humanitarian aid funding by tapping a fraction of billionaire income and stock gains. A 1% surtax combined with HARF ensures $9B annually, stabilizes U.S. global leadership, and provides flexibility for future crises.

WHAT EUROPE LEARNED FROM WEALTH TAXES — AND WHAT IT COULD MEAN FOR THE U.S. Research and opinion.

DOGE, Elon Musk’s budget assassination team, gutted decades old humanitarian agencies like U.S. A.I.D. and PEPFAR that saved lives across the world. DOGE and Trumps Big Beautiful Atrocity of a Budget Bill further cut important programs that assisted the vulnerable in the United States. We took a look, with the help of AI, how the wealthiest 1% of Americans could pay a fairer share of taxes to help the funding shortfall. Learning from past experiences in Europe, we see that a wealth tax holds promise in the U.S. if the Congress has the courage to hold the richest to help the poorest.

Spain: from patchwork to “solidarity”

Spain has long had a regional wealth tax (Impuesto sobre el Patrimonio), but several regions—most famously Madrid and Andalusia—granted 100% rebates, creating a patchwork where affluent residents could pay little or nothing. In late 2022, Madrid’s central government layered on a national “Solidarity Tax on Large Fortunes” for net wealth above €3 million, designed to harmonize outcomes and backstop revenues where regions zero-rated the regional tax. Rates are progressive (roughly 1.7%–3.5% over the threshold) and the tax sits on top of the regular wealth tax. BOEAgencia TributariaPwC Tax SummariesTax Foundation

What did it raise? In its first year, Spain said the solidarity levy collected €632 million from about 12,010 taxpayers(≈0.1% of filers). In total, taxes on large fortunes (solidarity + regional wealth tax) brought in more than €1.8 billion in 2023. Policymakers then made the solidarity tax permanent to prevent revenue leakage from regional rebates. Reutersinfobae

Takeaway: Spain shows a workable model when sub-national rebates undermine a national base: introduce a uniform top-up with clear thresholds and keep administration simple by mirroring existing wealth-tax rules. BOE

Sweden: a century of wealth tax, then repeal

Sweden introduced a national wealth tax in 1911 and kept some form of it for nearly a century. Over time, concerns grew about valuation complexity, tax avoidance, and capital flight (especially for owners of closely held firms). In 2007, the center-right government abolished the wealth tax. Academic post-mortems point to low revenue relative to administrative and economic costs and the difficulty of valuing private assets consistently. PikettyIFNEconometrics Laboratory

Takeaway: Sweden’s experience underscores that design details matter: if valuation is onerous and the base is porous, the tax can raise little while nudging high-wealth households toward avoidance or emigration. IFN

Norway: the durable model

Norway still levies a net wealth tax—one of Europe’s oldest (tracing to 1892). The combined municipal + national rate is about 1.1% on wealth above NOK 20 million (≈$1.8–1.9 million), with valuation discounts for certain assets (e.g., closely held shares) and coordinated state/municipal sharing. OECD and independent trackers note that Norway reliably collects meaningful, if modest, revenue from its wealth tax (on the order of ~1% of total tax revenue in recent years). After rate tweaks in 2022–23, Norwegian media reported a spike in wealthy out-migration, highlighting the importance of calibration—but the tax remains in force. Tax Foundation+1Skatteetaten

Takeaway: Norway suggests a pragmatic, durable design: moderate rates, clear valuation rules, and discounts to ease liquidity/valuation frictions for private businesses—all while keeping the base broad enough to matter. Skatteetaten

Lessons across the three

1. Base clarity beats ambition. Spain’s top-up mirrors the existing wealth-tax base; Norway codifies discounts and annual valuation methods; Sweden’s complexity/avoidance sank the policy. BOESkatteetatenIFN

2. Moderate rates + tight administration work better than high rates on a leaky base. Norway’s ~1.1% top rate is politically and administratively durable. Tax Foundation

3. Sub-national coordination matters. Spain’s solidarity levy overcame regional rebates; a U.S. analog would need federal-state coordination. infobae

The U.S. angle: closing aid gaps and shoring up human needs

Right now, U.S. humanitarian funding is under pressure. In August 2025, President Trump blocked $4.9 billion in already-approved foreign aid via a rarely used rescission maneuver, and broader proposals to pare back foreign assistance have circulated—raising near-term risks for global health, food security, and refugee support. Federal News NetworkThe White HouseThe Washington PostThe Wall Street Journal

A U.S. wealth-tax option—built to Norway/Spain specifications—could help:

• Who pays? Top 1% by net wealth (or a narrower “UHNW” tier).

• Rate & base (illustrative): 1% on net wealth above $50 million, with public assets marked to market each year and private assets taxed at realization with an interest charge (a “deferral charge”)—the same liquidity/valuation playbook seen in Norway’s discounts and Spain’s mirroring approach. SkatteetatenBOE

• Administration: Expanded third-party reporting for brokers and custodians; safe-harbor valuation for closely held firms; elective installment plans for illiquid cases—again, echoing Norway’s practicality. Skatteetaten

How much could it raise? The U.S. now has a record ~902 billionaires (Forbes, March 2025). Even a narrow billionaire-only levy at ~1% of net wealth could generate tens of billions per year; broadening the base to the top 1%would raise more. (For context, Spain’s wealth/solidarity taxes together raised ~€1.8 billion in 2023 from a far smaller high-wealth population.) ForbesReuters

Where it would go

Create a federal Humanitarian & Community Resilience Fund to channel receipts into:

• International humanitarian aid: stabilize a recurring $9 billion floor for food aid, health, and refugee response—insulated from rescissions. Federal News Network

• Domestic “humanitarian” programs: targeted grants for K-12 in low-income districts, nutrition (WIC/SNAP complements), and community health clinics, with transparent, formula-based allocations and independent audits.

Why this version is more likely to work

• Design learns from Europe: adopt moderate rates, clear valuation, and liquidity relief, avoiding Sweden’s pitfalls. IFN

• Stability by statute: dedicate funds to a trust-style account so short-term politics can’t raid them—an answer to the 2025 aid freeze episode. Federal News Network

Bottom line

Spain shows how to harmonize and backstop wealth-tax revenue; Norway shows how to keep it durable; Sweden shows what happens when complexity and leakage overwhelm the base. A U.S. version that borrows the Norway/Spainplaybook—moderate rate, clear valuation, liquidity protections, and earmarked uses—could reliably backfill humanitarian aid cutbacks and supplement domestic education, food, and health programs without leaning on annual budget brinkmanship. Tax FoundationBOEFederal News Network

THE MAN WHO SAW THE FUTURE OF AFRICA. Essay by Howard French in NY Times

Not long after John F. Kennedy was inaugurated as president, he received his first visit from a foreign leader. He had chosen Kwame Nkrumah, Ghana’s first president. By today’s standards, in which Africa seems to sit on the far margins of world affairs, the selection is practically unimaginable.

But even as a senator, Mr. Kennedy had begun to see Africa — with its enormous landmass, newly independent countries and young population — as a continent full of promise. By one count, during his presidential campaign speeches in 1960 he mentioned Africa 479 times. As president, he was keen to compete for influence there with the Soviet Union and even side with anticolonialism, courting tension with America’s European allies.

Until Mr. Kennedy’s assassination, Mr. Nkrumah remained the American president’s most important African interlocutor, a fact that reflects both the Ghanaian leader’s charisma and the tremendous prestige he had earned on the continent by peacefully leading his country to independence from colonial rule in 1957. Driven by his belief in Pan-Africanism, Mr. Nkrumah worked tirelessly to overcome the Balkanizing impact of colonial rule across Africa.

As the world’s powers turn away from the continent, it’s a vision that may hold the key to realizing Africa’s potential today.

The United States did not withdraw from Africa after Mr. Kennedy’s death, but the continent was sharply downgraded in the hierarchy of Washington’s interests. America’s involvement quickly narrowed to a policy of near-zero-sum competition with Moscow, in which each superpower forged alliances with the aim of restraining the influence of the other. Most of these involved military relationships and limited financial support to dictatorships of one kind or another, with little regard for democracy, governance or long-term economic development.

Since the end of the Cold War and the dissolution of the Soviet empire, American engagement with Africa has declined sharply and become largely limited to humanitarian assistance. Under President Trump, even this is now in doubt, with the virtual elimination of the United States Agency for International Development and apparent plans to end support for PEPFAR, a program created by George W. Bush that has had remarkable success in combating H.I.V. in Africa.

This summer, a new nadir was reached when news outlets reportedthat the White House was considering restricting entry to the United States from 25 African countries, in addition to the seven that were covered in a ban announced in June. And even as Washington raises barriers to immigration from Africa, it has begun to explore ways of using the continent as a dumping ground not only for Africans deported from the United States but also for people from other continents.

It is tempting to see the United States as a complete outlier, but its withdrawal from Africa reflects broader developments in the world. Europe’s involvement with the continent has also declined. This is attested to by France’s retreat from a large swath of West Africa in the Sahel, after years of failed efforts to defeat a variety of Islamic insurgencies. Today the biggest African concern of the former colonizing powers — as well as of the European Union generally — is preventing growing migration from the continent.

Even China, after more than two decades of a determined push to expand political and economic ties to Africa, has put on the brakes and started to focus elsewhere. After expanding rapidly from a tiny base, Chinese economic involvement with Africa has plateaued, as Beijing has quietly reassessed the difficulties of realizing profits on the continent. Chinese lending to Africa peaked in 2016, with its investment there now relatively flat.

In light of trends like these, Mr. Nkrumah’s logic about how Africa should engage the outside world appears remarkably sound. His determined nonalignment was based on more than the principled belief that African countries should be free to pursue their interests with whichever partners they wished. He was leery of the proposition that any foreign partner — even a United States led by Mr. Kennedy — would commit to Africa’s development in the long term. He believed that this was, above all, the duty of Africans.

At the time, Mr. Nkrumah was opposed and derided by some fellow African leaders for what they saw as his unrealistic dream of merging dozens of newly formed countries to form a continental government, perhaps with him at the helm. His ideas were more subtle, though, and his tactical vision more patient than he was given credit for in his day.

As long as the continent was composed of its legacy jigsaw countries, most of them small in size and population — and many of them landlocked, condemning them to additional poverty and instability — they would remain underdeveloped. The small size of their markets would make it all but impossible to industrialize or to sustain engagement with the outside world on favorable terms. This implies more than the kind of naked extraction of fossil fuels and minerals that is commonplace now and a shift to local transformation of the continent’s resources and commodities.

The Ghanaian leader saw this move toward larger units, both economically and politically, as a matter of successive voluntary steps — with states joining to integrate their markets and road and rail networks, then perhaps merging at the subregional level before any eventual attempt to form a nation that would encompass, say, all of West, East or Southern Africa. If it were ever to come about, a continental union lay in a distant future.

One surprising source for this vision was the Federalist Papers. While he was a college and graduate school student in Pennsylvania in the 1930s and ’40s, Mr. Nkrumah became deeply familiar with the history of how a group of small colonies bound themselves together to forge an independent, federal country that became much richer and stronger than the sum of its parts. This was the future he saw for his continent, as he explained to his peers at the founding summit of the Organization of African Unity, held in Addis Ababa, Ethiopia, in 1963.

Mr. Nkrumah’s fellow leaders rejected his idea. But the continent’s subsequent history — six decades of deprivation, poverty and corruption — has laid bare the costs of having a plethora of small countries that largely turn their backs to one another. In the absence of collaboration, they remain poor and condemned to engage as weaklings with the outside world.

In demographic terms, Mr. Kennedy was right that Africa is the continent of the future. Its population will more than double before 2070 and by the end of this century could be larger than India’s and China’s combined. It is up to Africans to unlock their economic future, matching that population growth with development.

With no one in the world serving up favors to the continent, Mr. Nkrumah’s insight about the gains to be had through federation is as salient as ever. What is lacking is sufficient action. The time has come for a continent cut loose in the world to take the next step.

U.S. AID CUTS ARE STARVING AFRICAN CHILDREN. Apoorva Mandavilli reports for The NY Times.

Original article edited for brevity.

A $45 treatment can keep a child alive.

Starvation in Gaza has brought intense international attention to the horrors of famine, but less attention has been paid to a wider issue: the dismantling of U.S.A.I.D. has worsened the problem of severe hunger and malnutrition throughout the world.

Saving children with severe acute malnutrition is simple and inexpensive. Each packet costs less than 30 cents, but contains a high-calorie mix of peanuts, sugar, milk powder and oil — flavors appealing to children — and a blend of vitamins and minerals. A complete six-week treatment for a severely malnourished child runs to less than $45.

U.S.A.I.D. funded roughly half the world’s supply of ready-to-use therapeutic food, or R.U.T.F., purchasing some directly from American manufacturers and funding the United Nations Children Fund, or UNICEF, to manage its distribution.

All those grants were abruptly halted when the Trump administration froze foreign aid earlier this year. U.S.A.I.D. eventually reimbursed grantees for costs already incurred. The State Department authorized a $93 million new grant to UNICEF last week, but it is less than half what the government had typically spent. In 2024, the agency spent about $200 million on this work, not including aid for countries and direct grants to organizations that implement programs.

Funds for 2025 have yet to be released to manufacturers, the World Food Programme — which distributes a similar product for moderate acute malnutrition — those who transport the products or the many organizations, like the International Rescue Committee, or Helen Keller International, that run the malnutrition programs.

In response to questions from the Times, the State Department emailed a statement asserting that lifesaving malnutrition programs “remain a priority.”

“Malnutrition treatment is among the first new obligations of foreign assistance funding,” the statement said.

But it also said that “other actors — including national governments and international humanitarian organizations — must step up.”

President Trump has made the same argument for many aid programs, saying the United States should not have to carry the bulk of the burden of caring for the world. Though other countries do already contribute, and some organizations are scrambling to fill the gap, it is unlikely that they can do so quickly enough to help the children who are now in need.

Before the sudden withdrawal of aid, “things were absolutely moving in the right direction,” said James Sussman, a spokesman for the International Rescue Committee.

Now, boxes containing millions of dollars worth of the lifesaving packets are stuck at every link in the supply chain: in manufacturers’ warehouses, at shipping companies, in cities that received the shipments and in treatment centers that have shut down all over the world.

In nearly a dozen countries, the supply chain for the packets has become so unstable that thousands of children are at high risk of dying, according to organizations that help distribute the treatments. Tens of thousands more could be in danger in the coming weeks and months if funds for this year do not move quickly.

“We have seen the mortality rates in the hospitals increasing by the day,” said Aliyu Mohammed Jabo, Helen Keller International’s director for Nigeria. “This is the ugly situation that we are facing because of this funding cut.”

In Nigeria, 150 clinics operated by the World Food Programme in Borno and Yobe states, which provided treatment for more than 300,000 children below the age of 2, shut down at the end of July. In Bauchi state, Helen Keller International has had to stop treating malnutrition in 16 of its 17 centers, leaving more than 17,000 children without treatment.

In eastern Chad, Mali and Niger, malnutrition treatments are unavailable or in dangerously short supply. Clinics in northeast Syria, Burkina Faso and Kenya have closed down. In South Sudan, the International Rescue Committee estimates that it will have to close 62 static treatment sites and nine mobile clinics if funding is not restored by September.

In Afghanistan, I.R.C. warehouses are bare, despite 900,000 children who are in desperate need of treatment for severe acute malnutrition. Nepal has no supply in about half of its provinces, and is facing a nationwide shortage starting this month, endangering about 200,000 malnourished children, including about 25,000 who are at risk of death.

Several other countries, including the Democratic Republic of Congo, Ethiopia and Madagascar, similarly have only enough products to treat children for a few more weeks or months.

Several organizations, including Doctors Without Borders and the aid group Action Against Hunger, have reported deaths in children related to malnutrition. More timely and precise estimates of deaths are difficult, because many of the programs that track children in need have shut down, and most organizations dare not speak up against the administration, fearing retaliation.

“No one’s counting these children,” said Jeanette Bailey, director of Nutrition for the International Rescue Committee, among the largest of groups implementing the treatments.

“With pretty strong certainty, we know children are dying,” she added. But, “we don’t know how many.”

One global study has estimated that more than 160,000 childrenmight die each year if the funds are not restored.

Read complete article in NY Times.