AFTER THE USAID drama started unfolding, I realized I was one of the only Americans in medical care in Malawi not directly affiliated with the U.S. Agency for International Development, the U.S. government, or paid by any of their partners, therefore I could talk when nobody else could. When the executive order came [to pause U.S. foreign aid], they stopped 90% of USAID-affiliated programs and almost all HIV-care access points suddenly closed. That put most of the HIV-related things on the chopping block. Some programs that restarted after [intervention by] the courts are closed again, probably for good. One program has lost 1,200 people who specialized in HIV prevention, treatment, and data collection. There’s no one to fill in who knows what those people know. Will we know how many babies died that were never tested and got HIV during delivery? Gathering data to prove that this suffering is related to the cuts will be difficult because funding for data gathering was the first to go. We know these bad things are going to happen, but it will be hard to prove.

Malawi is one of the poorest countries in the world. The government has worked hard to fill the gap on zero notice. It’s not the way any transition should happen. Nobody wants Malawi to be aid-dependent forever, but this is not a place where gross waste was happening. This is one of the most difficult areas to be alive. [Americans have] let a lot of people down. It’s really sad to see people so disillusioned at what they thought America was. The result of these cuts is just devastating. It’s hard for Christians in Malawi to understand why Christians somewhere else would support something that means they can’t go to school, feed their children, or take their life-saving medicine. It’s very confusing.