HIV/AIDS: a Global Class Struggle

By Gerry Scoppettuolo

These are worrisome and dangerous times for the 41 million people living with HIV/AIDS on the globe (1.2 million in the United States). In the past forty years for which there is reliable data, 44 million people have already died. U.S. deaths are approaching 800,000 making it the second most deadly pandemic in U.S. history after the Covid virus (1.2 million).

On Dec.1, World AIDS Day, contingents from ACT-UP Philadelphia, ACT-UP down traffic near the White House to protest the current and proposed deep cuts in the fiscal year 2026 budget. The protestors met at 16th and I Streets, about two blocks away from the White House, and unfurled huge red banners each representing a country in which countless lives are now on the chopping block because of recent cuts in U.S. international HIV medications and services. Interruption of HIV antiviral drugs, clinics and delivery systems of care have already wreaked havoc in a number of African countries. In Ethiopia, Kenya, Malawi, South Africa, Tanzania, Zambia, Kenya and Nigeria entire programs have been eliminated. The current cutbacks on global public health by the white supremacist Trump administration come just as efforts are on the verge of ending what has been an intractable plague. According to UN New York, Health Gap, National Minority AIDS Coalition and Housing Works traveled to Washington D.C. and took to the streets shutting AIDS.

At the end of 2024, the world was closer than in the past two decades to ending AIDS as a public health threat by 2030. 31.6 million of the 40.8 million (77%) [37 million–45.6 million] people living with HIV were on lifesaving treatment. HIV prevention and treatment services and focusing on the societal barriers that put people at heightened risk of HIV, led to a 40% decrease in the number of new infections and a 54% decrease in the number of AIDS-related deaths between 2010 and 2024. (Overcoming Disruption Transforming the AIDS Response; UN AIDS, 2025 World AIDS Day Report)

This progress has been achieved despite centuries of colonial subjugation, military occupation, and theft of natural resources, in short, imperialist oppression of the global working class by western powers. Instead of being consigned to history, the U.S. has given new life to a deadly pandemic.

“Globally, millions of people lost access to HIV prevention through pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) clinics were unable to dispense medication purchased with U.S. resources.” UN AIDS, which administers the Global Fund for AIDS, reported in April that, among 70 of its country offices, 28 (40%) had witnessed an end to community-led services due to the US funding cuts. Meanwhile, 21 (30%) reported that services by international NGOs had been stopped. In its Frozen Out report, found that 36% of programs previously supported by funds appropriated by the US congress were shut down within one week of Trump’s Executive Order cutting of US AID support. Across 13 countries, the number of people newly initiated on treatment has fallen. A November 25th report issued by the UN revealed that:

(Dangerously low) stocks of HIV test kits and essential medicines have been reported in Ethiopia and the Democratic Republic of Congo. Distribution of preventive medicines plummeted — down 31 per cent in Uganda, 21 per cent in Viet Nam, and 64 per cent in Burundi. 450,000 women in sub-Saharan Africa lost access to “mother mentors,” trusted community workers who link them to care and Nigeria recorded a 55 per cent drop in condom distribution.

HIV/AIDS Prevention and Treatment: A Global Class Struggle

The populations at risk for, and living with HIV/AIDS, are overwhelmingly those of the oppressed and the poor. If you were not impoverished before you were infected, and could not access anti-retroviral drugs, you soon will be and the rest of your life will be a daily struggle in which only constant pills and injections will be necessary for survival. The accompanying homelessness, poverty, substance use and stigma is often described by bourgeois sociologists as simply co-occurring conditions predictive of HIV, suddenly dropping from the heavens upon the unfortunate who then, sadly, find that they are sick and dying. HIV is a preventable illness which could have been eradicated decades ago but for the racism, homophobia and capitalist economic arrangements. It could never have spread as it did in Copenhagen or wealthy suburbs in Connecticut among the privileged rich.

In 1884 European rival colonial powers carved up Africa at the Berlin Conference so as to extract raw materials and subjugate human labor and make the profits that only imperialist conquest could guarantee. A virus unique to apes (SIV) jumped species in the Congo becoming HIV in the process and at first was confined to just a few workers. Years later the infection was unleashed when Belgian colonial health workers conducted unsanitary mass inoculations against sleeping sickness to thousands of Africans. Among these were a number of infected butchers and others who did not know they were infected with the new virus. HIV infected needles were used and reused over and over again to thousands vastly increasing HIV prevalence reaching which eventually reached threshold epidemic status. Those infected with HIV unknowingly spread the infection to others who did not know that they had not been infected and so on and so on. Even today the United States one out of seven persons living with the virus do not know they have it and are among those most likely to spread it to others. Without an HIV test, HIV can thrive undetected for many years before AIDS defining illnesses occur forcing the unknowing to seek medical help, and realizing that they were HIV positive for many years.

What happened in Africa was followed by the peoples’ struggle for self-determination there that could not be denied. Forms of self-governing statehood were won by 1960. The present HIV/AIDS calamity in Africa and elsewhere is a consequence of colonialist history, which is being perpetuated by today’s soft imperialism typified by US AID (Agency for International Development). U.S. financial assistance through the Pepfar program has certainly reduced the spread of HIV weaponize but at the same time has weaponized humanitarian assistance. US AID was launched by John F. Kennedy in 1961 who told its directors at the time that “we do not want to send American troops to a great many areas where freedom may be under attack, we send you.” As but one example, Miami-based CubaNet, received a dedicated $500,000 from USAID in 2024 to engage “on-island young Cubans through objective and uncensored journalism”. (Author’s note: Cuba today has the lowest HIV rate of any country in the global south without assistance from the U.S.) USAID provided $2.3 million in 2024, for propaganda programs through its so-called “Independent Media and Free Flow of Information” program. According to the mainstream journal Foreign Policy in Focus, much of US AID “foreign aid is tied to purchases of U.S. goods and services, which means that the U.S. government is basically just giving a lift to U.S. business. Economic development absorbs 27 percent of U.S. foreign aid, much of it spent within the United States. U.S. AID once boasted on its website that the principal beneficiary of America’s foreign assistance programs has always been the United States. Close to 80 percent of the US Agency for International Development’s contracts and grants go directly to American firms.” Reuters, on Feb 10, reported that US AID provides about 42% of all humanitarian aid globally and that most of the funds are spent on delivering US-produced food supplies 2025; (Orinoco Tribune, Feb 14, 2025). According to the Quixote Center USAID “is paying US contractors, rather than helping local markets and encouraging local providers.” (Quixote Center. 2/6/2025).

It is impossible to avoid the conclusion that U.S. withdrawal of support for ending global HIV prevention and treatment has led to a new genocide of neglect and a return to the old days of colonial violence. Secretary of State, Marco Rubio can now cut $1.9 billion from the FY 2026 budget to make room for the trillion-dollar Pentagon allocation. On a positive note, there may be enough funds left in the coming year to distribute the new PreP “wonder drug”, Lenocapavir, globally, only because it is being provided by its manufacturer, Gilead pharmaceuticals, at cost, $48 a year. (PreP is short for pre-exposure prophylaxis). However, this new drug will be provided to counter mother to child transmission only and will be denied all adult males by explicit order of Marco Rubio and the U.S. State Department leaving countless millions without protection, a condition found acceptable by Gilead. Gilead stockholders will not suffer, in just the most recent three months of 2025, Gilead had $5.3 billion in net income of its HIV drugs alone, 73% of all their drug sales are HIV drugs.. (https://www.indexbox.io/blog/gilead-sciences-q3-2025-profit-rises-on-strong-hiv-drug-sales/)

These are worrisome and dangerous times, but not hopeless times. South Africa provides most of the funds for its HIV programs. Cuba provides successful HIV prevention practices targeting men who have sex with other men that they train other countries in the global south in their methods. Cuba also has the lowest HIV prevalence of any country in the Global South.

The author is a former HIV Prevention Agency Director and Medical HIV Case Manager and has given out eight HIV positive tests results to clients among the over one thousand HIV counseling and testing interventions he has administered.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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c
ompanies is m uch to be excited about in Africa. Despite centuries of colonial underdevelopment, African leaders in Zambia, Ghana, Nigeria, South and Rhodesia are forging promising new paths in HIV prevention despite the best efforts of the U.S. white supremacist government to cancel support for life-saving HIV drugs. In a move that leaves behind dependance on what amounts io capitalist charity, these countries have skillfully negotiated massive import deals for generic formulations for the new groundbreaking Lenavapavir. This injectable drug requires only two shots a year and has been found to be 100% effective in preventing HIV infections. It is the closest thing to a vaccine that exists.
Pretoria logos and ,,,,, by passed U.S. trade regulations and negotiated directly with Gilead Pharmaceuticals and UNAIDS to allow generic production of this brand-new drug whose initial price is listed at $28,000 a year reducing the cost to $25/year. Pricing in the U.S. will be around $2000/year.

Africa and World AIDS day this year
The road to lenacapavir https://www.science.org/doi/10.1126/science.adz2598

• Kenya, Nigeria and South Africa have allocated additional budget funds to health, or are awaiting parliamentary approval for increases;
• Nigeria increased its health budget by US$ 200 million to offset aid shortfalls, with increased allocations for immunization, epidemic response, and priority programmes;
• Ghana lifted the cap on excise tax earmarked for its national health insurance agency, resulting in a 60% budget increase. The country also launched “the Accra Reset”, a bold framework to reimagine global governance, financing and partnerships in health and development; and
• Uganda has outlined a clear policy agenda for integration of health services and programmes, aiming to improve efficiency an
• d sustain service delivery.
Source who
25,5 million deaths avered by US AID source Daniella Cavalcanti, a researcher at the Federal University of Bahia (Brazil)
In South Africa, at least three Pepfar-funded programmes – transgender clinics of the Wits Reproductive Health Institute, the Anova Health Institute’s Ivan Toms Centre for Health in Green Point and OUT’s Engagement Men’s Health clinics in Gauteng and the Eastern Cape – let staff and patients know they were temporarily shutting their doors last week.
https://profiles.bu.edu/Brooke.Nichols trackoing US AIDS cuts
https://www.unaids.org/en/resources/presscentre/featurestories/2025/october/20251024_south-africa bi lelacavir rollout in south africa
https://www.theglobalfund.org/en/hivaids/
https://www.unaids.org/en/resources/presscentre/featurestories/2025/march/20250331_ESA-region_UN AIDS analysis of US AIDS cuts
https://newsroom.ucla.edu/stories/USAID-cuts-global-impact-14-million-deaths
Without continued PEPFAR programs, models predict that by 2030, an additional 1 million children will become infected with HIV, 500,000 additional children will die of AIDS, and there will be 2.8 million more children orphaned by AIDS. Country data on declines in early infant diagnosis, treatment initiation, and support in care are dire warnings that these projections could become realities. These risks are especially acute in the first years of life, when children with HIV face very high mortality without timely diagnosis and treatment. Early warning data also point to fragile supply of pediatric antiretroviral and testing commodities in several countries, suggesting that service disruptions may increasingly be compounded by stock risks. Together, these trends signal a heightened risk of reversals against global pediatric HIV targets and efforts to eliminate mother-to-child transmission. Aid Cuts Devastated PrEP and Testing for Highly Vulnerable Communities The scale of US government award terminations impacting HIV, tuberculosis, and malaria programs has been difficult to quantify with precision, as no official tally of cancelled US Agency for International Development (USAID) mechanisms has been released, nor have country programs clearly outlined which activities covered by cancelled awards have resumed in whole or in part with other external or domestic resources. At the same time, PEPFAR has ceased all public-facing data sharing, ending the routine quarterly data reviews both in countries and globally through online resources. Triangulating available information on cancelled awards, country data on service delivery, and reports on the robustness or challenges of data collection, CHAI and partners find: X Worst-case scenarios for adult HIV treatment may have been averted—for now. Projections of impact on ART have used available information on award cancellation to extrapolate to treatment risk. Approximately 24 percent of USAID’s FY25 PEPFAR awards were terminated by August 2025, representing US$485 million, with an additional US$220 million (11 percent) in unknown status. Terminated awards are estimated to affect timely ART delivery for 2.3 WHAT TO WATCH IN 2026: X Diagnosis and treatment gaps for infants and children: Ministries of Health, pediatric HIV programs, and partners should monitor infant and child testing volumes and coverage, pediatric ART initiation, and retention in care together to understand where service disruption is driving missed diagnoses and delayed treatment, and focus available resources where children are most at risk, including finding children who have already fallen out of care. X Pediatric commodity security: Building on CHAI’s early stock-status signals, Ministries of Health, procurement units, and partners should closely track pediatric treatment and testing stock levels, pipeline, and supplier performance, intervening early to prevent stockouts, avoid backsliding from optimal child-friendly formulations and regimens, and maintain continuity of care. Our data suggest that an increasing proportion of these children will die without an HIV diagnosis, a further failure of the health system and a barrier to accurate assessment of the impact of aid cuts.

Meet the New Fascists – same as the Old Fascists
Project 2025, or its source, the Heritage Foundation, did not suddenly fall from the sky last year. It was founded a half century ago with millions of Coors Brewery money at the dawn in the first years of the post-Watergate and post-Vietnam era of the early 1970’s. It has dreams dreamed the fever dream of White Supremacy and the Ku Klux Klan ever since releasing its first edition, the 1980 Mandate for Leadership, written and delivered to Ronald Reagan by Joe Coors to be used by him as leader of Reagan’s “kitchen Cabinet’.
1972 he wrote a $250,000 check to begin the Heritage Foundation. Other philanthropists like the Samuel Roberts Noble Foundation and Richard Mellon Scaife joined the cause, but the Coors cash was catalytic, and also consistent. Coors continued to invest in the Heritage Foundation over many years, including a $300,000 gift in 1980 that allowed it to move to improved offices. (Philanthropy Roundtable)
The Walton Family Foundation describes itself on its website as “[continuing] a philanthropic vision begun by Walmart founders Sam and Helen Walton.” The website’s grants page (archived) featured a search box allowing users to easily locate past contributions. The website displayed contributions to The Heritage Foundation from 1992 through 2018 totaling $650,000.1972 he wrote a $250,000 check to begin the Heritage Foundation. Other philanthropists like the Samuel Roberts Noble Foundation and Richard Mellon Scaife joined the cause, but the Coors cash was catalytic, and also consistent. Coors continued to invest in the Heritage Foundation over many years, including a $300,000 gift in 1980 that allowed it to move to improved offices…….We noted the foundation’s website also displayed past contributions to other organizations presently named as Project 2025’s advisory board partners, including American Compass in 2022 and 2023 (totaling $300,000); The Claremont Institute between 1994 and 1998 ($277,000); Discovery Institute in 2015 ($200,000); Foundation for American Innovation in 2023 ($119,456); Heartland Institute between 2002 and 2017 ($420,000); Independent Women’s Forum between 2016 and 2022 ($525,000); James Madison Institute between 2012 and 2015 ($290,000); Mackinac Center between 1999 and 2012 ($470,000); National Center for Public Policy Research in 1997 ($97,000); Oklahoma Council of Public Affairs between 2014 and 2020 ($2,155,630); Pacific Research Institute between 1995 and 2014 ($875,000); and Texas Public Policy Foundation between 1995 and 2022 ($1,030,000).