‘My wife fears sex, I’m afraid of death’

The life of Mike Elvis Tusubira, a motorcycle rider with HIV in Uganda, has been sponsored since the president of the United States, Donald Trump, stopped foreign aid last month.

The 35 -year -old not only fears for his own survival, since he takes antiretroviral drugs (ARV) that save lives, but says he will have to separate from his wife, since they can no longer have safe sex.

Your partner is HIV negative and depends on the preparation, a medicine that reduces the risk of contracting HIV.

“It means that even my marriage will end, because in reality without preventive measures, she is not going to stay,” he told the BBC.

“Without condoms, without lubricants (anti-vih), without preparation, nothing. We cannot stay in marriage without gathering. It means that I have to remain single.”

All medications and contraceptives of the couple were supplied thanks to the financing of the main agency for abroad of the United States government.

Since the sudden closing, which he heard on social networks, they have not been able to replace their supplies. His wife has been completely without preparation now and both fear that trusting only condoms, something is left, it is too risky.

Trump ordered the 90 -day pause on foreign aid on his first day in office, after which stop orders began to broadcast organizations financed by USAID.

Subsequently, exemptions for humanitarian projects were issued, but at that time the HIV program, Mr. Tusubira, was part of the Marpi Clinic in the north of the capital, Kampala – had closed.

He called his advisor at the Kiswa Health Center III in the city to find out what was happening.

“My counselor was in the village. He told me that he is no longer in the clinic.”

The father of one, who positively gave HIV in 2022, has lost a test to determine how much viruses there are in his blood and the strength of his immune system.

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

He does not believe that his work driving a motorcycle taxi, known locally as a “wedding -Boda”, can help your family overcome the obstacles they now face.

“Some other people say that drugs will be in private pharmacies … like wedding rider-wedding, I don’t know if I can raise money to hold my treatment.”

They have also been affected by the loss of services provided by non -governmental organizations (NGO) that received USAID funds, he says.

His wife was getting his preparation through an NGO in Marpi and his five -year -old son was benefiting from one provided by school and food for vulnerable children.

“My son is no longer in school now,” he said.

The Uganda health sector depends largely on the financing of donors, which supports 70% of its AIDS initiatives.

The Nation of East Africa is among the 10 main receptors of USAID funds in Africa. According to US government data. UU., El País received $ 295 million (£ 234 million) in agency’s health funds in 2023, classifying third after Nigeria, which received $ 368 million and Tanzania with $ 337 million.

USAID also supports its malaria, tuberculosis and leprosy programs, as well as financing maternal and child health services and emergency health assistance.

Thousands of health workers have been affected by the freezing of funds from the United States.

Dr. Shamirah Nakitto, a Reach Out Mbuya (ROM) clinic, a faith -based community organization that provides medical and psychosocial support to people who live with HIV in Uganda, was based on the Kisenyi IV Health Center , which serves a densely populated marginal neighborhood in Kampala.

On average, 200 patients with HIV/AIDS and tuberculosis attended daily. But after the stop order, all health workers supported by ROM were fired.

Its tuberculosis unit now remains silent and its section of orphans and vulnerable children has also closed in Kisenyi.

“We are waiting for 90 days. So, this mandatory license had not prepared for it,” he told the BBC.

“It was very abrupt. We didn’t have adequate delivery in the facilities. We simply stop working.”

The Uganda Ministry of Health says it is exploring ways to minimize interruptions.

Dr. Diana Atwine, the best Ministry official, urged the staff “willing to continue working in the spirit of patriotism as volunteers” to get in touch.

Further south in Malawi, the activities financed by USAID have also stopped.

The country received $ 154 million from the USAID health budget in 2023, which makes it the tenth largest receiver in Africa.

In the city of northern Mzuzu, the doors are closed in a clinic that has been a key provider of HIV services in the region. Vehicles remain inactive; There are no signs of activity at the Mzuzu Clinic. The workers closed the doors, turned off the lights and went home 18 days ago.

Despite the exemption of the US Department of State challenge.

Even when services are allowed technically to resume, many contracts remain in limbo. Health workers are not sure of what they can and cannot do.

The Trump administration plans to reduce USAID staff by more than 90%.

Atul Gawande, former USAID global health assistant administrator, published in X that the agency’s workforce would be cut from 14,000 to 294, with only 12 employees assigned to Africa.

More than 30 NGOs in Malawi have also been severely affected by the freezing of funds.

Eddah Simfukwe Banda, a 32 -year -old subsistence farmer, has been obtaining ARV since 2017 from the Macro Clinic, where several NGOs were providing HIV programs.

She is concerned about her own destiny, and that of her sister -in -law, who also trusts in donor -financed medications, and says that little choice but to pray.

“We have to pray as Malauíes. Those of us who believe we depend on a God who opens doors when one is closed,” he told the BBC.

The mother of three children, who has a three -week ARV supply, also said that systemic failures were to blame: “Like the Malauíes, we depend too much on receiving help. Sometimes we are lazy and we waste and depend on other countries for other countries Help us.

“That this is a lesson that we have to be independent,” he said.

But this is difficult for one of the poorest countries and dependent on the help of the world. According to the World Bank, Malawi is vulnerable to external clashes, including prolonged droughts, cyclones and erratic rain.

An interruption of this magnitude in your health system presents a huge challenge.

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

In particular, through its innovative program to counteract the global propagation of HIV, which was launched in 2003. called the emergency plan of the president of the United States for the relief of AIDS (Pepfar), it has saved more than 25 million lives.

According to the head of the disease control and prevention centers of Africa (Africa CDC), USAID provided $ 8 billion of help to help Africa during the past year.

“The seventy -three percent went to medical attention,” Jean Kaseya told BBC Newsday last month.

Health experts warn that replacing this financing will be extremely difficult.

African governments have advanced in reducing aid dependence. Kenya now finances almost 60% of her response to HIV. South Africa covers almost 80%.

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

AMREF Health Africa, one of the main health NGOs in the continent, warns that without urgent actions, global health safety is at risk.

“This would require African governments and Africa CDCs to increase their own financing, which is almost impossible in the current conditions of debt anguish,” said his CEO Dr. Githinji Gitahi to the BBC.

“With accelerated outbreaks of climate change and human conflict -environment, this would leave the fragile and insecure world, not only for Africa but for all.”

Throughout the world in 2023, there were 630,000 deaths related to AIDS and 1.5 million new infections.

While infection rates have decreased in the most affected countries, the impact of USAID closure could reverse these profits.

“If you eliminate this important contribution from the United States government, we hope that in the next five years, there are 6.3 million additional deaths related to AIDS,” Winnie Byanyima, Chief of Unida, He told the BBC Africa Daily Podcast this week.

“There will be 8.7 million new infections, 3.4 million additional AIDS orphans. I don’t want to sound like a prophet of fatality, but I have the duty to give the facts as we see them.”

The medical beneficial Organization Médecins Sans Frontières (MSF) has also warned about the dangers of interrupting HIV treatments.

“HIV medications should be taken daily or people run the risk of developing resistance or mortal health complications,” said MSF Southern Africa, in a statement.

Back in Uganda, Mr. Tusubira feels bleak on the future.

He has about 30 days of his ARV medication, and he can choose to leave Kampala and go home to his people after that.

“At least it will be a little simpler. If I die, they simply bury me there, instead of disturbing my people here in Kampala.

“Because I have no way that I can live here without ARV services.”