A dangerous HIV disruption from Washington, D.C. to Cape Town.
By Jahan Sharif
After the 2024 presidential election, I decamped to Cape Town, South Africa—hoping for a reprieve from the chaos of the American political scene, a sort of artificial disassociation from the news. And while Biden was President, I got that. Unfortunately, Trump has blown it all to bits.
Each of President Trump’s announcements cracks across the Atlantic like the Concorde—collapsing the 8,000 miles of ocean into a shallow pond, and whipping me into a dizzying tailspin that reminds even the most cynical just how long and penetrating America’s reach is.
Trump wanted to “flood the zone” and to “shock and awe.” And to a large extent he has succeeded. As I write this, three trillion dollars may or may not be flowing again after his administration rescinded a stop-order that effectively defunded everything from Medicaid to the Missing Alzheimer’s Disease Patient Assistance Program to PEPFAR, which is an acronym for the President’s Emergency Plan for AIDS Relief.
Here in South Africa and across the continent, the consequences of eliminating PEPFAR could be devastating. Of the more than 25 million people in treatment through the program, 6 million are in South Africa. Clinics that distribute medications vital to the prevention and treatment of HIV, as well as provide testing, monitoring, and counselling closed without warning, leaving patients stranded—uncertain, vulnerable, and scared.
On a personal note, it has caused a panic among my friends and me, as many of us depend on these clinics to access these life-preserving medicines. Fearing a run on drugs, I went to my local pharmacy and bought a year’s supply of anti-retroviral medications. The cost? Nearly 4,000 Rands, or roughly $240.
For many South Africans, this is a staggering sum—an amount beyond the reach of average households, especially in a country marked by some of the most extreme income inequality in the developed world. The poorest South African households earn less than 8,000 Rands a month—around $400. Faced with such financial strain, the cruel choice between food and medicine is not just morally indefensible, it’s a recipe for disaster.
