The graves at the edge of the orphanage tell a story of despair. The rough planks in the cracked earth are painted with the names of children, most of them dead in the 1990s. That was before the HIV drugs arrived.
Today, the orphanage in Kenya’s capital is a happier, more hopeful place for children with HIV. But a political fight taking place in the United States is threatening the program that helps to keep them and millions of others around the world alive.The AIDS epidemic has killed more than 40 million people since the first recorded cases in 1981, tripling child mortality and carving decades off life expectancy in the hardest-hit areas of Africa, where the cost of treatment put it out of reach.
The issue of abortion has been a sensitive one since PEPFAR’s inception in 2003. But each time the program came up for renewal in Congress, Republicans and Democrats were able to put aside partisan politics to support a program that’s long been seen as the vanguard of global aid. In language echoing the early, harsh years of the epidemic, Heritage called HIV/AIDS a “lifestyle disease” that should be suppressed by “education, moral suasion and legal sanctions.” It recommended halving U.S. funding for PEPFAR, saying poor countries should bear more of the costs.
Supporters of the program say that under existing U.S. law, partners are already prohibited from using its funding for abortion services. The head of PEPFAR, John Nkengasong, told the AP he knew of no instance of the program’s money going directly or indirectly to fund abortion services. “If PEPFAR goes, who is going to meet that cost?” asked Josephine Kaleebi, who leads an organization in Uganda that helped the program’s first-ever recipient of HIV treatment medication.The group, Reach Out Mbuya Community Health Initiative, was founded by members of Uganda’s Catholic Church, which is against abortion. In the reception area, portraits of priests line the walls.
In neighboring Kenya, Bernard Mwololo believes he is alive because of the drugs that PEPFAR provides. “Sometimes it’s so crazy when you hear people saying that these HIV drugs should be bought by the local government,” he said. “I am telling you, they can’t manage it.”
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