When Elon Musk and Donald Trump, the richest and the most powerful people on the planet, respectively, decided to defund, dismember and then destroy America’s international aid effort, it was obvious that it would unleash untold suffering on the most vulnerable people on the planet.
America’s official overseas assistance programme was by no means generous in the first place, but the performative, clumsy cruelty inflicted on what is now the former US Agency for International Development (USAID) and associated programmes has reduced it to virtually nothing. It was done carelessly and with no consideration for the consequences in the communities devastated by the abrupt withdrawal of help. At the time, Mr Musk even “joked” that his underqualified team of coders had accidentally cancelled an Ebola prevention programme.
That moment should have prompted more thought in the Trump administration about how infectious deadly diseases rarely stay confined to the developing world, but have a habit of travelling to the prosperous West – just as Covid went global within about a month. But the administrative vandalism went on.
However, the lethal repercussions for America itself of the cuts to overseas aid are now beginning to emerge, and the law of unintended consequences is starting to make itself felt. As The Independent reports, disruption to HIV programmes caused by cuts to the US President’s Emergency Plan for Aids Relief could drive resistance to critical antiviral medications in those parts of the world, such as sub-Saharan Africa, where Aids is endemic (and, ironically, a part of the world with which Mr Musk is highly familiar).
The UNAIDS deputy executive director Angeli Achrekar told The Independent that this is “a recipe for disaster”: “When we have drug resistance to the medication that people are on, they have to be put on second- or third-line therapy, which is much more expensive and much more difficult to access…disaster. This is going to compound the issue we are facing right now and again will make ending Aids much more difficult to reach.”
The point is that Aids is a global phenomenon – and that includes America. As with Covid, if it is less well suppressed by treatment, public health education and condoms, the human immunodeficiency virus finds more and more hosts in which it can mutate. New and more dangerous strains can develop, which are resistant to existing drugs. Even if a few people find themselves skipping their suppression medication for a few days, the virus is allowed to evolve and become more dangerous. There is no way that such strains can be kept out of the United States, or anywhere else, by any wall or campaign against irregular migration.
Sooner or later, Americans could die from a new form of Aids arriving from Africa – and the cycle that started via that precise channel in the early 1980s will be given a fresh twist. Even now, even with the many billions of dollars expended on medical research, there is no cure for Aids, only measures that can relieve suffering, prolong life and slow its spread. There is, in other words, no “backstop” drug that Mr Trump’s America can turn to if a drug-resistant form of HIV becomes established in the United States. The human suffering and the economic cost will both be vast.
To put it at its simplest, and most mercenary, it seems obvious with only a few weeks’ worth of reflection that the cuts in US overseas aid are a false economy. That is the kind of language that the president and his Maga followers might understand. The rest of America, and the world, will already be persuaded of the moral case for saving the lives of poor strangers in far-off lands without any additional appeal to self-interest.
The human suffering in poor and middle-income countries without the means to provide anything like comprehensive health care is really too vast and too harrowing to comprehend fully. Americans have a conscience, and they should be troubled by that. They know by now that Aids is real and understands no national boundaries.
