Haunted by hopelessness: 12 Zambians share their stories as HIV drugs run out

From the pulpit, Reverend Billiance Chondwe counts the empty seats. "We are close to 300 [worshipers] but nowadays we are only less than 150. People are sick at home," says Chondwe — or Pastor Billy as everyone calls him — as he greeted congregants on a Sunday in early April at the entrance to his church, the Somone Community Center, a branch of the Pentecostal Holiness Church in Zambia. People are falling ill because the U.S.-funded clinics where they got their HIV medications and care have suddenly been shuttered. The staff is gone. The electricity has been shut off. Some patients have already run out of their daily pills that keep HIV at bay — and they have started to feel the physical consequences of the virus surging back.

The Trump Administration, in January, abruptly halted the vast majority of U.S. foreign assistance in light of their America First agenda. Officials said that lifesaving aid — such as HIV medications — would continue to flow. But the reality on the ground shows otherwise. An untold number of people with HIV have simply and suddenly lost access to their medication. That is largely because the halting of foreign assistance and cancelling of programs crippled the systems that enabled people to get their AIDS medicines. And, of the small number of programs that are technically allowed to continue, many report not being paid by the U.S. government and, thus, having to close their doors and lay off workers. The State Department, which oversees foreign assistance, did not respond to requests for comment.

In 2024, Zambia received $240 million from the U.S. to support HIV/AIDS work, including prevention, treatment and distribution of medications. NPR visited and spoke to many in this southern African nation who have expressed great frustration that the cuts to aid came with no warning and no transition plan. But they also acknowledged that their country had become dependent on foreign aid and that the government needs to do more to fill the vast gaps left by the sudden U.S. withdrawal.

"The main victim that is paying the price of this disruptive decision to cut the U.S. aid funding is the ordinary Zambian person living in poverty," says Chris Zumani Zimba, a Zambian political scientist affiliated with the University of Central Africa. According to the World Bank, more than 60% of the population there lives in poverty. And, more than 10% of adults in the country have HIV — half the rate of a decade ago. A study out this month in The Lancet estimated what would happen if the U.S. does not continue its flagship HIV/AIDS program that's been pivotal to reversing the downward trend in life expectancy due to AIDS. The researchers from Oxford University and elsewhere found that half a million additional children will die of AIDS in the next 5 years in sub-Saharan Africa and nearly 3 million more African children will be orphaned by AIDS. In many Zambian communities, people say these numbers will soon be more than just a forecast.

https://www.npr.org/sections/goats-and-soda/2025/04/14/g-s1-59863/hiv-aids-drugs-usaid-zambia

Blood on your hands, DJT, and yours too Elon Musk.