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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No sex for the win? This was the advice given to this year’s NBA champions.
New York Knicks owner James Dolan addressed the now-champs as they headed into the playoffs in April 2026, acknowledging their high potential to eventually win the championship.
“I don’t know if you understand what it would mean for you to win a championship this year … It would be life-changing,” he said. “It will stick with you the rest of your lives, and if you don’t win, you’ll be thinking about it the rest of your lives.”
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As Dolan’s inspirational speech to the team went on, he explained how the next 10 weeks would require each player to make sacrifices – watching their diets, getting proper sleep and perhaps even abstaining from sex.
“You need sacrifice and you need to eliminate all the distractions around you,” he said.
Jalen Brunson of the New York Knicks celebrates with the Bill Russell NBA Finals Most Valuable Player Award trophy and Knicks owner James Dolan after defeating the San Antonio Spurs in Game Five of the 2026 NBA Finals at Frost Bank Center in San Antonio, Texas, on June 13, 2026. (Gregory Shamus/Getty Images)
“I had this idea that maybe you should give up sex for the next 10 weeks,” the owner said. “You don’t have to give up sex for the next 10 weeks – but, like the Spartans … They denied themselves, so that they can have an edge. Get the edge.”
This received a few snickers from the team, and Dolan responded, “Don’t tell [your wives and girlfriends] you’re not going to have sex and don’t tell them it was my idea. But let them know what this is going to be like … and how they’re going to have to sacrifice, too.”
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Dr. Anna Elton, licensed marriage and family therapist and clinical sexologist in Massachusetts, confirmed that this belief has been around for centuries, dating back to the ancients Spartans and early Olympic competitors.
Avoiding sex can preserve energy, increase aggression and sharpen focus, according to Elton.
The theory behind abstaining from sex for better athletic performance supports that it can preserve energy, increase aggression and sharpen focus. (iStock)
But modern research has found little evidence that consensual sexual activity negatively impacts strength, endurance, reaction time or athletic performance when it occurs at least 10 hours before competition, the doctor countered.
However, “activity very close to competition may affect recovery measures,” she added. What may be more important, according to Elton, is the psychological value of abstinence.
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“Choosing to abstain can reinforce discipline and total commitment to a larger goal,” she said. “In those cases, the advantage may come more from mindset and focus than from any physical effect.”
“Whether the sacrifice is alcohol, social activities, favorite foods or sex, the message is often the same: ‘We are all in.’”
New York Knicks guard Jalen Brunson celebrates with teammates after the Knicks defeated the San Antonio Spurs in game five of the 2026 NBA Finals at Frost Bank Center in San Antonio, Texas, on June 13, 2026. (Geoff Burke/Imagn Images)
The science of abstinence
This discussion has historically focused on men, which Elton said is often based on “misconceptions about testosterone and energy depletion.”
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“Research has not demonstrated that normal sexual activity causes a meaningful decline in athletic performance, and concerns about testosterone depletion have not been consistently supported by the evidence,” she said.
“For women, sexual activity may have additional benefits related to stress reduction, emotional regulation and relationship satisfaction.”
Abstaining from sex for athletic performance may create a sense of discipline, minimize distractions, maintain focus on training and reinforce a team culture centered on sacrifice and commitment, experts say. (iStock)
In a separate interview with Fox News Digital, Dr. Anthony Puopolo, a men’s health expert and lead medical provider for RexMD, echoed Elton’s assessment that research largely does not support abstinence as a performance enhancer.
This is despite a small amount of evidence that suggests engaging in sexual activity within two hours of competition could pose a risk to cardiovascular recovery.
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“Unfortunately, nearly all studies (99%) have been conducted in males aged 20 to 40, so there is virtually no data on female athletes, older athletes or diverse populations,” said the Puerto Rico-based expert. “We know what to tell the Knicks, but we are not sure what to recommend for the New York Liberty.”
Importance of connection
Elton said abstinence may still offer psychological benefits for some competitors. “For some athletes, it can become part of a pre-competition ritual that enhances confidence,” she told Fox News Digital.
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Some other potential benefits of sexual activity include stress reduction, improved sleep, mood enhancement, emotional connection with a partner and relief from performance-related tension.
“Strong, supportive relationships are associated with better psychological resilience, which can be valuable during high-pressure competitions,” Elton said.
“One of the most overlooked performance advantages may be having a supportive relationship waiting at home,” a doctor said. (iStock)
“Ultimately, there is no universal rule,” she went on. “What helps one athlete perform at their best may not help another.”
Elton stressed that sleep, recovery, nutrition, stress management and support from loved ones are universal performance boosters.
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“Athletes devote tremendous attention to training their bodies, while overlooking the importance of their personal relationships,” she cautioned. “A supportive partner can be one of the greatest assets during a demanding season.”
“If competition requires temporary sacrifices, make those decisions together and keep communication open.”
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Eliminating sugar from your diet may seem like the key to healthy eating, but research suggests it could have unintended effects on digestive health.
A study presented at ENDO 2026, the Endocrine Society’s annual meeting, suggests that a total lack of sucrose, or table sugar, may harm gut health and disrupt the body’s natural metabolism.
To explore how the total absence of dietary sugar impacts the body, researchers at the Dasman Diabetes Institute in Kuwait City conducted a 16-week study on two groups of mice. Both groups were placed on a low-fat diet, but with one critical difference.
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One group consumed a low-fat diet that included a standard amount of sucrose, while the other group ate a low-fat diet that was completely sugar-free, according to the study’s press release.
Throughout the trial, the scientists monitored a wide variety of physiological factors, including the animals’ weight, glucose tolerance, insulin sensitivity, hormone levels, internal inflammation and the specific composition of their gut bacteria.
A total lack of dietary sugar can cause imbalances in the gut bacteria and lead to signs of fatty liver disease, even without any weight gain, researchers said. (iStock)
The study outcome suggested that completely removing sugar caused several unexpected health problems.
“Completely removing sucrose from a low-fat diet may unexpectedly disrupt gut health and promote inflammation and metabolic dysfunction,” Rasheed Ahmad, principal scientist and head of the Immunology & Microbiology Department at the Dasman Diabetes Institute, said in the release.
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Even though the mice on the sugar-free diet did not gain any extra weight compared to the control group, their internal health indicators deteriorated.
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The animals that lacked sucrose developed an imbalance in their gut microbes and increased inflammation within the intestines and liver.
They also showed signs of poor glucose regulation, insulin resistance and cellular changes associated with fatty liver disease, according to the research.
Future dietary guidelines may shift away from strict, absolute sugar bans and instead focus on overall gut health through balanced nutrition. (iStock)
“The findings suggest that complete removal of sucrose from a low-fat diet may negatively affect gut microbiota and metabolic health,” Ahmad concluded.
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While the risks of high-sugar diets are well-established, the researchers noted that little attention has been given to the effects of completely eliminating sugar from low-fat meals.
Scientists say these new findings highlight that dietary carbohydrates play a valuable role in supporting balance between the immune system and the gut microbiome.
Completely cutting sucrose from a low-fat diet can unexpectedly trigger gut inflammation and disrupt the metabolism, experts say. (iStock)
Because this research was conducted on mice over a relatively short 16-week period, further clinical trials are necessary to determine whether a completely sugar-free diet causes the same gut and liver inflammation in humans.
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Additionally, the study focused specifically on removing sucrose from low-fat meals, meaning the results might not apply to people eliminating sugar while following higher-fat or ketogenic eating plans, the researchers noted.
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The team believes that future dietary guidelines may shift away from strict, absolute sugar restrictions and instead place a greater emphasis on maintaining a diverse, healthy population of gut bacteria through balanced nutrition.
“In the long term, these findings could help improve strategies for preventing and managing metabolic disorders, fatty liver disease and chronic inflammatory conditions,” Ahmad said.
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