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.
Health
Single infusion of controversial drug changed severe depression symptoms within hours, study finds
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People experiencing severe depression with suicidal symptoms may not have to wait weeks for traditional antidepressants to take effect.
A recent review suggests that a single intravenous ketamine infusion can provide rapid relief for some patients.
Originally developed as an anesthetic, ketamine is a medicine that can reduce pain and, in some cases, help treat depression, but it can also be misused as a recreational drug, experts warn.
SINGLE DOSE OF POWERFUL PSYCHEDELIC CUTS DEPRESSION SYMPTOMS IN CLINICAL STUDY
Researchers from the University of Connecticut School of Medicine reviewed 26 clinical trials that included more than 1,100 patients. Approximately 626 received ketamine and 540 served as controls who did not take the drug.
Most of the trials included patients with major depressive disorder, but 11.5% included those with bipolar depression and 7.7% included people with both unipolar and bipolar depressive diagnoses.
A recent review suggests that a single intravenous ketamine infusion can provide rapid relief for some patients with treatment-resistant depression. (iStock)
Compared to a placebo, a single treatment significantly reduced depression in just four hours and dramatically lowered suicidal thoughts within 24 hours, the study found.
Patients reported fewer depressive symptoms after a week and reduced suicidal thoughts for up to a month after one ketamine infusion. Those who received repeated ketamine infusions showed a similar reduction of suicidal and depressive symptoms at the end of the treatment.
WHAT IS KETAMINE THERAPY? MORMON REALITY STARS TOUT CONTROVERSIAL TREATMENT
The most common adverse effects of ketamine – including headaches, numbness, dissociation (“out of body” experiences), nausea, dizziness and visual disturbances – were temporary and resolved within hours of the infusion.
Rarer, more serious side events included hospitalization, suicide attempts and suicide, but most were unrelated to ketamine, the review stated.
The analysis was published in May in JAMA Psychiatry.
Treatment-resistant depression
Major depressive disorder is a formal psychiatric diagnosis affecting approximately 280 million people globally, according to recent research.
Effective treatment involves a combination of therapy and medication, frequently antidepressants. However, for a few patients, symptoms do not respond to multiple therapies, a condition known as treatment-resistant depression, doctors say.
“When all existing treatment options fail, patients with severe depression could consider ketamine infusions.”
These patients are at a higher risk of very serious, sometimes tragic consequences, including suicidal thoughts, suicide attempts and death.
“When all existing treatment options fail, patients with severe depression could consider ketamine infusions,” lead author Taeho Greg Rhee, PhD, of the University of Connecticut School of Medicine, told Fox News Digital. “This is still a safer option when compared to electroconvulsive therapy (ECT).”
Compared to a placebo, a single treatment significantly reduced depression in just four hours and dramatically lowered suicidal thoughts within 24 hours, the study found. (iStock)
Traditional antidepressants stabilize mood by slowly elevating serotonin levels in the brain, but it can take weeks for the full effect to be achieved.
Ketamine, in contrast, works rapidly by blocking glutamate, a neurotransmitter that can impact emotions negatively when levels are too high in the brain, according to Cleveland Clinic.
Implications for care
The authors say their findings have two important potential clinical applications.
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First, ketamine’s rapid effects can be a life-saving treatment in the emergency room for patients presenting with suicidal ideation.
Experts caution that the medication should only be administered in closely monitored settings, such as clinics, to ensure safe treatment. (iStock)
Second, the effects of a single ketamine infusion are relatively short-lived – as almost all patients relapsed with depressive symptoms after a single infusion – so those with treatment-resistant depression will need repeated sessions.
“While intravenous ketamine is not yet FDA-approved for treating depression, it may still be used with off-label indications for those with severe depression and/or with a high risk of suicidal behaviors,” said Rhee.
Experts urge caution despite promise
Dr. Lama Bazzi, a psychiatrist in private practice in New York City, has had several patients receive ketamine infusions.
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“For a small subset of patients in a major depressive episode or struggling with suicidal thoughts, intravenous ketamine can be genuinely lifesaving,” Bazzi, who was not involved in the study, told Fox News Digital. “The relief they experience is almost immediate, offering them distance from the intensity of their emotions.”
However, she cautions that the medication should only be administered in closely monitored settings, such as clinics, to ensure safe treatment.
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Ketamine is not a panacea, Rhee agreed, warning of the potential risk of abuse and addiction.
“It should only be used medically,” he advised.
Ketamine’s rapid effects can be a life-saving treatment in the emergency room for patients presenting with suicidal ideation, some experts claim. (Getty Images)
Dr. Marc Siegel, Fox News senior medical analyst, noted in previous comments to Fox News Digital that ketamine is increasingly being used to treat severe depression, but emphasized that it should be administered under careful medical supervision because of its potential risks.
Study limitations
Although the studies compared ketamine with a placebo, some patients may have realized they were receiving the drug. This could have influenced how they reported their symptoms and how effective they perceived the treatment to be, according to the researchers.
“It should only be used medically.”
Another limitation is the small sample size of the studies, which could make the effects seem disproportionately magnified.
Also, as this was a review of many different studies, it is challenging to apply the findings to the general population, the researchers noted.
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“While long-term outcomes have not been studied, I believe that when patients are severely depressed or suicidal, ketamine is sometimes the only choice that almost always works,” Bazzi added.
Anyone interested in exploring alternative depression treatments should first consult a doctor.
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Tick bite-related ER visits are at their highest seasonal levels since 2017 across most U.S. regions, raising concerns about increased Lyme disease and other tick-borne illnesses.
That’s according to recent data from the Centers for Disease Control and Prevention’s Tick Bite Tracker, which monitors weekly emergency department visits associated with tick bites across the country.
For every 100,000 ER visits, approximately 71 were related to tick bites in April 2026, compared to a historical seasonal average of roughly 30 per 100,000.
DOCTORS REVEAL KEY SIGNS OF LYME DISEASE AS TICK SEASON INTENSIFIES ACROSS US
Some of the highest rates of tick-based ER visits were among children younger than 10 years and adults between 70 and 79 years.
A close-up shows a parasitic mite in motion on a human fingertip, highlighting the potential for disease transmission such as encephalitis. (iStock)
“Over the past three decades, the geographic range of the blacklegged tick has expanded significantly, and with it, the risk of Lyme disease and other Ixodes-transmitted infections,” Dr. Steven Goldberg, a family medicine physician who practices urgent care and family medicine at UofLHealth in Louisville, Kentucky, told Fox News Digital.
‘RABBIT FEVER’ CASES RISING IN US AS CDC WARNS OF ZOONOTIC BACTERIAL DISEASE
“The Ohio River Valley region is one of the most striking examples — Lyme disease cases in Ohio have increased roughly 10-fold over the past decade, likely driven by the convergence of Northeastern and Upper Midwestern tick populations meeting in that corridor.”
States like Virginia and West Virginia, as well as areas south of the traditional endemic zone, are reporting increasing tick abundance and disease cases, the doctor noted.
“Over the past three decades, the geographic range of the blacklegged tick has expanded significantly.”
“The lone star tick is also expanding its range northward beyond its traditional stronghold in the Southeast, which means diseases like ehrlichiosis and alpha-gal syndrome are appearing in regions where clinicians may not yet be thinking about them,” he warned.
Some climate studies predict that the blacklegged tick’s suitable habitat could expand by over 200% by the end of the century, Goldberg noted, including into Canada and across the central and southern U.S.
What’s driving the spike?
“Warmer, wetter conditions allow ticks to survive in habitats that previously would have been too cold,” said Dr. Suraj Saggar, chief of infectious disease at Holy Name Medical Center in Teaneck, New Jersey. “Milder winters also extend the lifespan of both ticks and the animals they feed on, accelerating tick reproduction and shortening their life cycles.”
Areas that historically experienced longer, colder winters or significant snow cover are now more hospitable to ticks, the doctor noted.
COPPERHEAD SNAKE BITE LEAVES MAYOR’S WIFE IN ‘EXCRUCIATING PAIN,’ HE REVEALS
“As temperatures rise and precipitation patterns change, ticks are able to spread northward and thrive in new ecosystems,” he said.
Another contributing factor is increased land development and human expansion into wooded and grassy areas, as well as reforestation of formerly agricultural land.
“As temperatures rise and precipitation patterns change, ticks are able to spread northward and thrive in new ecosystems,” an expert said. (iStock)
“The recovery and expansion of white-tailed deer populations — critical hosts for adult blacklegged ticks — has been a major driver,” Goldberg added. “Deer density is positively associated with Lyme disease incidence. Small mammal communities, particularly white-footed mice that serve as key reservoir hosts for Borrelia burgdorferi, also play a central role.”
Tick-borne diseases
Tick bites are known to transmit numerous illnesses, the most widespread of which is Lyme disease, a bacterial infection.
“Lyme disease cases alone have increased roughly two- to threefold over the past 20 years,” Saggar said. Approximately 476,000 Americans are diagnosed and treated for Lyme disease each year, per CDC surveillance data.
MOSQUITO-BORN DENGUE FEVER CASES SURGE AT POPULAR US VACATION DESTINATION
Also common are anaplasmosis and ehrlichiosis, two different types of bacterial infections, according to the doctor. Tick bites can also cause babesiosis, a malaria-like parasitic disease that infects and destroys red blood cells.
“Another growing concern is alpha-gal syndrome, a condition in which a (lone star) tick bite triggers a serious allergic reaction to red meat,” Saggar said. “In rare cases, people have died from anaphylactic reactions linked to alpha-gal syndrome following a tick bite.”
Some common symptoms of tick-borne illness include fever, chills, fatigue, headaches, muscle aches and joint pain. (iStock)
Ticks can also transmit viruses, including the Powassan virus, which can cause severe neurologic injury.
“Powassan virus disease is arguably the most concerning emerging tick-borne infection,” said Goldberg, who is also chief medical officer at HealthTrack. “It’s transmitted by the same blacklegged tick that carries Lyme disease, but unlike Lyme, it can be transmitted within minutes of tick attachment.”
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Powassan can cause severe encephalitis with a roughly 10% to 15% fatality rate, and more than half of survivors have lasting neurological deficits, Goldberg noted.
In the Rocky Mountain states, the Rocky Mountain wood tick (Dermacentor andersoni) transmits Rocky Mountain spotted fever and Colorado tick fever.
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“In the Southeast and South-Central U.S., the lone star tick (Amblyomma americanum) drives a different set of concerns: ehrlichiosis, tularemia, and two emerging viral threats — Heartland virus and Bourbon virus,” said Goldberg.
Symptoms to watch for
Some common symptoms of tick-borne illness include fever, chills, fatigue, headaches, muscle aches and joint pain, according to Saggar.
Another sign is the classic “bull’s-eye” rash associated with Lyme disease, known medically as “erythema migrans.”
“If you think you have been bitten by a tick, you should seek medical attention if you develop symptoms after a known tick bite or after spending time in tick-prone areas, especially during the spring, summer and fall.” (iStock)
“Because testing can sometimes be falsely negative early in the disease process, doctors may treat patients based on symptoms and exposure history rather than waiting for laboratory confirmation,” Saggar noted.
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“If you think you have been bitten by a tick, you should seek medical attention if you develop symptoms after a known tick bite or after spending time in tick-prone areas, especially during the spring, summer and fall.”
Preventing tick bites
As there are no vaccines currently available for any tick-borne disease in the U.S., prevention is the most effective strategy.
Goldberg shared the following recommended prevention strategies.
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- Use EPA-approved repellents, including DEET, picaridin, IR3535 or oil of lemon eucalyptus on exposed skin. Treat clothing and gear with permethrin (a synthetic insecticide and repellent) or purchase pre-treated clothing.
- Wear light-colored clothing (to spot ticks more easily), long sleeves and long pants tucked into socks when in wooded or grassy areas.
- After spending time outdoors, check your entire body, paying special attention to the scalp, behind the ears, armpits, groin and behind the knees, the doctor advised. It’s also recommended to shower within two hours of coming indoors.
- Tumble-dry clothing on high heat for at least 10 minutes to kill any ticks on clothing.
- Remove ticks promptly and properly. Using fine-tipped tweezers, grasp the tick as close to the skin as possible, and pull upward with steady, even pressure. Clean the bite area afterward.
Approximately 476,000 Americans are diagnosed and treated for Lyme disease each year, per CDC data.
“The longer a tick is attached, the higher the risk of disease transmission — for Lyme disease, transmission generally requires at least 36 hours of attachment,” Goldberg said. “The Powassan virus can be transmitted much more quickly.”
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