Health
Foreign Aid Freeze Leaves Millions Without H.I.V. Treatment
Two weeks into President Trump’s sweeping freeze on foreign aid, H.I.V. groups abroad have not received any funding, jeopardizing the health of more than 20 million people, including 500,000 children. Subsequent waivers from the State Department have clarified that the work can continue, but the funds and legal paperwork to do so are still missing.
With the near closure of the American aid agency known as U.S.A.I.D. and its recall of officers posted abroad, there is little hope that the situation will resolve quickly, experts warned.
H.I.V. treatment and services were funded through the President’s Emergency Plan for AIDS Relief, or PEPFAR, a $7.5 billion program that was frozen along with all foreign aid on Mr. Trump’s first day in office.
Since its start in 2003 during the George W. Bush administration, PEPFAR has delivered lifesaving treatment to as many as 25 million people in 54 countries and had enjoyed bipartisan support. The program was due for a five-year reauthorization in 2023; it survived an effort by some House Republicans to end it and was renewed for one year.
Without treatment, millions of people with H.I.V. would be at risk of severe illness and premature death. The loss of treatment also threatens to reverse the dramatic progress made against H.I.V. in recent years and could spur the emergence of drug-resistant strains of H.I.V.; both outcomes could have a global impact, including in the United States.
The pause on aid and the stripping down of U.S.A.I.D. have delivered a “system shock,” said Christine Stegling, a deputy executive director at UNAIDS, the United Nations’ H.I.V. division.
“Now you need to see how you can work with the system as it is, to make sure that what is theoretically possible will actually happen,” she said.
On Jan. 28, Secretary of State Marco Rubio issued a waiver for lifesaving medicines and medical services, ostensibly allowing for the distribution of H.I.V. medicines. But the waiver did not name PEPFAR, leaving recipient organizations awaiting clarity.
On Sunday, another State Department waiver said more explicitly that it would cover H.I.V. testing and treatment as well as prevention and treatment of opportunistic infections such as tuberculosis, according to a memo viewed by The New York Times. The memo did not include H.I.V. prevention — except for pregnant and breastfeeding women — or support for orphaned and vulnerable children.
Although PEPFAR is funded by the State Department, roughly two-thirds of its grants are implemented through U.S.A.I.D. and the Centers for Disease Control and Prevention. Neither organization has released funds to grantees since the freeze was initiated.
In an interview with The Washington Post, Mr. Rubio appeared to blame the recipient organizations for not acting on the waiver, saying he had “real questions about the competence” of the groups. “I wonder whether they’re deliberately sabotaging it for purposes of making a political point,” he said.
But experts familiar with PEPFAR’s requirements said his comments belied the complexity of its system of approvals.
“The messaging and guidance from the State Department expose an ignorance of how these programs function — and an alarming lack of compassion for the millions of lives at risk,” said Jirair Ratevosian, who served as chief of staff for PEPFAR in the Biden administration.
For instance, the stop-work orders compelled each program to cease immediately. The organizations are now legally required to wait for equally explicit instructions and cannot proceed on the basis of a general memo, according to a senior official at a large global health organization that receives PEPFAR funds.
“We have to wait till we get individual letters on each project that tell us not only we can start work, but tell us which work we can start up and with how much money,” the official said. The official asked not to be named for fear of retaliation; 90 percent of the organization’s money comes from PEPFAR.
The freeze is also disrupting the network of smaller organizations that deliver H.I.V. treatment and services in low-income nations.
In a survey of 275 organizations in 11 sub-Saharan countries conducted over the past week, all reported that their programs or services had shut down or were turning people away, said Dr. Stellah Bosire, executive director of the Africa Center for Health Systems and Gender Justice.
At least 70 organizations reported disruptions in H.I.V. prevention, testing and treatment services, and 41 said that some programs had closed. “Without immediate intervention, these funding suspensions could lead to devastating reversals in public health progress,” Dr. Bosire said in an email.
In Kenya, 40,000 doctors, nurses and other health workers have been affected by the freeze, according to Mackenzie Knowles-Coursin, who was deputy chief of communications at the American mission in Nairobi until Monday. In South Africa, the halt in funding will affect the salaries of more than 15,000 health workers and operations across the country, the nation’s health minister, Aaron Motsoaledi, said during a televised news conference last week.
Some organizations rely on a patchwork of grants, with a stream of funding from one donor applied to purchasing medications and another stream applied to paying staff. Interruption of even one source can hobble the clinics, leaving them without medications to dispense or workers to dispense them.
The Uganda Key Populations Consortium, an umbrella organization that provides H.I.V. treatment and other services, has lost 70 percent of its funding. It has shuttered 30 of the 54 drop-in centers around the country that dispense medications, and it terminated the contracts of 28 of its 35 staff members.
The organization received about $200,000 per year from the C.D.C. via the Infectious Diseases Institute at Makerere University, as well as an $8 million grant over five years from U.S.A.I.D. The latter provided housing and employment assistance, including to gay and transgender people, and has been shut down to comply with Mr. Trump’s executive order on diversity, equity, inclusion and accessibility.
In 2023, Uganda enacted a sweeping law that criminalized consensual sex between same-sex adults and made same-sex relations while having H.I.V. punishable by death. It has caused scores of Ugandans to be evicted from homes and fired from jobs.
“Cases of human rights violations haven’t really slowed, and now it’s really concerning,” said Richard Lusimbo, director general of the Uganda Key Populations Consortium.
“We don’t even have the capacity or even the tools that we need to actually respond to some of these issues,” he said.
Some organizations dispense medicines to children, which requires more skill than treating adults. Children’s medications are tailored to their age, weight and prior exposure to antiretroviral drugs, and the children must be carefully monitored for drug resistance.
In children who acquired H.I.V. at birth, the infection can progress very quickly to illness, with death occurring as early as eight to 12 weeks after birth — shorter than the 90-day pause on foreign aid.
On Tuesday night, the Trump administration put nearly all of U.S.A.I.D.’s global work force on leave and recalled those posted abroad to return to the United States within 30 days.
“There’s a loss of institutional memory, which may be purposeful, but it’s also creating just a backlog of paperwork, and it’s paralyzing the whole system,” said Elisha Dunn-Georgiou, the president of Global Health Council, a membership organization of health groups.
“Who do you ask questions to?” she said. “How do you move to the next step?”
Without U.S.A.I.D. staff to process waiver applications, organizations fear they will not see funds anytime soon. Even large global health organizations are struggling to stay afloat; some have already cut programs and staff.
Even if the funds return quickly, it may not be easy to restart programs and return to something resembling normalcy, Ms. Dunn-Georgiou said.
“It costs a lot to restart something, so I don’t think we really know yet if that’s even possible,” she said.
Lynsey Chutel and Stephanie Nolen contributed reporting.
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Washington, DC – GLP-1 weight-loss drugs have become a prevalent part of American healthcare, and the current administration is getting behind the movement.
In an exclusive interview with Fox News Digital at the Great American State Fair in the nation’s capital on July 6, CMS Administrator Dr. Mehmet Oz voiced his support for the use of GLP-1 (glucagon-like peptide-1) medications, such as Ozempic, for appropriate uses.
“I’m a fan of GLP-1 drugs when used correctly,” he said. “They do help people who are overweight lose weight quite effectively. They’re not a replacement for diet and exercise, but they might jumpstart the system so it’s easier for you to use healthier tactics.”
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This is especially helpful for those who may have trouble moving due to joint pain or are experiencing internal dysfunction, Oz said.
Certain GLP-1 drugs are covered by Medicare for overweight candidates with certain conditions, such as high blood pressure and diabetes, and Oz projected the benefits will continue to benefit taxpayers.
Dr. Mehmet Oz is pictured in Washington, D.C., at the Great American State Fair, where he spoke about federal health policy. (Angelica Stabile/Fox News Digital)
“We believe these are so effective in reducing conditions like high blood pressure and diabetes that they’ll actually save money for the federal taxpayer, because [they’re] going to make you healthy enough that you don’t have to consume health services,” Oz said.
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“We think about 70% of all the money we spend on healthcare is caused by chronic conditions, and obesity is the No. 1 driver of all that, so it’s a smart decision.”
Oz recently announced the launch of the Medicare GLP-1 Bridge program, which will allow more seniors to access GLP-1 drugs for only $50 a month if they meet qualifying health criteria and receive prior authorization from a doctor.
The doctor expressed support for broadening affordable access to GLP-1 medications for Americans. (iStock)
“There are a lot of overweight people who don’t have high blood pressure, diabetes or other conditions, so they don’t get access to the drug normally,” he said. “We want them to have the ability to use it as well.”
Although these access shifts could boost Americans’ overall health — and in some cases could be lifesaving — Oz noted that there is “no silver bullet” when it comes to these medications.
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“I love the fact that the innovation that’s coming out of pharmaceutical companies is allowing us to save lives and make lives better,” he said. “But the real secret to longevity is eating right, exercising, sleeping, dealing with the stress of your life, finding some purpose in your existence [and] realizing you have agency over the future.”
“These are things that your mom would have told you [and that] you don’t need a doctor to be emphasizing.”
Medicating appropriately, combined with eating right, exercising and staying connected with others, can help make health goals attainable, the doctor said. (iStock)
While GLP-1s may not be a fix-all, combining these medications with foundational health practices “makes a lot of sense,” Oz said.
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“I don’t want people being fat-shamed … I don’t want you feeling guilty that you’re gaining weight even though everyone else around you seems to have figured it out,” he said. “It’s not that simple — our set points for hunger are different. We have different things going on in our lives.”
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“But if you realize how precious you are — the temple of the soul is so valuable. It’s the greatest gift your parents ever gave you, and you take advantage of every tool out there to make it work … which includes using medications when appropriate. That, to me, is MAHA.”
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Amid warnings of a Legionnaires’ disease outbreak on Manhattan’s Upper East Side, health experts say that early recognition of symptoms can mean the difference between a quick recovery and life-threatening complications, especially for high-risk groups.
New York City health officials are urging anyone who has visited the east side of Central Park or Manhattan’s Upper East Side since late June to watch for symptoms.
As of July 6, the New York City Health Department had confirmed 23 cases and 17 hospitalizations associated with the respiratory infection. No deaths have been reported.
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Officials are investigating contaminated cooling towers as the likely source. They have emphasized that the illness is not spread person-to-person and is not linked to the city’s drinking water.
Health experts say that early recognition of symptoms can mean the difference between a quick recovery and life-threatening complications, especially for high-risk groups. (iStock)
“Legionnaires’ disease is deadly but can be effectively treated if diagnosed early,” said NYC Health Commissioner Dr. Alister Martin in a press release. “New Yorkers at higher risk, including anyone who is 50 and older, those who smoke or people with chronic lung conditions should be especially mindful of their symptoms and seek care as soon as symptoms begin.”
What is Legionnaires’?
Legionnaires’ disease is a type of pneumonia caused by Legionella bacteria.
The bacteria is usually found in lakes, streams and other freshwater environments, but can grow in any area where water sits for a long time, according to the CDC.
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That can include shower heads, sink faucets, hot tubs, water features/fountains, plumbing systems and other water systems.
When people swallow or breathe in droplets of water that contain Legionella, they can potentially become ill.
Although human transmission is possible in rare cases, the disease is not typically transmitted among people, per the Centers for Disease Control and Prevention.
Symptoms of infection
Infections can lead to severe pneumonia in older people and those with compromised immune systems, according to Dr. Andrew Handel, a pediatric infectious diseases expert at Stony Brook Children’s Hospital on Long Island, New York.
Symptoms of Legionnaires’ disease usually show up between two and 14 days after exposure.
New York City health officials are urging anyone who has visited the east side of Central Park or Manhattan’s Upper East Side since late June to watch for symptoms. (iStock)
“Legionella infections cause symptoms that are similar to other forms of pneumonia — fever, coughing, difficulty breathing, shortness of breath and chest pain,” Handel previously told Fox News Digital.
“Legionnaires’ disease is deadly but can be effectively treated if diagnosed early.”
The signs are similar to other types of pneumonia, and include the following:
- Cough
- Fever
- Shortness of breath
- Muscle aches and headaches
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Some patients may also experience nausea, diarrhea and confusion, the CDC noted.
Diagnosis, treatment and prevention
A medical professional can diagnose the infection with laboratory tests and chest X-rays.
The condition is typically treated with antibiotics. In cases of severe infection, hospitalization may be required for breathing support and IV hydration.
Around 10% of people who contract Legionnaires’ disease will die from those complications — and the mortality risk rises to 25% for those who get Legionnaires’ while staying in a healthcare facility, according to the CDC.
The bacteria is usually found in lakes, streams and other freshwater environments, but can grow in any area where water sits for a long time, according to the CDC. (iStock)
“Treatment needs to be early and aggressive,” Dr. Nathan Goodyear, an Arizona-based integrative medicine expert, previously told Fox News Digital. “Legionella infection is an intracellular infection that requires antibiotic treatment.”
Antibiotics that are appropriate for Legionella infection include Levofloxacin and Azithromycin.
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“Therapy can be prescribed orally in healthy individuals… but intravenous antibiotics often prove to be the initial option for treatment secondary to the pathogenicity of the disease,” Goodyear said.
Currently, there are no vaccines for Legionnaires’ disease.
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The best strategy to prevent infection is to reduce the growth and spread of the Legionella bacteria. The CDC recommends that building owners and managers use a water management program to reduce the risk.
“New Yorkers at higher risk, including anyone who is 50 and older, those who smoke or people with chronic lung conditions should be especially mindful of their symptoms and seek care as soon as symptoms begin,” city officials stated. (iStock)
To prevent serious illness from Legionnaires’, Goodyear recommends that all smokers kick the habit, and also emphasizes the need to “aggressively support” chronic pulmonary disease.
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“Increasing immune support (vitamin D3, vitamin C, Zinc) is required to counter the immune dysfunction associated with advancing age.”
Obesity is another foundational risk factor for all chronic inflammatory diseases, the doctor added.
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Journalist Katie Couric is sharing a scary medical episode that she experienced on June 27.
In a post on Substack titled “The Day I’ll Never Remember,” she detailed a sudden episode that left her unable to recall the current month, year and president.
“I thought it was 2024. And I believed Joe Biden was president,” she wrote.
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The event occurred while Couric was attending the Aspen Ideas Festival in Colorado, during which she participated in two public panels — one on AI and one on journalism — both of which she cannot remember at all.
“I have no idea what we talked about, or of what occurred when the panels ended,” she said.
Journalist Katie Couric is sharing a scary medical episode that she experienced on June 27. (Getty Images)
John Molner — Couric’s husband, who was in attendance at the festival and the two panels — also shared his account.
After the event, someone told Molner that Katie wasn’t feeling well. When he reached her, an EMT and a doctor were tending to her. “I could tell something was off,” he wrote. “It could have been altitude sickness, but Katie was definitely not all there.”
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At the hospital, when Couric struggled to recall the year, the president and her grandchildren’s names, doctors began checking for a stroke.
An MRI revealed no signs of stroke, which was a relief, but “Katie’s ‘fog’ became a lot more apparent,” Molner wrote.
John Molner, Couric’s husband, who was in attendance at the festival and the two panels, also shared his account. (Getty Images)
“She repeatedly asked me the same questions: ‘What was I doing before we got to the hospital?’ ‘Why am I at the hospital?’”
Couric was ultimately diagnosed with transient global amnesia, a sudden, temporary episode of memory loss that prevents a person from forming new memories and may also erase some recent memories, according to Mayo Clinic.
“The cause seems to be as mysterious as the brain itself.”
It is not caused by a stroke, seizure or head injury, and it usually resolves completely within 24 hours.
“[It’s] just a very weird neural episode that’s pretty uncommon and, at least in most cases, is a ‘one and done’ experience,” Molner said.
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Couric said she finally began feeling “like herself” again around 9 p.m. and went to sleep at 2 a.m.
As TGA leaves a “permanent gap in memory” for the duration of the episode and for hours beforehand, Couric said that from around noon on that day until at least 7 p.m. will remain a “big, black hole.”
As TGA leaves a “permanent gap in memory” for the duration of the episode and for hours beforehand, Couric said that from around noon on that day until at least 7 p.m. will remain a “big, black hole.” (Getty Images)
Data shows that approximately three to eight people per 100,000 will have an episode of transient global amnesia, with people 50 years of age and older at higher risk.
The specific cause of TGA is not known, but some experts believe it stems from a “temporary dysfunction in the brain’s hippocampus — the area responsible for creating new memories,” Couric shared.
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“Doctors believe this is driven by brief interruptions in blood or oxygen flow, or microscopic spasm in the blood vessels.”
Episodes could potentially be triggered by intense physical exertion, emotional distress, extreme temperature changes or migraines, experts say.
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Approximately 15% of patients will have a recurrence 10 years later.
“Why did this happen to me? Was the altitude an issue? Was I dehydrated? Tired? Stressed? The literature doesn’t seem to indicate that these are contributing factors, but the cause seems to be as mysterious as the brain itself,” Couric wrote.
Anyone who experiences sudden memory loss, confusion, difficulty speaking, weakness, numbness, vision changes, severe headache or other stroke-like symptoms should seek immediate medical attention or call 911, doctors advise. (iStock)
“All I know is that those hours will be forever lost. Someone described it as my brain failing to hit the ‘record button.’”
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“While this was a freaky occurrence, it could have been much more serious. So ultimately, I’m relieved — even though several hours of a Saturday in June will always be missing for me.”
Anyone who experiences sudden memory loss, confusion, difficulty speaking, weakness, numbness, vision changes, severe headache or other stroke-like symptoms should seek immediate medical attention or call 911, doctors advise.
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