In August 2010, I traveled with 20 New Yorkers to KwaZulu-Natal, South Africa, to serve at an orphanage caring for more than a hundred children — many born with HIV, most orphaned by AIDS. That trip reshaped my worldview and deepened my commitment to a fight that has claimed more than 44 million lives and afflicts more than 40 million people worldwide.
Today, on World AIDS Day 2025, that battle remains far from over.
Before the trip, I worried about health risks and cultural barriers. But the moment we arrived, those fears vanished. The children didn’t see strangers, they simply reached for our hands. Their needs were universal: love, safety, opportunity, belonging.
I met Nkululeko, born HIV-positive and rescued from abuse by a neighbor. Tebogo had lost both parents to AIDS and nearly starved before a teacher found her and her siblings. Nomfundo’s aunt brought her after robbers stripped their home bare.
The memory of those children stayed with me long after I returned to New York, inspiring me to found a nonprofit, Loving All Nations, to help raise funds for their care. Through the years, I’ve watched them not only survive but succeed.
I was grateful to play a small part in their journey, and proud that my country was helping lead the global fight against AIDS. Nowhere was that more evident than in South Africa. Though it still has the world’s highest number of people living with HIV — more than eight million — countless lives have been saved through U.S. programs like PEPFAR, the President’s Emergency Plan for AIDS Relief. For 22 years, PEPFAR has provided testing, treatment, and infrastructure that turned despair into hope. Just three years ago, it pledged to help end the pandemic by 2030.
But in January 2025, decades of progress began to unravel when the U.S. froze most foreign aid, gutting an estimated 80% of global health and development programs. The dismantling of USAID soon followed. PEPFAR clinics slashed staff, cut testing, and halted lab services, forcing many to close entirely.
The Center for Global Development estimates that 2.3 million people lost access to lifesaving HIV treatment — half in South Africa — where PEPFAR’s budget was cut, along with 53% of its health care workers.
The damage wasn’t limited to overseas. Nearly 200 U.S. HIV research grants — more than $200 million — were cut this year, including a program at Meharry Medical College. At the NIH and NIAID, leaders who helped turn HIV from fatal to manageable were fired or reassigned, including 45-year veteran Clifford Lane — signaling not just lost expertise, but the unraveling of a legacy built on compassion.
UNAIDS warns that permanent PEPFAR cuts could cause 6.6 million new HIV infections by 2029 and 4.2 million additional deaths, leaving three million more orphans. Those numbers aren’t abstract to me. When I hear them, I see Nkululeko, Tebogo, and Nomfundo — and know their futures depend on whether the world still chooses to care.
Observed each Dec. 1 since 1988, World AIDS Day reminds us the epidemic is far from over. In 2024 alone, 630,000 people died and 1.3 million were newly infected. This year’s theme, “Overcoming Disruption, Transforming the AIDS Response,” underscores both the urgency and the hope still driving the fight. Yet this year, the State Department barred employees from promoting or commemorating the day, citing a new policy against messaging on “commemorative observances.”
The rollbacks have only strengthened the HIV community’s resolve. In April, activist Peter Staley led a protest outside the State Department, laying 200 symbolic coffins to mark PEPFAR’s gutting. “Everything we built has been destroyed,” he warned. Charles King of Housing Works echoed that urgency: “As we honor those we’ve lost, we fight to end AIDS for everyone — through treatment, prevention, and support.”
Still, there is hope. A new injectable, lenacapavir, could revolutionize prevention, and with help from the Global Fund, should soon become available in South Africa. “The new drug will be accessible, affordable, and locally produced,” says Dr. Aaron Motsoaledi, South Africa’s Minister of Health.
Such breakthroughs give me hope that children in South Africa will grow up with the same dignity and opportunity as the friends I met in 2010.
PEPFAR still insists AIDS eradication by 2030 is possible. But progress depends on us — urging leaders to restore funding, supporting organizations like Housing Works, the HIV/AIDS Bureau, the Global Fund, WHO, and standing up against stigma.
The progress we’ve made is real. So is the risk we’ll lose it.
It will take all of us — standing in the gap — to make sure we don’t.
Ray Stanton is author of “Out of the Shadow of 9/11: An Inspiring Tale of Escape and Transformation.”
