‘My wife fears sex, I fear death’

Life for Mike Elvis Tusubir, a motorcycle rider from HIV in Uganda, was turned down because last month, US President Donald Trump stopped foreign aid.

A 35-year-old fear for his own survival when he takes rescue antiretroviral (ARV) drugs he says he will have to share with his wife because they can no longer have safe sex.

HIV is not negative and relies on Prep, a medicine that reduces the risk of HIV infection.

“This means that even my marriage is over because it is not really going to stay without preventive measures,” he said BBC.

“No condoms, no (anti-wich) lubrication, no preparation, nothing. We can’t stay married without a meeting. It means I must remain lonely.”

All the couples and contraceptives were provided through the financing of the General Agency for the USAID government.

Since the sudden shutdown he heard in social media, they were unable to replenish their supplies. His wife fully ended with preparation, and they both afraid that relying only on condoms – they remain – too risky.

Trump ordered a 90-day pause for foreign aid on his first day ago, after which the order of the termination began to be issued by organizations funded by USAID.

After that, refusals were issued for humanitarian projects, but still the HIV g -tusubir program was part of the Marpi clinic in the north of the capital, Camol closed.

He called his advisor at Kissva III Health Center to find out what was happening.

“My advisor was in the village. He told me he was no longer in the clinic.”

A friend’s father, who has experienced a positive HIV in 2022, has since missed a test to determine how much the virus is in his blood and the strength of his immune system.

“I am moving in the dark, in the dark. I don’t know if my viral load is suppressed. I’m injured.”

He does not believe that his work managed a taxi on a motorcycle – local, known as “Boda -Bodo” ​​- will be able to help his family overcome the obstacles they face.

“Some others say the drugs will be in private pharmacies … As a Boda-Boda rider, I don’t know if I can raise money to maintain treatment.”

They were also affected by the loss of services provided by non -governmental organizations (NGOs) that received financing from USAID, he says.

His wife received training through NGOs in Marpi, and his five -year -old son won from the one who provided school and food for vulnerable children.

“My child is no longer at school,” he said.

Uganda’s health sector depends heavily on the financing of donors, which supports 70% of its AIDS initiatives.

The Eastern African nation is among the top 10 USAID Funds in Africa. According to US government data, the country has received $ 295 million (234 million pounds) financing the health agency in 2023 – ranking third after Nigeria, which received $ 368 million and Tanzania with $ 337 million.

USAID also supports its malaria, tuberculosis and proclamation of the program – as well as financing the health care services of the mother and children and the ambulance assistance.

Thousands of healthcare providers were affected by US financing.

D -R Shamir Correction, MBUYA Clinic (ROM) – an organization based on a faith providing medical and psychosocial support for people living with HIV in Uganda – founded at the Kisenyi IV health center, which serves a dense slum in the carol.

On average, she visited 200 patients with HIV/AIDS and tuberculosis daily. But after the order for stopping, all employees who support themselves were fired.

Currently, the tuberculosis department was also closed in Kiseni, and his orphans and vulnerable children were.

“We are waiting for 90 days. So, I didn’t prepare this mandatory vacation,” she said the BBC.

“It was so sharply. We didn’t have a proper transfer to the facility. We just stopped working.”

Uganda’s Ministry of Health states that he studies ways to minimize disruptions.

D -R Diana Atvin, Chief Public Servant of the Ministry, called on employees “ready to continue working in the spirit of patriotism as volunteers” to contact.

Further to the south in Malawi, the activity funded by USAID also stopped.

The country received $ 154 million from the USAid budget in 2023, which made it 10 -largest African recipients.

In the northern city of the MSU, the gates are closed at the clinic, which was a key HIV provider in the region. Cars sit in a hideoul; The Macro Mzuzu clinic has no signs of activity. The workers closed the door, turned off the light and went home 18 days ago.

Despite the refusal of the US State Department on January 28, which will allow the delivery of medicine, such as ARV, many clinics have clinics, because without critical employees coordinating USAID activities, the distribution of medicines is a problem.

Even where the services are technically allowed to restore, many contracts remain in the suspended state. Medical workers are not sure they can and what they cannot do.

Trump’s administration plans to cut USAID employees by more than 90%.

Atuli Golando, a former USAID World Health Administrator, has published on X that the agency’s workforce would be cut from 14,000 to 294 – only 12 staff appointed to Africa.

More than 30 NGOs in Malawi have also been badly affected by the financing.

Edda Simfukwe Banda, a 32-year-old peasant’s existence, has been receiving ARV since 2017 from a macro clinic, where various NGOs provided HIV programs.

She is worried about her fate and her daughter-in-law, which also rests on the medicines funded by donors, and says they have little opportunity except for prayer.

“We must pray as Malawica. Those who think depend on God who opens the door when one is closed,” she said the BBC.

The mother of three years, which left three weeks of ARV, also stated that weighted system failures: “Like Malavitsa, we depend too much on receiving help. Sometimes we are lazy and squeezed and hope for other countries to help we help.

“Let it be a lesson we need to be independent,” she said.

But it is difficult for one of the poorest and most dependent on the world of the world. According to the World Bank, Malawi is vulnerable to external shocks – including long drought, cyclones and incorrect rainfall.

Violation of such a magnitude in its health care system is a big problem.

For decades, the United States has been the most significant health partner in Africa.

In particular, due to its main program of counteraction to the global HIV distribution, which was launched in 2003. He named the US President’s Emergency Plan for AIDS (PEPFAR), he saved more than 25 million lives.

According to the head of the African Disease Control Centers (CDC AFRICA), USAID has provided $ 8 billion in Africa over the last year.

“Seventy-three percent went to healthcare,” Jean Kasei said at the BBC Newsday last month.

Health experts warn that the replacement of this funding will be extremely difficult.

African governments have succeeded in reducing the assistance. Kenya now finances almost 60% of his HIV response. South Africa covers almost 80%.

But for many low -income countries, debt, climatic disasters and economic shocks make self -sufficiency almost impossible.

Amref Health Africa, one of the leading NGOs in the continent, warns that without urgent action global health safety is at risk.

“This will require the African governments and Africa CDC to increase its own financing, which is almost impossible in the current environment of debt,” said its CEO Dr. Hiting Hitihi.

“With the acceleration of outbreaks from climate change and human conflicts, it will leave the world gentle and dangerous – not only for Africa, but for everyone.”

Worldwide in 2023 there were 630,000 AIDS deaths and 1.5 million new infections.

While the infection levels decreases in the most affected countries, the impact of USAID can change these income.

“If you take this great contribution from the United States Government, we expect that in the next five years there will be another 6.3 million AIDS deaths,” Winnie Banima, the head of Unid, said the daily podcast bbc africa daily This week.

“There will be 8.7 million new infections, 3.4 million additional AIDS orphans. I do not want to sound like a prophet, but I have a duty to give facts as we see them.”

Medical charity Médecins Sans Frontères (MSF) also warned of the danger of interruption of HIV.

“HIV medicines need to be taken daily, or people risk developing resistance or mortal health complications,” said Tom Elman from South Africa MSF.

Returning to Uganda, Mr. Tusubir feels gloomy in the future.

He left about 30 days from ARV medicines – and can choose a companion and then return home to his village.

“At least it will be a little easier. If I die, they just bury me there instead of bothering my people here in Camol.

“Because I don’t have the opportunity to live here without ARV services.”