AFRICA TO BUILD VACCINE PRODUCTION FOR 70 MILLION SHOTS. Devex Newswire

Africa is partnering with a slew of global organizations to bolster ownership of its healthcare, especially when it comes to vaccines. The partnerships are highly technical and hugely consequential.

For example, Gavi, the Vaccine Alliance wants to inject $189 million into Africa’s vaccine production ecosystem. The proposal aims to strengthen Africa’s regulatory network and make it easier for governments to buy vaccines, guaranteeing direct sales for up to 70 million vaccines made on the continent.

On the vaccine side, governments would go through Gavi’s standard cofinancing model. Eligible lower-income countries contribute directly toward the cost of their vaccines, starting at a flat rate of $0.20 per dose and rising with national income.

That money would be “only spendable on African-made products, representing a win-win by filling a public health need and securing assured demand,” a Gavi spokesperson says.

Meanwhile, the regulatory side would focus on streamlining vaccine approvals and procurement across the continent. “The African vaccine manufacturing sector is still so fragile and fragmented,” says Petro Terblanche, CEO of Afrigen Biologics. “If we can work on one dossier for 10 countries, and not 10 dossiers for 10 countries, that’s important.”

That’s also a prime objective of the African Medicines Agency, or AMA, which entered into force in 2021 to harmonize the regulation of medical products across the African Union’s member states.

In addition to the Gavi initiative, the Gates Foundation is also looking to beef up the fledgling agency by investing in it, as well as ensuring there are strong national regulators, which will be coordinated at the continental level by AMA.

Currently, regulatory systems in Africa are balkanized and manufacturers have to register products in each country. This means a lengthy, expensive process that can discourage companies from entering certain markets.

AMA is expected to address these challenges by introducing joint assessments, single inspections, and issuing opinions to guide countries.

A mature and effective AMA “allows Africa to take its own health and its own future into its own hands,” says David Mukanga, deputy director of Africa regulatory systems at the Gates Foundation.

BEHIND TRUMP’S APPARENT ANIMUS TOWARD AFRICA: THE DOSSIER ON STEPHEN MILLER. AI report for The Caring World.

We’ve moved from comments like “Shit hole countries,” to blocking immigration from most African countries, to cutting humanitarian and develop aid from U.S. to Africa, to holding any aid hostage for access to African resources of rare minerals. What happened to the vision of JFK and George W Bush? It could be the man writing Trump’s national strategy and policy for “America First.”

There is substantial evidence that Stephen Miller was an influential architect of the Trump administration's broader "America First" agenda that resulted in the dismantling of much of USAID and the cancellation of most U.S. foreign-assistance programs in 2025. However, unlike immigration policy, Miller was rarely the public spokesperson on aid issues. The public record ties him more strongly to the ideology behind the cuts than to specific aid decisions.

Dossier: Stephen Miller, Foreign Aid Cuts, and Africa

Executive Summary

There is substantial evidence that Stephen Miller was an influential architect of the Trump administration's broader "America First" agenda that resulted in the dismantling of much of USAID and the cancellation of most U.S. foreign-assistance programs in 2025. However, unlike immigration policy, Miller was rarely the public spokesperson on aid issues. The public record ties him more strongly to the ideology behind the cuts than to specific aid decisions.

The strongest documented case against Miller is therefore:

• He helped shape the administration's nationalist, anti-globalist policy framework.

• That framework contributed to the termination of over 90% of USAID programs.

• Congressional critics argued the cuts would have severe consequences for Africa, particularly HIV/AIDS treatment, maternal health, food security, and humanitarian relief.

• Members of Congress who had previously accused Miller of promoting white-nationalist ideas viewed these aid cuts as part of the same ideological worldview.

Miller's Ideological Influence

Miller's public career has consistently centered on several themes:

• reducing immigration,

• limiting international commitments,

• prioritizing domestic spending over foreign aid,

• advancing "America First" nationalism.

The administration's January 2025 foreign-aid freeze explicitly directed USAID personnel to align assistance programs with the President's "America First" vision. Reuters reported that USAID employees were told they had a responsibility to help transform foreign assistance in accordance with that agenda.

Although official announcements were typically issued through figures such as Secretary of State Marco Rubio and other administration officials, many observers viewed Miller as one of the principal strategists behind the broader policy direction.

Scale of the Cuts

According to House Foreign Affairs Committee Democrats:

• More than 90% of USAID programs were terminated.

• Thousands of humanitarian and development projects were cancelled.

• Congress was not consulted before many of the decisions were implemented.

Subsequent reporting found:

• Over 5,300 USAID grants and contracts were terminated.

• Programs addressing HIV/AIDS, tuberculosis, vaccines, and public health were among those affected.

• Congressional Democrats challenged the legality of the reductions.

Impact on Africa

Africa was among the regions most dependent on USAID and PEPFAR-supported programs.

Congressional critics specifically warned that the aid freeze and cancellations would:

• interrupt HIV treatment,

• reduce maternal and newborn health services,

• disrupt food assistance,

• weaken disease surveillance,

• increase instability in fragile states.

Representative Sara Jacobs, Ranking Member of the Africa Subcommittee, warned that the freeze had already prevented access to anti-retroviral medications intended to stop mother-to-child HIV transmission.

Reporting from Uganda, South Sudan, and Malawi described:

• HIV patients losing access to treatment,

• education programs shutting down,

• food-aid delays,

• worsening cholera and public-health risks.

Congressional Criticism

Gregory Meeks

Gregory Meeks became one of the administration's most vocal critics.

He argued that the aid cancellations would:

"mean that people will unnecessarily die preventable deaths"

and warned that infectious diseases, instability, and humanitarian crises would worsen as a result.

He later accused the administration of "chaotically" gutting USAID and withdrawing America from global leadership.

Sara Jacobs

Representative Sara Jacobs repeatedly emphasized Africa-specific consequences and joined efforts to investigate the impacts of dismantling USAID.

House Appropriations Democrats

Members of the House Appropriations Committee accused the administration of:

• firing thousands of staff,

• halting humanitarian programs,

• dismantling agencies,

• acting without congressional consultation.

Did Critics Connect Aid Cuts to White Nationalism?

This is where the evidence becomes more indirect.

Members of Congress have explicitly accused Miller of promoting ideas associated with white nationalism and white supremacy in the immigration context. Those accusations stem from leaked emails, immigration policies, and demographic rhetoric.

However, congressional statements about Africa aid generally did not say:

"Stephen Miller cut aid because he dislikes Africans."

That claim is not supported by the available record.

Instead, critics tended to argue that:

1. Miller promoted an exclusionary nationalist worldview.

2. That worldview opposed immigration and international engagement.

3. The same worldview drove the dismantling of foreign-aid programs.

4. The consequences fell heavily on African countries.

That is a stronger and more defensible argument than claiming direct anti-African intent.

Republican criticism of Miller

Traditional Republican immigration reformers

During the 2013–2018 period, Republicans who supported immigration reform often viewed Miller as a major obstacle.

For example, Miller worked closely with Senator Jeff Sessions to defeat the bipartisan "Gang of Eight" immigration bill. Republicans who favored legal immigration expansion, guest-worker programs, or comprehensive reform frequently accused Miller of pursuing an overly restrictive agenda.

Business-oriented Republicans, particularly those aligned with the former U.S. Chamber of Commerce position on immigration, often opposed Miller's approach because they believed immigration was economically beneficial.

Republican senators questioning Miller

More recently, some Republican lawmakers have criticized Miller's conduct and judgment.

In early 2026, Senator Thom Tillis said he had "no confidence" in Miller following controversy surrounding Miller's public comments about a federal law-enforcement shooting. Other Republicans declined to defend Miller publicly.

That criticism was directed at Miller's handling of a specific incident rather than his immigration philosophy.

Internal Republican friction

Journalists and former congressional staffers have reported longstanding tensions between Miller and portions of the Republican establishment. Miller has often been viewed as a disruptive ideological operator who pushed the party away from the more immigration-friendly positions common during the administrations of George W. Bush and figures such as John McCain and Marco Rubio. While anecdotal reports should be treated cautiously, accounts of friction between Miller and establishment Republicans have been common for years.

Does Miller represent Republican voters?

This is where the evidence becomes interesting.

On immigration restriction: largely yes

Polling consistently shows Republican voters have moved sharply toward Miller's position on immigration.

Gallup found Republicans are much more likely than Democrats to support:

• increased border enforcement,

• expanded border barriers,

• deportation of unauthorized immigrants,

• restrictions on asylum claims.

A large share of Republican voters also favor reducing immigration levels overall.

Other polling has found immigration has become one of the most important issues for Republican voters, with many identifying it as a top or even single-issue concern.

On border security and immigration enforcement, Miller's views are therefore much closer to the GOP base than they were in the early 2010s.

On "America First" nationalism: largely yes

The broader themes Miller promotes—national sovereignty, skepticism of globalization, opposition to mass immigration, and prioritizing domestic concerns over foreign commitments—have become mainstream within the Trump-era Republican coalition.

This helps explain why Miller's influence has grown rather than diminished.

Where Miller may be more extreme than the average Republican voter

There is less evidence that average Republican voters fully share some of the more controversial ideas associated with Miller.

For example:

• explicit demographic-replacement rhetoric,

• references that critics connect to "white replacement" theories,

• interest in immigration restrictions tied to cultural or ethnic change rather than border control,

• arguments for drastically reducing legal immigration.

The available polling generally shows Republicans are much more concerned about illegal immigration than about legal immigration. Support drops when proposals affect immigrants broadly rather than focusing on unauthorized migration.

On foreign aid and Africa

This is actually the area where Miller may be furthest from the median Republican voter.

Republican voters have become more skeptical of foreign aid overall, especially aid perceived as unrelated to U.S. interests. However, polling often finds greater support for specific humanitarian programs than for "foreign aid" as an abstract category.

For example, programs involving:

• HIV/AIDS treatment,

• famine relief,

• disaster response,

• anti-malaria efforts,

often receive substantially more bipartisan support when voters are told what the programs actually do.

That means there is stronger evidence that Miller's hard-line immigration views reflect today's GOP base than there is evidence that the average Republican voter supports dismantling large humanitarian programs in Africa.

Bottom line

The historical picture is somewhat paradoxical:

• In the early 2010s, Stephen Miller was well to the right of many Republican leaders on immigration.

• By the mid-2020s, much of the Republican electorate had moved toward Miller's immigration position.

• Republican criticism of Miller today tends to focus on his methods, rhetoric, or personal conduct rather than opposition to his core immigration agenda.

• His views on sharply reducing immigration appear broadly aligned with much of the GOP base.

• His role in dismantling foreign-aid programs, particularly those affecting Africa, is less clearly supported by public opinion among Republican voters, because polling on humanitarian aid is more nuanced and often more favorable than broad "foreign aid" questions suggest.

FOR FURTHER INSIGHT TO MILLER, SEE https://www.thecaringworld.com/news/the-cruel-world-according-to-stephen-miller

THE KEY TO STOPPING HIV TRANSMISSION IN AFRICA IS, GUESS WHAT?, MONEY. Devex newsletter.

Gilead knew it had a blockbuster on its hands as soon as the results came back in 2024, showing that lenacapavir, a twice-yearly injectable, had been 100% effective in preventing HIV infections during a study among thousands of women in Uganda and South Africa.

The pharmaceutical company also “knew it would put on everyone responsibility, including politically, massive calls for access in the countries where you have high incidence,” Michel Joly, Gilead’s vice-president of global patient solutions, explained at a Devex Impact House panel this week.

After an unprecedented push by communities, governments, activists, and Gilead, lenacapavir is now available in 10 African countries. And Dr. Neil Buddy Shah, the CEO of Clinton Health Access Initiative, says the demand has been as high as everyone anticipated.

“We’re seeing oversubscription from key populations and more generally,” he tells me on the sidelines of WHA. “All of this is very, very promising in terms of, we’ve got the product, we’ve got the demand, and we’re figuring out the delivery channels.”

According to a CHAI flash market report out last week, in the eight countries that had introduced lenacapavir by April, more than 11,000 people had been initiated on the drug.

That’s still far short of the kinds of numbers everyone involved in the rollout hopes to reach. But ongoing hurdles, including funding and building program infrastructure to ensure people will continue to receive injections, could limit its uptake, Mitchell Warren, AVAC’s executive director, said.

Rhoda Igweta of the Elizabeth Glaser Pediatric AIDS Foundation raised another challenge during the Devex Impact House session: Cuts in U.S. funding for the global AIDS response led to the firing of thousands of health workers. But those health workers are crucial to providing lenacapavir, which must be administered in a clinical setting.

“We need to make good on the promise of a product that can prevent infections in everyone at risk everywhere in the world,” Warren said during the same session. “That will require us to dig deep financially, dig deep programmatically.”

For Shah, “the question now really is mobilizing the resources to scale it up.” Despite this initial success and efforts by CHAI and others to bring generic versions of lenacapavir online by early 2027, there’s no guarantee the funds will be there to ensure the drug reaches everyone who could benefit from it. But with actual subscriber numbers now available, Shah said it’s time “to start to have that conversation about the whole next phase and what it will look like to fully close the gap in terms of funding.”

THIS IS WHAT HAPPENED WHEN TRUMP ABANDONED THE WORLD’S POOREST CHILDREN. Nicholas Kristof for The NY Times.

A year after some of the world’s richest men cut aid for the world’s poorest children, they’re trying to roll out a new public relations narrative:

Aid continues! We’re saving lives from AIDS! Anyway, aid never really worked, so we’re focused on trade! Building opportunities for American companies while saving babies!

As Jeremy Lewin, the acting under secretary of state for foreign assistance, put it: “Contrary to false media narratives, the data shows that President Trump’s foreign assistance review maintained and improved frontline lifesaving programs, while reducing NGO bloat and costs.”

“False media narratives” may refer to my reporting from a seriesof African countries on children dying as a result of the Trump cuts.

Let’s first concede a few points. American humanitarian aid was never great at nurturing economic growth, but it did save one life every 10 seconds until last year. It’s also true that public pressure led the administration and Congress to retain some lifesaving programs, particularly for H.I.V./AIDS, and to its credit the administration has expanded use of a drug called lenacapavir to fight AIDS. Finally, the Trump administration is right that trade is crucial, which is why President Bill Clinton started a fine trade program with Africa; unfortunately, it expires this year, and its long-term future under Trump is in doubt.

None of this changes the fact that this glossy new Trump narrative is absurd. Trump’s most lethal policy will almost surely be his 71 percent cut in humanitarian aid from 2024 to 2025. A Boston University researcher estimated that the aid cuts cost more than 750,000 lives worldwide in their first year. A recently published study in The Lancet, the British medical journal, forecast that at present rates the defunding will cost 9.4 million lives by 2030, including 2.5 million children under the age of 5.

Are these figures correct? Exaggerated? I can’t be sure, and neither can Trump or anyone else, partly because the administration has cut data collection that might help us assess mortality accurately.

Meanwhile, Trump and his aides continue to take steps that will add to the toll.

The administration is now withholding aid for vaccines for poor countries in ways that may cost the lives of vast numbers of children. Trump slashed funding for an international vaccine alliance called Gavi, and now the administration is also refusing to release $600 million for Gavi that Congress has already appropriated and that must be spent by September.

Gavi is one of the most cost-effective aid programs in history. One study found that each dollar spent on vaccines in poor countries brings a return of $54 in reduced health costs and other benefits. I was once hospitalized with a serious case of malaria that I caught in the Democratic Republic of Congo, and I think it’s a miracle that a few doses of a $3 malaria vaccine can now save a Congolese child’s life — and a scandal that administration officials are willing to let such children die because of ideological hostility toward vaccines.

Gavi also pays for HPV vaccines that prevent cervical cancer, which kills more than 900 women every day worldwide. Cervical cancer is an excruciating, humiliating way to die — it is sometimes diagnosed partly by the odor of rotting flesh — yet a $4 vaccine can prevent it. Gavi’s vaccinations have already averted almost one million of these horrific deaths from cervical cancer.

Trump’s cuts have created a budget crisis for Gavi and other aid agencies. It has been magnified because European countries followed America’s lead with cuts to their own aid budgets. Gavi estimates that 600,000 lives will be unnecessarily lost by 2030 as a result. Think of your mother, wife, daughter; multiply by 600,000, and you glimpse the cost of Trump’s destruction of just the Gavi element of American aid.

The Trump administration is also, unintentionally, exacerbating global poverty with its catastrophic war with Iran, and not just because the war has displaced more than 2.2 million women and girls in Iran and Lebanon. Because of the war, diesel prices have risen 160 percent in Myanmar and 87 percent in Nigeria, while 40 percent of gas stations have closed in Laos, according to the United Nations. Rising fuel prices are increasing costs of transportation and thus food.

The upshot is that if the Gulf crisis doesn’t end by next month, an additional 45 million people worldwide are likely to suffer severe hunger in the latter part of this year, according to Cindy McCain of the U.N World Food Program.

An even bigger impact may come, after a delay, from shortages of fertilizer, often made with oil and gas byproducts from the Persian Gulf. Perhaps one-third of the world’s fertilizer production will be disrupted if the Strait of Hormuz remains closed, and shortages will most likely mean lower crop yields, higher food prices and more starvation. José Andrés of World Central Kitchen has warned that fertilizer shortages could lead to a multiyear famine beginning as early as the end of this year.

Think of it this way: Artificial fertilizers keep roughly half of humans alive. Without them, the earth would be able to produce enough food to support only about 4 billion people.

Even as the Trump administration has created this crisis, it has unraveled some of the global health systems that would normally save lives of starving children. And Trump administration proclamations of “trade over aid” sound empowering until you realize that what they mean in practice is that America is talking about withholding lifesaving medicines from villagers in Zambia unless the Zambian government sells more minerals to American companies.

A new book, “Into the Wood Chipper,” recounts the reckless way in which DOGE officials dismantled the United States Agency for International Development. Written by Nicholas Enrich, a former top health official at the agency, it chronicles the “callousness, dishonesty and ineptitude” of Trump aides who destroyed programs that they didn’t understand.

“I had no idea you did all this,” Enrich quotes one of the newly arrived officials saying. “As a Republican, when I think of what U.S.A.I.D. does in global health, I assumed it was just, you know, abortions.” (In fact, no American aid dollars went to abortions.)

Please excuse my intemperate tone. But in my travels over the last year, I’ve seen children dying because of our aid cuts. This doesn’t feel like policymaking so much as vandalism, accompanied by wasted food, ruined contraceptives and an estimated $6.4 billion spent closing down the United States Agency for International Development (that sum alone could have saved more than one million children’s lives).

Actually, for all my harsh words, Trump is talking about providing emergency financial support for one nation. That’s the United Arab Emirates, which is pinched by the Iran war and may get a lifeline from Washington to support its currency.

So we’re ready to support a country that is roughly as rich as Britain and France and is fueling the world’s worst humanitarian crisis, in Sudan, by arming a militia committing mass murder and mass rape? Could one factor be that high-level Emiratis have approved investments of half a billion dollars in a Trump family crypto company?

Forget the efforts to dress this show up. The truth is ugly: The world’s richest men are crushing the world’s poorest children.

‘THE DEATH ZONE’: HOW RUSSIA IS LURING AFRICANS TO UKRAINE. By Matthew Mpoke Bigg, John Eligon and Zimasa Matiwane for NY Times. Photograph by Ed Ram

James Kamau Ndungu told only a few friends that he was heading to Russia. He told them he had been promised a job as a day laborer there. He was 32, unemployed in Kenya and needed the work.

Last June, Mr. Kamau sent a photo to his friends from Istanbul Airport, saying he was in transit, one of the friends said. A few weeks later, he sent another photo. This time, he was wearing fatigues and holding a gun. In August, he wrote to say that he was in a trench in Ukraine. Things were bad. He asked for prayers.

It was the last anyone in Kenya heard from him.

A growing number of Africans are ending up on the front lines of Russia’s war with Ukraine. Some go there willingly as mercenaries, but many more are like Mr. Kamau, young men lured by the promise of ordinary civilian jobs — from bodyguards to line cooks — only to be forced into joining Russian forces in battle.

A string of fly-by-night companies have been set up across the continent to recruit the men. The companies often appear as travel agencies or job placement firms and advertise on WhatsApp or Telegram.

The New York Times interviewed several victims and recruiters. The interviews suggest that the recruiters do not work directly with the Defense Ministry in Moscow. Contracts seen by The Times were in Russian, meaning the Africans could not read them.

Formal jobs in Africa are scarce, making the promise of work overseas a powerful magnet. And Africa has the fastest growing youth population on the planet. Many young people are unemployed, making the continent a prime target for the false recruitment of unwitting soldiers.

“Why has Russia taken my son?” Hannah Wambui Kamau wailed as she collapsed into the arms of relatives at Mr. Kamau’s memorial on a muddy hillside outside Nairobi in March.

It is unclear how many men have been falsely recruited from Africa, though the authorities in at least nine countries have reported cases. And in Kenya, the National Intelligence Service found that around 1,000 Kenyans had gone to Russia and ended up in Ukraine so far. Only 30 of them have returned alive. To curb the number of men being caught in the dragnet, the government said it had bolstered checks on young men leaving the country on international flights.

Okoiti Andrew Omtatah, a senator in Kenya, used a metaphor to describe the desperation created by the jobs crisis across Africa. “If a slave ship docked today in Mombasa with a banner saying, ‘Slaves required in the West,’” he said, referring to the coastal city in Kenya, “you would not have space on that ship.”

Russia’s foreign minister, Sergey V. Lavrov, acknowledged in March that foreigners were participating in what Moscow calls its special military operation in Ukraine but said that the government does not hire or recruit people to fight against their will. “Volunteers get there in full compliance with Russian legislation,” he said in Moscow at a news conference.

Asked whether any Africans had gone to Russia on the basis of a promise of civilian work only to find themselves pressed into military service, the Kremlin spokesman, Dmitri S. Peskov, told The Times last week through his press service, “We are unaware of any such cases.”

Ukraine’s ambassador to South Africa, Olexander Scherba, accused Russia of taking advantage of young Africans looking for work. “I’m just amazed at how devious and how inhumane and imperialist people can be toward Africans who just need money,” he said.

Kenya, Tanzania, Zambia, South Africa, Nigeria, Ghana, Togo, Botswana and Mali have all reported men being falsely recruited into the Russian Army. Prosecutors in Kenya charged a man in February with recruiting 22 Kenyans to Russia. The same month, President Cyril Ramaphosa of South Africa spoke by telephone with President Vladimir V. Putin of Russia about the recruitment of South Africans. A week later, 17 South Africans returned home from the front lines. Prosecutors are investigating a South African politician’s involvement in misleading the men.

Vincent Odhiambo Awiti said he was recruited last year by an agent he met on the street in central Nairobi, Kenya’s capital. The man told him he worked for the Global Faces Human Resources Agency and promised Mr. Awiti a job in a shop in Russia. He paid for him and four other men to fly to St. Petersburg on July 14, Mr. Awiti said.

“We ended up buying the idea because I didn’t have anything else to do,” he said. “We thought that it was a great opportunity.”

Mr. Awiti said he and the others were told to sign a contract to join the Russian military when they arrived. At first they refused, he said, but then he said they were told the only way to return to Kenya was to repay what had been spent to get them to Russia. None of the men had the money. They all signed the contract, he said.

The group was sent by train for four days of military training in a camp near the town of Shebekino, close to the frontline south of Belgorod, Russia, Mr. Awiti said. He encountered an Egyptian recruit there who told him that he and the others were “dead men walking.”

Mr. Awiti said he was sent into battle near the city of Vovchansk in Ukraine’s Kharkiv Province, the site of significant fighting last summer. His squad was instructed to cross two small rivers and a patch of open ground to get to a trench. His squad commander was killed before they reached the first river, he said.

“His head left his body,” Mr. Awiti recalled. “They call it the death zone.”

By the time he reached the second river, he said he was virtually alone. Unburied corpses littered the battlefield, and the dead floated on the river “like waterlilies.”

When he got to the trench, it reeked of death. The Russian soldiers who had taken shelter there beat him for abandoning his gun at one of the rivers. He was given another gun, and for the next 20 days he was forced to shoot at an unseen enemy, he said. He showed The Times photographs of what he said were maggots that infested his wounds.

Mr. Awiti said he escaped with a Russian deserter who shot himself in the leg so he could be designated an invalid. He said he watched in horror as the Russian closed his eyes, aimed at the fleshy part of his lower leg and pulled the trigger twice.

Mr. Awiti said he was treated in Belgorod for wounds to his hand and hip from a drone attack and then shipped to a military hospital in Moscow. Doctors told him he would be sent back to the front once he recuperated, but he managed to get to the Kenyan Embassy and was put on a plane back to Nairobi. The embassy in Moscow did not reply to a request for comment.

Mr. Awiti is now jobless, penniless, wounded and badly traumatized. “Better you be here. Here you have a lot of freedom,” he said, reflecting on his experience. “I was fighting for Russia. I was wearing a Russian uniform. But the fight was not mine.”

At least 25,000 Russians were lost to death or injury every month last year during the war, studies show. The country has responded by enlisting conscripts from prisons, providing cash incentives and instituting an unpopular draft. But with such a staggering attrition rate, still more bodies are needed.

Advertisements for Russian military service have flooded African social media over the past year, some promising monthly salaries of up to $3,000, lump-sum payments of $18,000 and even Russian citizenship after six months of service. Middlemen looking to cash in have turned these calls for Russian military service into business opportunities.

St. Fortunes Travels and Logistics is a travel agency owned by Fortune Chimene Amaewhule, a Nigerian. Mr. Amaewhule said in an interview with The Times that he began to get requests last year from several African clients seeking help getting to Russia. They told him they heard there was money to be made with the Russian military, he said.

Last October, he posted an advertisement on Facebook: “Slots available for Drivers, Cooks, Logistic Workers & other positions to join the Russian military & get automatic citizenship with lots of benefits.”

That same month, he posted a photo on Facebook of two people and wrote that they were Nigerians who had received $30,000 bonuses for joining Russia’s military. “Don’t forget recruitment is still ongoing,” the post said.

A Nigerian friend who lived in Russia and had citizenship there was tasked with facilitating travel for the job seekers, Mr. Amaewhule said. But Mr. Amaewhule denied ever sending clients to Russia for military training and did not respond to questions about that post offering a $30,000 bonus.

The recruitment pipeline from Africa to Russia often appears to rely on personal connections like the one Mr. Amaewhule had with his friend in Russia.

A Tanzanian woman who asked to be identified by her middle name, Nyariwa, for fear of her safety, said she connected a male Malawian friend with a Russian man she had met online years ago through a dating app. Her friend was interested in serving in Russia’s military, she said.

Nyariwa said she thought the man worked for the Russian military. After the man helped her friend obtain the paperwork needed to travel to Russia, others began to ask her about similar opportunities, she said. She eventually connected with recruiters in Russia and was paid $150 to $1,000 per recruit, she said.

Cameroon’s government said in April that 16 of its citizens had died in Ukraine, while Ghana said in February that about 55 of its citizens had been killed. Botswana’s foreign minister said in March that about 16 citizens of his country were targeted by recruiters promising jobs in security and bodyguard services, with four having actually traveled to Russia.

One of them was Kgosi Pelekekae, 25. Last year, Mr. Pelekekae was back in his native Botswana after two years in jail in South Africa for armed carjackings. He decided he wanted to turn his life around and messaged a friend asking if he knew of any honest work.

To his surprise, he said, the friend replied and said he had just moved to Russia, where there were plenty of jobs with good pay. The friend even sent pictures of himself playing in the snow. Soon, Mr. Pelekekae was exchanging messages over Telegram with a Russian his friend knew named Dmitri. The Russian identified himself as a travel agent and job recruiter, but he did not mention the military or war, Mr. Pelekekae said.

Mr. Pelekekae said he sent his travel documents to Dmitri on Dec. 6. The Russian bought him a ticket to St. Petersburg, Mr. Pelekekae said. When he arrived, he was flown to a training camp in a town far from St. Petersburg, where he was given military fatigues and trained to use a rifle, he said.

When he refused to sign several contracts written in Russian, Dmitri hit him and urged him to sign, said Mr. Pelekekae. During the ordeal, the Russian authorities gave him a physical and detected a heart condition.

For this reason, he said, he was never sent to the front. He said he escaped from the camp, and a diplomat from Botswana helped him get back home.

ZAMBIA MUST MAKE LIFE AND DEATH DECISIONS A YEAR AFTER U.S. CUT FUNDING TO FIGHT AIDS. Stephanie Nolen reports for The NY Times. Photograph by Arlette Bashizi

Saulo Kasekela died of AIDS on March 7, in a small town called Mpongwe in the copper belt of northern Zambia. He was a 37-year-old security guard, admitted to the mission hospital two days earlier. After his body was wheeled out of the men’s ward, a nurse set aside his chest X-ray, a clouded smear of lungs devoured by tuberculosis, a hallmark of advanced, untreated H.I.V. infection. A scrawled doctor’s note indicated the X-ray should be saved for medical students.

Of the eight patients in the ward that day, four had AIDS. Lewis Chifuta, 33, was bone thin, feverish and barely able to recognize his siblings when they reached his bedside.

A year ago, in Mpongwe, there was one case like this each month, or maybe two. In January this year, there were 28 new cases; in February, 28 more; in March, seven more.

During President Trump’s first month in office, his administration upended much of the flagship global H.I.V. program that had saved the lives of hundreds of thousands of people in Zambia. The Zambian government went into emergency mode, desperate to ensure that people with the virus could continue to receive lifesaving medications.

But other crucial aspects of the program had to be scrapped — interventions that had helped stop the spread of the virus and protected the most vulnerable people, those like Mr. Kasekela.

Today, a pared-down system is operating on reduced U.S. support, and Zambia may lose that help entirely in the next few days. The Trump administration has set an April 30 deadline for the Zambian government to accept a new health funding agreement that is tied to giving the United States expanded access to the country’s mineral resources.

The administration says the deal would offer Zambia five years of funding and help to build a stronger system that gives the country more control. But if Zambia doesn’t sign, officials warn that Washington could cut off all of its H.I.V. aid, a situation health officials here say would be disastrous.

What is happening in Mpongwe now is a grim echo of a time that most of the nurses and clinicians here are not old enough to remember. Three decades ago, hospitals in Zambia were packed with young men and women dying agonizing deaths, and the H.I.V./AIDS pandemic had overwhelmed the health system. Life expectancy had dropped to 37.

In 2003, President George W. Bush’s administration launched a historic humanitarian response to the pandemic — the President’s Emergency Plan for AIDS Relief, or PEPFAR — and Zambia was a focus country. By then, a lifesaving cocktail of antiretroviral medications had beaten back AIDS in the United States and other high-income countries, but the drugs cost tens of thousands of dollars, and almost no one in Africa could get them.

PEPFAR changed all that. Hundreds of thousands of people were given free access to those drugs in cheap generic forms. The United States built a network of laboratories and clinics that drew on the best of American innovation and technology. The rate of new infections was driven steadily down. Life expectancy in Zambia rose back to 67.

Then, last year, as part of its restructuring of foreign aid, the Trump administration cut off its funding for H.I.V. programs, saying many of the programs had been wasteful and an inappropriate use of taxpayer dollars.

Then it restored some of the funding, then withheld some. The United States Agency for International Development was delivering PEPFAR services in the northern half of Zambia — the region with highest rates of H.I.V. prevalence and transmission in the country — through dozens of local organizations. They closed abruptly.

Zambia’s top officials held emergency meetings and sent a directive to provincial health offices: Redeploy whatever staff you have to keep the antiretroviral medication moving.

“It was like a military state of emergency,” said Dr. Suilanji Sivile, the national technical adviser to the H.I.V. program. They managed it: 2,885 treatment facilities, a vast majority, have stayed open, he said. Most of the medications they distribute were purchased by the United States.

Today, the Zambian government says that most of the 1.3 million people who were on H.I.V. treatment in January 2025 are still receiving their drugs. (The health ministry estimates that 100,000 people stopped taking their medication in the upheaval, and 40,000 of them have yet to be re-engaged.)

But because many prevention services have been cut, health officials fear infection rates are inevitably rising. Testing has been cut, too, though, so they cannot be sure how much or how quickly. Many new H.I.V. infections will not be caught until people are seriously ill, and by then they may have infected others.

Dr. Lloyd Mulenga, who leads Zambia’s national H.I.V. program, sat with his colleagues in early 2025 and did the painful exercise of deciding what services they would cut.

They kept the bare essentials, Dr. Mulenga said, but much else had to go:

• When a person tested positive for H.I.V., a team traced that person’s sexual contacts, counseled and tested each of them and put them on H.I.V. treatment if they were infected. This labor-intensive system, known as index testing, found 70 percent of the infections identified each year. It has shut down.

• Pregnant women with H.I.V. had the amount of virus in their system tested three times over their pregnancy, so that a clinician could respond quickly to any hint that their medication was failing and their fetus exposed. That testing has been cut to once.

• Babies born to H.I.V.-positive mothers were tested for the virus through a highly accurate but expensive genetic test within hours of birth, and antiretroviral treatment was started immediately for those who tested positive. Now babies are not tested until 6 weeks old, when a cheaper standard blood test can be used.

• Everyone who came to a medical center for any kind of care was tested for H.I.V. Now testing is restricted to people who ask for a test or who have another sexually transmitted infection or tuberculosis symptoms.

• The genetics of the virus infecting people newly diagnosed were sequenced, indicating how new the infection was: When the data showed a number of recent infections in people from one place — like a hub on a trucking route, for example — a “hot zone” team could blanket the area with testing and prevention services. The ministry of health decided it could not fund that testing.

• Antiretroviral drugs were distributed in communities — in small market shops, at churches — making it easy and discreet for people to get their medication. Those sites were closed.

• Community health workers phoned people to remind them of appointments and, if they did not turn up, went to their homes or traced them to new locations, to make sure they did not miss a dose of medication. Most of those workers have lost their jobs.

• People from communities that are highly vulnerable to H.I.V. infection but who may face harassment or shame in the main medical system — gay men, sex workers — received services in small, dedicated sites. Those have been closed.

• At every H.I.V. treatment site, data teams used electronic records to track who was positive, who picked up their medications and whose viral load was uncontrolled — so that clinicians could track patients. Most have returned to using paper.

• Teenage girls have for years been the demographic most likely to be infected with H.I.V. Dedicated programs worked to target them with H.I.V. prevention and educational and vocational training to motivate them to avoid infection. Those were closed.

• More than 100,000 Zambian men were given free circumcisions each year. (Circumcised men are less likely to become infected or transmit H.I.V.) That program was canceled.

A year later, the impact of all these cuts is visible in the hospital wards and H.I.V. clinics in the copper belt.

At the mission hospital in Mpongwe, Dexter Fundulu, an H.I.V. clinician, closed out Mr. Kasekela’s file after he died. Mr. Fundulu had diagnosed Mr. Kasekela with H.I.V. in December. But his new patient lived about 40 miles from the hospital, and he did not show up to pick up his medications in January or February. The mobile community team that used to deliver medicines to patients like him had been eliminated.

It seemed, Mr. Fundulu said, that more patients had been missed, or fallen away from care, in the upheaval a year ago. Now the devastating symptoms of uncontrolled H.I.V. are catching up with them.

At a clinic in a gritty neighborhood called Chipulukusu, in the regional hub of Ndola, Maureen Dhaka, who has H.I.V., gave birth on March 5. The baby was chalky and silent, the umbilical cord wrapped around his neck, and an ambulance was summoned to take mother and infant to the children’s hospital.

There, the baby was placed on oxygen, and began to regain color. But no one tested him for H.I.V., even though his mother lives with the virus. No one gave him H.I.V. prophylaxis for nearly two full days after his birth, even though every moment counts to prevent an infection.

Before the cuts, a community health worker would have accompanied Ms. Dhaka and the baby to the hospital, and made sure the baby was swiftly given prophylaxis. Today, only one community health worker works at the Chipulukusu clinic, not five, and she did not catch up with Ms. Dhaka for days.

In Ipusukilo, a scrappy community outside the mining town of Kitwe, a 25-year-old patient named Precious Mulenga came to the H.I.V. clinic to pick up medication in February. When she arrived, she learned that the clinic — where a staff of 11 was reduced to just one for months after the funding cuts — had lost track of the results of a blood test she had taken last July. Those results were alarming: Her viral load was high. But there were no community health workers left to track her down to let her know, and help her take the correct medication to control it.

When Ms. Mulenga learned of those results seven months later, she was pregnant. The child she was carrying had been exposed to the virus for months. She was tested again, and in March came back to hear the new results. She sat, swinging her feet with anxiety, in the office of Ireen Lubwesha, the clinician who ran the clinic alone for much of last year. Ms. Lubwesha read Ms. Mulenga’s file, lifted her eyeglasses, and rubbed at the bridge of her nose. Here was another child facing a potential lifetime of infection, and it could have been avoided.

Despite years of discussion and millions of dollars spent on “localization” — moving responsibility for running services from PEPFAR to countries’ governments — the disruptions of the past year have made clear how little the Zambian government has taken over in the past two decades.

Thousands of critical health care workers were still employees of aid groups, and not the ministry of health, so they lost their jobs. Ministry employees had no idea how to use the drug- and test-ordering system. In Ndola they had to plead with the fired data clerks to come back and teach the remaining clinicians the passwords and how to look up patient records. The purchase of medications, operation of the supply chain, payment of staff: Zambia had continued to let the United States pay for and manage almost all of it.

At clinics throughout the north, visitors last month would see paper records stacked into teetering piles on desks, and heaped into boxes. Many clinics no longer have the funds to pay for internet access, so the tracking is intermittent and haphazard. That has led to weeks- or monthslong delays to follow test results.

At the Chipulukusu clinic, diagnosing infants now takes six weeks, not a week or 10 days as it used to. The region has a highly mobile population, people who cycle through the mines and related jobs, and in the six weeks it takes to learn if a baby is infected, mothers have often moved on — no one finds out children have contracted H.I.V. until they repeatedly fall ill. Half of Zambian children with the virus will die before age 2 if untreated.

There have been more new infections, more suffering and more deaths, Dr. Mulenga, the head of the country’s H.I.V. program, acknowledged. But Zambia is in the process of taking full responsibility for its H.I.V. program, and when it does, the country will be stronger, he said.

He hopes that a big push to distribute H.I.V. prevention medications — especially the new injectable lenacapavir, which provides protection from the virus for six months after each shot — may make up for the strategies that have been cut, and renew the effort to end the epidemic.

The United States continues, for now, to pay for a reduced but still significant amount of the H.I.V. care here, through bridge funding intended to carry the program while a new aid model is implemented.

The State Department is negotiating new health assistance funding agreements with countries that used to have U.S.A.I.D. support. These come with conditions, and Zambia’s has proved particularly thorny, because the State Department has tied support for the H.I.V. program to access to the country’s minerals.

The department has warned Zambia that if no agreement is signed by April 30, all U.S. support will end.

Zambia still has the support of the Global Fund to Fight AIDS, Tuberculosis and Malaria, but that fund is also heavily reliant on the United States and is cutting its budget.

Without a deal, Zambia will have to take over buying and moving antiretroviral drugs, laboratory chemicals, and H.I.V. tests itself; it is entirely ill prepared to do so. “If the stocks we have are the last we will get, what will we do?” Ms. Lubwesha said. “I always think about it. It will mean death.”

Under the terms of a draft agreement seen by The New York Times, Zambia would agree to hire thousands of new health workers, to replace those once paid by the United States. Dr. Mulenga hopes many will be community health workers who can restore some of the outreach that kept people in care.

In Ipusukilo, the bridge funding has allowed the clinic to rehire one data technician and a community health worker. Of the 2,000 people they had on antiretrovirals in February 2025, they lost 500 but have managed to bring 200 back. But there is no more testing or tracing the contacts of infected people.

These days, two or three people turn up in Ms. Lubwesha’s clinic every week with dangerously compromised immune systems, she said. “I know we can’t just depend on donors, we have to live within our means,” she said. “But it’s like we don’t care like we used to.”

A YEAR AFTER U.S.A.I.D.’S DEATH, FIRED WORKERS FIND FEW JOBS AND MUCH LOSS. By Elisabeth Bumiller and Eileen Sullivan for NY Times

She was fired by email while on maternity leave, given 24 hours to clear out her desk and left with three days of health insurance and no severance pay. She had worked for the U.S. Agency for International Development or related groups for more than two decades. She made $175,000 a year.

That was Jan. 28, 2025. Today Amy Uccello and her husband, who also lost his job when U.S.A.I.D. funding for his nonprofit dried up, rely on food stamps, Medicaid and a supplemental nutrition program for women and children that helps with their now 19-month-old daughter.

The mortgage on their home in Washington was until recently in forbearance, meaning they negotiated to pay less than they owed each month. But the bank has now cut them off and suggested they apply for a low-income mortgage program. “We don’t know if we’ll qualify,” Ms. Uccello said. She and her husband have applied for more than 100 jobs with no luck. Most of their friends don’t have jobs either.

Nights are the hardest.

“I can’t sleep because of our own situation,” Ms. Uccello, 49, said over coffee on a recent afternoon. “I can’t sleep because of what I know what’s happening around the world. I can’t sleep because my former colleagues and friends are also suffering.”

When the Trump administration dismantled the sprawling global aid agency last year, it wiped out virtually an entire industry — international development — that had been based in Washington since U.S.A.I.D.’s creation in 1961 under President John F. Kennedy. Nearly all of the agency’s 16,000 employees were laid off. An estimated 280,000 contractors, partners and local hires worldwide lost their jobs as well.

A year later, people have plowed through savings, cashed out retirement funds and moved in with friends and relatives. Former U.S.A.I.D. workers who have done informal surveys estimate that less than half have found full-time work, with many making less than before. An estimated third are unemployed. Others are in part-time work. The District of Columbia currently has the highest unemployment rate in the nation, at 6.7 percent, in large part because of major reductions in the federal work force, including U.S.A.I.D., and cuts to government grants and contracts.

The few former U.S.A.I.D. workers who have landed similar or better jobs don’t like to talk about it in front of unemployed friends.

“I feel guilty, honestly, that of all my colleagues who I know are still unemployed, I’m the one who found something,” said Sara Miner, 42, who was a senior adviser in the agency’s H.I.V.-AIDS office and previously ran health programs in Mozambique, Zambia and Zimbabwe. Now she helps manage health and human service programs for Fairfax County, Va.

Jobs are also gone at the many nonprofits and partner agencies once funded by U.S.A.I.D. “Everyone I know is also up the creek, all my bosses, my mentors, the people you would normally go to, the people providing me references,” said Catherine Baker, 36, who, as a contractor, made $127,000 a year recruiting staff and helping to start up U.S.A.I.D. projects. Ms. Baker now volunteers as a manager for OneAid, which helps former U.S.A.I.D. workers, and works nine hours a week as a companion for two elderly women.

The New York Times interviewed 30 former U.S.A.I.D. employees, contractors and partners in Washington, around the country and overseas to see how they were faring in the year since Elon Musk, the world’s richest man, proudly announced that he had fed the agency “into the wood chipper.” Unlike in early 2025, when many who lost jobs thought they might be reinstated and declined to speak on the record for fear of antagonizing Trump officials, this time almost all gave their names and spoke emotionally and at length.

Many said they were still dealing with mental trauma and a loss of confidence in their professional abilities after brutal job hunts. All mourned the loss of a mission in working for an agency that has contributed billions of dollars every year for decades to global humanitarian assistance. Some cited studies estimating that cuts to the agency’s H.I.V.-AIDS programs could lead to millions of deaths, including young children.

Others acknowledged that there was bloat and waste in the agency and a need for reform. Much of the $35 billion it managed in 2024 went to Washington-based contractors, not directly to people in need overseas. The success of many projects was hard to measure.

But all of those interviewed said they were still incredulous that an agency that amounted to less than 1 percent of the federal budget had been so quickly obliterated and reduced to a skeletal operation within the State Department. U.S.A.I.D. workers who once thought of themselves as ambassadors for American “soft power” said they worried about the trust in the United States that was lost overseas. They said they were still burning from President Trump’s characterization of them as “radical-left lunatics.”

“I’m a queer, brown immigrant," said Adrian Mathura, 55, a Navy veteran and a former senior U.S.A.I.D. adviser in global health who was involuntarily retired last July and is still fighting for the retirement pay he is due. “I got to do all of this incredible stuff in my life and my career, and I spent all of my adult life touting how great the city on the hill was.”

In the end, he said, “I never even once imagined I would be so betrayed by my government.”

‘Daddy, Have You Gotten Fired Today?’

Many of the hardest hit are those with years of experience.

Sheryl Cowan, 57, was making $272,000 a year as a senior vice president at a U.S.A.I.D.-funded nonprofit when she was let go at the end of March 2025. Last month she had an online interview for a $19-an-hour job managing a Penzeys Spices store near her home in Falls Church, Va.

Her take-home pay would not cover her mortgage, but said she was eager to do something other than spending down her savings and has applied for 60 jobs. She has since been called back for an in-person interview. “Aside from the salary, it would be fun,” she said. “I could do it for a little while.”

She has learned from online webinars on job hunting that her three decades of work in international development, including as the Peace Corps country director for Benin, need to be papered over on her résumé.

“Somehow, after 20 years of experience, you’re suddenly trying to hide the number because it makes you sound old,” Ms. Cowan said over lunch in her Falls Church townhouse. “I was writing in the blurb at the top of my résumé, ‘I have over 30 years of experience.’ No, no. And don’t put in the year you graduated from Bucknell.”

The long months without work, she added, have made her doubt herself. “Did I really do all those great things?” she said. “Was I really good once?”

Alysha Beyer, 53, who had a 25-year career as a U.S.A.I.D. contractor and ran reproductive health programs in Africa, is a single mother of two teenagers who moved in with a neighbor last year so she could rent out her home in Rockville, Md., to cover the mortgage. She has since moved back but said because of complications with Medicaid she has delayed getting a biopsy for what her doctor thinks is non-Hodgkin lymphoma.

“We were running these large programs looking for vulnerable populations, trying to help support them, and then you find yourself a user of the system,” Ms. Beyer said. She said she feels a stigma relying on social welfare programs, “having to tell people you’re unemployed all the time and going to the doctors and saying Medicaid. It’s a humbling experience to have to ask all the time for help.”

Courtney Blake, 47, was working last year in Geneva in U.S.A.I.D.’s bureau of humanitarian assistance. Today, she is staying with her sister and her sister’s family in New Paltz, N.Y.

“I’m living with family all over again like I’m 22 and just out of college,” she said. She has applied for more than 40 jobs, and remains angry about losing a calling that since 2012 has taken her to war zones in Iraq and Ebola outbreaks in Liberia.

“I spent the last 13 years of my career and also personal life turning up to work every day in service to my country," she said. “Doing work that, at the core, I believed in. But suddenly, and on a whim, all of that is forgotten.”

Don Niss, 56, spent 21 years at U.S.A.I.D., including three years managing the agency’s billion-dollar budgets for Afghanistan and Pakistan. Last year he was making $195,000 annually as a U.S.A.I.D. development adviser at the Pentagon.

He has 12-year-old twin sons and the tension over his impending job loss was particularly tough last year.

“There was a period of time, like between February and March, where every other day my son would get home from school and say, ‘Daddy, have you gotten fired today?’” Mr. Niss said. “It’s kind of a gut punch.”

His wife works as a schoolteacher but as of last month he had depleted his savings and dipped into his 401(k). “I pulled out enough money to cover expenses for the next six months, just not knowing what to expect,” he said.

Jacqueline Devine was one of the very few to talk to The Times on the record a year ago about losing her job as a contractor in the agency’s office of HIV-AIDS. Ms. Devine, 66, is a behavioral scientist who worked largely in sub-Saharan Africa on H.I.V. treatment. She spoke out, she said at the time, because “I have nothing to lose.”

A year later, her $200,000 income as an agency contractor has been replaced by $9,000 for teaching two courses in public health at Towson University in Maryland. She has made ends meet with some income from investments and an annuity from a previous job at the World Bank. But she said what amounted to a sudden, forced retirement had left her at a loss.

“I feel invisible professionally,” she said. She was not ready to stop working full time and had not thought about what she would do next. “I feel paralyzed in some way.”

Guy Martorana, 44, was a U.S.A.I.D. foreign service officer in Ivory Coast and is now back home in Birmingham, Ala., with his wife and infant daughter. He spends half of each day applying for jobs — he is up to 100 — and at other times volunteers for a nonprofit that is continuing some of U.S.A.I.D.’s work in peace promotion in northern Ivory Coast.

He stays in touch with former colleagues, but it’s difficult. “We’re all applying for similar jobs,” he said.

Samuel Port, 32, an Army veteran who worked at a nonprofit helping manage U.S.A.I.D. projects in South Sudan and Indonesia, has applied for more than 60 jobs. He said he was so discouraged at one point last year that he went alone to Great Falls Park in Virginia. “I sat down by the river and I cried a bit,” he said.

‘I Got Very Lucky’

There are some success stories.

Jackie Ndebeka, 39, who worked as a contractor on the administrative team that arranged travel for top agency officials, including Samantha Power, the U.S.A.I.D. administrator under President Joseph R. Biden Jr., now has a job as a contractor arranging travel to Antarctica for the National Science Foundation’s Antarctic Program. “I got very lucky,” she said. In her spare time she volunteers for OneAid.

Alicia Contreras-Donello, who was working for U.S.A.I.D. as a foreign service officer when she was laid off while in Tunisia with her two young children, is now running for Maryland’s House of Delegates.

Then there is Michael Nicholson, 51, who was working for U.S.A.I.D. as a foreign service economist in Mozambique when he and his wife, also a foreign service officer, were laid off. They have a 4-year-old daughter and have since moved to Nairobi, where Mr. Nicholson is running his own start-up, AfriqueU, that connects talented African student basketball players with American universities.

His business is still in the “pre-revenue” stage, he said, but he is optimistic.

He does not feel that way about America. He said he preferred living overseas, with other former American diplomats.

“I feel that the United States is not a welcome place for my family right now," he said. “We wanted to be around a group of people, Americans and others, that understand what happened to us.”

The pain, he said, still hasn’t gone away.

“It’s been over a year, and it still is as bad,” he said. “I’m just able to talk about it now. I’m going to carry this the rest of my life.”

U.S. PIVOTS, BETS BIG ON LENACAPAVIR. Devex Newswire.

The United States has upped its goal for distribution of the twice-yearly HIV prevention treatment lenacapavir, aiming to get it to 3 million people in three years. Supply is ready — but demand is already outstripping the rollout.

State Department official Jeremy Lewin, speaking at a Center for Strategic and International Studies event on the sidelines of the IMF-World Bank Spring Meetings, said the target for the injectable HIV prevention drug is now 3 million people in three years, up from 2 million. The logic: Cut old programs, free up cash, and go big.

“One of the things that we did through the sort of creative destruction of the last year was to free up resources for things like this,” he said, arguing legacy efforts “don’t deliver when you look at the reality of today’s world.”

Supply isn’t the problem. “We at Gilead are not supply constrained,” said Daniel O’Day, CEO of the American pharmaceutical company that developed the drug. “As we go from 2 million to 3 million, we will meet that. If it goes beyond that, we will meet that.” Accelerated manufacturing of generic versions of the drug are also part of the plan.

The rollout is already moving fast, writes my colleague Elissa Miolene — “by far the fastest rollout of a global health medication in the developing world,” Lewin says — but demand is moving faster. “[Lenacapavir] is literally flying off the shelf,” said AVAC’s Mitchell Warren.

Warren also warns that the 3 million goal isn’t enough, saying at least 5 million people must be using the drug in order to push down prices. And beyond that, he said, the destruction of USAID has destabilized HIV prevention programs across the world. According to one analysis, 71% of USAID’s HIV-related awards were canceled.

“I worry we are building lenacapavir programs on a foundation of sand,” he said.

Washington is teeing up another sharp pivot: less aid, more deals.

A new “Trade Over Aid” initiative, circulated to U.N. member states ahead of an April 15 deadline, takes direct aim at the traditional model.“For decades, government aid has been flowing from developed to developing countries with only limited impact,” the U.S. note says. “It has not solved the world’s economic development challenges, and it has often created dependency, inefficiency, and corruption.”

The pitch: swap grants for growth. “The old model has been government-centered and one-directional,” the note argues. “The new model emphasizes mutually profitable business relationships between private sectors and countries.”

U.S. Ambassador to the U.N. Mike Waltz puts it more bluntly: “This old model of sovereign nations providing taxpayer dollars to aid organizations, to a network of NGOs, I do not believe is sustainable in the long run.” The goal, he adds, is to “pull in the private sector” and ultimately “move these aid grants and organizations out of business, right, over the long term, which should be all of our goals.”

Not everyone’s shocked, writes Devex Senior Global Reporter Colum Lynch. “While there’s some exaggerated language that might be off putting to the U.N. community, I view this initiative as very positive insofar as the U.S. is engaging substantively on issues related to development and economic affairs,” one U.N. official tells Devex. Still, it’s unclear how many other governments will sign on to the initiative.

“LIVES WILL BE LOST.” UK FOLLOWS U.S. LEAD AND CUTS AID TO AFRICA. Fatma Tanis reports for NPR.

When the Trump administration made massive cuts to U.S. foreign aid last year, Dr. Manenji Mangundu, director of Oxfam in the Democratic Republic of the Congo, thought other countries would step in to fill the funding shortfalls.

Specifically, he hoped that the United Kingdom, one of the largest global donors with a long history of development work, would increase its spending.

But that hasn't happened.

Instead, the U.K. announced severe cuts to its own global aid spending by about 40% in February 2025. Then, in a statement to Parliament on March 19, Foreign Secretary Yvette Cooper provided more details, saying the U.K. had taken the "hugely difficult decision" to reduce its development budget in order to fund its defense spending.

The announcement comes at a time when aid groups like Oxfam are still grappling with the effects of the U.S. aid cuts. Mangundu says the consequences of the U.K. cuts will be catastrophic.

"We have no hope to reach the people who need our help," Mangundu says.

Last year, the U.K. spent over the equivalent of about $100 million (80 million pounds) on aid to the DRC, supporting protection for survivors of sexual violence and providing water and food to people. Mangundu says everything from environmental conservation to health care will be affected.

"People will not have access to medicine. People will not have access to nurses and doctors, because the U.K. government was funding all these programs," Mangundu says, adding that education programs would also be cut, leaving around 4.5 million children at risk of losing access to schools.

Since the announcement, Mangundu has heard from health officials and doctors all over the country. In addition to losing resources to treat everyday health problems, they also worry about ongoing disease outbreaks.

"We have actually cholera on the rise. Mpox is on the rise, and then we have also the cases to do with Ebola," he says.

DRC is one of many countries across Africa and the Middle East that are facing drastic cuts from the U.K. In fact, 56% of the U.K.'s aid to countries in Africa will be slashed, leaving some of the world's poorest countries at risk of further poverty and disease.

"Sierra Leone and Malawi are likely to have no or almost no U.K. support on health, even though they are one of the poorest countries in the world and have high maternal mortality," says Pete Baker, deputy director of the Global Health Policy Program at the Center for Global Development.

Countries with high rates of child malnutrition like Afghanistan, Yemen and Somalia are also facing cuts to funding.

Flora Alexander, the Executive Director of the International Rescue Committee in the U.K., says the tradeoffs will have real effects. "These cuts will no doubt have a devastating impact on issues like child malnutrition and child health in Somalia, where food insecurity is always a risk," she says.

The problem is compounded by the disruption to food and fertilizer marketsbecause of the war in Iran and the closure of the Strait of Hormuz, according to Alexander.

"It feels incredibly shortsighted to make such an enormous cut to Africa," she says. "There's going to be a massive risk of increased hunger."

"Lives will be lost," Baker says.

The U.K.'s Foreign, Commonwealth and Development Office, which oversees aid efforts, told NPR in a statement that while national security is the government's first duty, "we remain absolutely committed to tackling the global challenges of hunger, disease, insecurity and conflict, but we have been clear we must modernise our approach to development to reflect the changing global context."

Cooper said in her statement in March that the U.K. will use what's left of its aid budget to prioritize "support for countries and communities facing the worst humanitarian need – those affected by war and crises." Those countries are Ukraine, Lebanon, the Palestinian Territories, and Sudan.

Baker says these are places that carry geopolitical interest for the U.K.

"You get an idea that this is a government using the aid budget that doesn't really believe in the development objectives. It's using it for tactical reasons, strategic reasons for the country."

It's a departure for a country that used to be a global champion for aid and development, Baker says, adding that the U.K. was one of the only major countries that diverted a large portion of its budget toward aid and was known for developing worldwide institutions like GAVI, the Vaccine Allianceand The Global Fund, which works to tackle diseases like AIDS, malaria and tuberculosis .

"It was recognized for doing aid well and intelligently," Baker says.

A wider geopolitical shift has made these cuts acceptable for the U.K. government, he says. That shift was brought on by the Trump administration's overhaul of U.S. foreign aid, according to Alexander.

"The world's biggest aid donor enormously slashing its aid budget is, of course, setting a kind of tone and trend that enables what some people have described as a race to the bottom," Alexander says.

"You wouldn't have expected the progressive political party in the U.K. - the Labour government - to cut the aid budget by 40%, but it does feel that we are in a kind of very new era in terms of the focus on defense spending."

She fears more countries will follow suit to stop using taxpayer funds to aid in low income countries.

Mangundu with Oxfam says he's really surprised about the cuts to the DRC, because of how important its natural resources are to the U.S. and the U.K.

"Every country is interested in going to the DRC for critical minerals to mine," he says. The U.S. and the U.K. are seeking access to minerals like copper, cobalt, lithium, diamond and others. But he says those minerals should be processed in the DRC, which would create jobs for the local population. Instead, they are exported to other countries.

"So how do you expect the population of DRC to benefit?" Mangundu says.

The humanitarian and health funds, he says, at least provided people with some solace that they would be supported.

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.

x x x

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. ■