Individuals queue outdoors the Unjani Clinic in Braamfischerville, Soweto, Johannesburg, South Africa on Could 25, 2026.
Gulshan Khan for NPR
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Gulshan Khan for NPR
This essay first appeared within the Up First e-newsletter. Join right here.
It may be onerous to recollect what the HIV/AIDS epidemic in Africa seemed like many years in the past: Hospitals throughout the continent had been overwhelmed with younger women and men, dying excruciating deaths.
South Africa was on the heart of the epidemic. Activist Fortunate Mazibuko remembers, vividly.
He advised me that on the time, the nation “was filled with the stench of death.”
It appeared, he went on to say, that there could be no finish to the struggling.
“There was no hope, there was basically no light,” he advised me. “And even if there was a light at the end of the tunnel, it looked like that of an oncoming train.”
The Esselen Clinic, which is located on the identical avenue as the WITS RHI Girls’s Well being Clinic continues to function with sufferers lining up outdoors on Esselen avenue, Hillbrow, Johannesburg, South Africa on Could 25, 2026.
Gulshan Khan for NPR
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Gulshan Khan for NPR
PEPFAR modified the whole lot — throughout the continent.
President George W. Bush introduced the President’s Emergency Plan for AIDS Aid, or PEPFAR, in January 2003. This system is usually cited as the best public well being marketing campaign ever, and is estimated by the State Division to have saved roughly 26 million lives since its inception. And for many years, this system loved widespread bipartisan help.
However the Trump administration has radically modified the way in which the U.S. delivers overseas help, making sharp cuts and creating uncertainty about future funding. In order my colleagues and I tracked these developments, we needed to see first-hand what these sweeping modifications may imply for the worldwide combat to fight HIV/AIDS.
A discover informs of the ceasing of the CATALYST research in January 2025 resulting from USA coverage modifications and funding cuts, in addition to alternate choices for HIV prevention and healthcare companies outdoors the WITS RHI Girls’s Well being Clinic in Esselen avenue, Hillbrow, Johannesburg, South Africa on Could 25, 2026.
Gulshan Khan for NPR
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Gulshan Khan for NPR
That curiosity is what led us to Soweto Township in South Africa to sit down down with Mazibuko. He is an activist and former journalist, who we met on the restaurant he now runs.
Again in 1999, at a time when the illness was nonetheless shrouded in stigma and disgrace, Mazibuko disclosed his personal HIV-positive standing in a column in South Africa’s greatest newspaper.
Even at funerals for individuals who had died after contracting HIV, Mazibuko advised me, “people spoke in hushed voices about what the cause of death could have been, even if they knew.”
Once I requested him why he selected to come back ahead so publicly, he grew emotional as he advised me that he felt he had no different selection.
Individuals stroll previous the closed WITS RHI Girls’s Well being Clinic in Esselen avenue, Hillbrow, Johannesburg, South Africa on Could 25, 2026.
Gulshan Khan for NPR
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Gulshan Khan for NPR
Over the course of almost two weeks of reporting, alongside my All Issues Thought-about colleagues Matt Ozug and Vincent Acovino, we heard tales of how the shifts in overseas assist have destabilized long-effective applications in South Africa and neighboring Mozambique.
South Africa nonetheless has the best variety of individuals with HIV of any nation, and the U.S. Embassy in Mozambique notes it’s dwelling to the second-largest AIDS epidemic on this planet. Our reporting in each international locations was supported by the Pulitzer Heart.
We spoke with public well being employees who nervous that the shifts have created uncertainty that might result in lack of life or extra infections. However maybe what caught with me probably the most had been the tales of resilience.
From the well being employees going with out a full paycheck to ensure they nonetheless have the belief of sufferers of their communities; to the revolutionary TV present educating viewers on wholesome relationship dynamics; to the advocates doing the whole lot they’ll provide intercourse employees customized care after the closure of a U.S.-funded clinic – all over the place we went, we met individuals who remained deeply dedicated to their work.
You’ll be able to hear our tales right here, and see extra within the coming days throughout NPR’s social media channels.
Passersby outdoors the WITS RHI Girls’s Well being Clinic in Esselen avenue, Hillbrow, Johannesburg, South Africa on Could 25, 2026.
Gulshan Khan for NPR
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Gulshan Khan for NPR
