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What the closure of USAID is really costing the world

The abrupt withdrawal of American funding has stranded millions of patients and will be felt by countries for years to come

Bongi Nkosi remembers the devastating impact of the Aids epidemic. “I grew up in a place where kids were raising kids,” he says of a time, in the 1990s, when every other child in Eswatini seemed to have lost their parents.

As the epidemic spread in the tiny southern African nation, then known as Swaziland, life expectancy crashed. By 2005, it had fallen from 62 to just 44. Nearly 40 per cent of adults aged 15 to 49 contracted the disease, the highest incidence in the world.

Back then HIV was a death sentence. Though the first antiretroviral drugs to suppress the virus had been rolled out in the US from the late-1980s, it was at least 15 years before they reached countries like Eswatini. For those who could not afford expensive western medicine, HIV progressed in the body unchecked, ravaging the immune system and rendering people vulnerable to opportunistic infections like tuberculosis.

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