Podcasts about pepfar

Dr. Andriy Klepikov, the founder and executive director of the Alliance for Public Health (Ukraine), reflects on the Alliance's remarkable evolution over the past 25 years into a major Ukrainian—and regional—non-governmental force in HIV, TB, and harm reduction programs. Foundational to its early success was the exemplary partnership with the Global Fund and PEPFAR. Ukraine, in the midst of war, cannot at present soon transition to self-reliance. In the past three and a half years of war following the Russian invasion, the Alliance has become a provider of mass emergency humanitarian relief to the most vulnerable in Ukraine. It now serves five times the numbers it served before the war. Recovery will draw on telemedicine and mobile clinics, and prioritize mental health, war veterans who are blinded, have lost limbs, and struggle with long-term trauma. The United States remains indispensable to Ukraine's future—for peace and social justice.  

In this episode of A Shot in the Arm Podcast, host Ben Plumley engages in a comprehensive discussion with journalist and author Emily Bass about the current state of global health, specifically focusing on HIV/AIDS. Recorded in sunny Sacramento, they reflect on the extraordinary events of the past few months and assess the alignment of innovation and equity in global health. Their conversation covers a wide range of topics, including the importance of community-based care and accountability, the evolving role of international NGOs, and the critical nature of differentiated service delivery in HIV treatment. They also discuss the geopolitical uncertainties affecting global health funding and the influence of recent political changes in the US on the future of the global HIV response. They touch upon the significant role of entities like PEPFAR, the Global Fund, and UNAIDS, and the necessity for national contributions and regional procurement in sustaining HIV programs. Emily emphasizes the need to preserve community-based accountability and the value of innovative, country-led solutions for delivering healthcare. They conclude with a commitment to delve deeper into HIV prevention in a future episode, recognizing the ongoing challenges and opportunities in achieving global HIV/AIDS objectives. Emily's book: To End a Plague: America's Fight to Defeat AIDS in Africa https://www.amazon.com/End-Plague-Americas-Defeat-Africa/dp/1541762436 Emily's recent essay in the New York Times: https://www.nytimes.com/2025/07/14/opinion/pepfar-hiv-foreign-aid.html Emily's Substack: https://substack.com/@emilysbass Ben's Substack: https://substack.com/@benplumley1 Chapters: 00:00 Introduction and Host Welcome 00:36 Guest Introduction: Emily's Expertise 02:26 Global Health Check-In 03:11 Humanitarian Crises and HIV 05:00 Impact of Global Health Policies 06:44 HIV Treatment Challenges 08:57 Sustainability and Ownership in HIV Response 12:47 Global Health Architecture and Funding 16:33 The Role of PEPFAR and Global Fund 22:25 Future of Global Health Initiatives 38:25 Global Fund's Role in Procurement and National Contributions 40:33 US Congress and Global Health Budget 42:15 Innovation in Global AIDS Response 49:30 The Importance of Differentiated Service Delivery 01:00:58 Community Accountability in Public Health 01:09:38 Challenges and Future of HIV Prevention Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health discussions: www.youtube.com/@shotarmpodcast

Welcome to a world where medicine meets politics: a space that brings together scientific research, government wrangling, public push-back and healthcare conspiracies…Dr Anthony Fauci was the Director of America's National Institute of Allergy and Infectious Diseases for nearly four decades, during which time he not only helped study, treat and prevent viruses such as HIV/AIDS and Covid-19; he also advised seven US Presidents, from Ronald Regan through to Joe Biden.Along the way, Tony Fauci's picked up a public profile and taken a fair amount of flack; not least because of his complicated relationship with President Donald Trump. But he's also made great strides in medical research and policy, from working with activists who initially challenged him on the government response to HIV/AIDS - to spearheading the USA's PEPFAR project to share vital medication with developing nations.In a candid conversation with Professor Jim Al-Khalili, Tony discusses his childhood in Brooklyn, the dark early days of the HIV/AIDS epidemic and lessons from the Covid-19.Presented by Jim Al-Khalili Produced for BBC Studios by Lucy Taylor Reversion for World Service by Minnie Harrop

We've covered the US Agency for International Development, or USAID, pretty consistently on Statecraft, since our first interview on PEPFAR, the flagship anti-AIDS program, in 2023. When DOGE came to USAID, I was extremely critical of the cuts to lifesaving aid, and the abrupt, pointlessly harmful ways in which they were enacted. In March, I wrote, “The DOGE team has axed the most effective and efficient programs at USAID, and forced out the chief economist, who was brought in to oversee a more aggressive push toward efficiency.”Today, we're talking to that forced-out chief economist, Dean Karlan. Dean spent two and a half years at the helm of the first-ever Office of the Chief Economist at USAID. In that role, he tried to help USAID get better value from its foreign aid spending. His office shifted $1.7 billion of spending towards programs with stronger evidence of effectiveness. He explains how he achieved this, building a start-up within a massive bureaucracy. I should note that Dean is one of the titans of development economics, leading some of the most important initiatives in the field (I won't list them, but see here for details), and I think there's a plausible case he deserves a Nobel.Throughout this conversation, Dean makes a point much better than I could: the status quo at USAID needed a lot of improvement. The same political mechanisms that get foreign aid funded by Congress also created major vulnerabilities for foreign aid, vulnerabilities that DOGE seized on. Dean believes foreign aid is hugely valuable, a good thing for us to spend our time, money, and resources on. But there's a lot USAID could do differently to make its marginal dollar spent more efficient.DOGE could have made USAID much more accountable and efficient by listening to people like Dean, and reformers of foreign aid should think carefully about Dean's criticisms of USAID, and his points for how to make foreign aid not just resilient but politically popular in the long term.We discuss* What does the Chief Economist do?* Why does 170% percent of USAID funds come already earmarked by Congress?* Why is evaluating program effectiveness institutionally difficult?* Why don't we just do cash transfers for everything?* Why institutions like USAID have trouble prioritizing* Should USAID get rid of gender/environment/fairness in procurement rules?* Did it rely too much on a small group of contractors?* What's changed in development economics over the last 20 years?* Should USAID spend more on governance and less on other forms of aid? * How DOGE killed USAID — and how to bring it back better* Is depoliticizing foreign aid even possible?* Did USAID build “soft power” for the United States?This is a long conversation: you can jump to a specific section with the index above. If you just want to hear about Dean's experience with DOGE, you can click here or go to the 45-minute mark in the audio. And if you want my abbreviated summary of the conversation, see these two Twitter threads. But I think the full conversation is enlightening, especially if you want to understand the American foreign aid system. Thanks to Harry Fletcher-Wood for his judicious edits.Our past coverage of USAIDDean, I'm curious about the limits of your authority. What can the Chief Economist of USAID do? What can they make people do?There had never been an Office of the Chief Economist before. In a sense, I was running a startup, within a 13,000-employee agency that had fairly baked-in, decentralized processes for doing things.Congress would say, "This is how much to spend on this sector and these countries." What you actually fund was decided by missions in the individual countries. It was exciting to have that purview across the world and across many areas, not just economic development, but also education, social protection, agriculture. But the reality is, we were running a consulting unit within USAID, trying to advise others on how to use evidence more effectively in order to maximize impact for every dollar spent.We were able to make some institutional changes, focused on basically a two-pronged strategy. One, what are the institutional enablers — the rules and the processes for how things get done — that are changeable? And two, let's get our hands dirty working with the budget holders who say, "I would love to use the evidence that's out there, please help guide us to be more effective with what we're doing."There were a lot of willing and eager people within USAID. We did not lack support to make that happen. We never would've achieved anything, had there not been an eager workforce who heard our mission and knocked on our door to say, "Please come help us do that."What do you mean when you say USAID has decentralized processes for doing things?Earmarks and directives come down from Congress. [Some are] about sector: $1 billion dollars to spend on primary school education to improve children's learning outcomes, for instance. The President's Emergency Plan for AIDS Relief (PEPFAR) [See our interview with former PEPFAR lead Mark Dybul] is one of the biggest earmarks to spend money specifically on specific diseases. Then there's directives that come down about how to allocate across countries.Those are two conversations I have very little engagement on, because some of that comes from Congress. It's a very complicated, intertwined set of constraints that are then adhered to and allocated to the different countries. Then what ends up happening is — this is the decentralized part — you might be a Foreign Service Officer (FSO) working in a country, your focus is education, and you're given a budget for that year from the earmark for education and told, "Go spend $80 million on a new award in education." You're working to figure out, “How should we spend that?” There might be some technical support from headquarters, but ultimately, you're responsible for making those decisions. Part of our role was to help guide those FSOs towards programs that had more evidence of effectiveness.Could you talk more about these earmarks? There's a popular perception that USAID decides what it wants to fund. But these big categories of humanitarian aid, or health, or governance, are all decided in Congress. Often it's specific congressmen or congresswomen who really want particular pet projects to be funded.That's right. And the number that I heard is that something in the ballpark of 150-170% of USAID funds were earmarked. That might sound horrible, but it's not.How is that possible?Congress double-dips, in a sense: we have two different demands. You must spend money on these two things. If the same dollar can satisfy both, that was completely legitimate. There was no hiding of that fact. It's all public record, and it all comes from congressional acts that create these earmarks. There's nothing hidden underneath the hood.Will you give me examples of double earmarking in practice? What kinds of goals could you satisfy with the same dollar?There's an earmark for Development Innovation Ventures (DIV) to do research, and an earmark for education. If DIV is going to fund an evaluation of something in the education space, there's a possibility that that can satisfy a dual earmark requirement. That's the kind of thing that would happen. One is an earmark for a process: “Do really careful, rigorous evaluations of interventions, so that we learn more about what works and what doesn't." And another is, "Here's money that has to be spent on education." That would be an example of a double dip on an earmark.And within those categories, the job of Chief Economist was to help USAID optimize the funding? If you're spending $2 billion on education, “Let's be as effective with that money as possible.”That's exactly right. We had two teams, Evidence Use and Evidence Generation. It was exactly what it sounds like. If there was an earmark for $1 billion dollars on education, the Evidence Use team worked to do systematic analysis: “What is the best evidence out there for what works for education for primary school learning outcomes?” Then, “How can we map that evidence to the kinds of things that USAID funds? What are the kinds of questions that need to be figured out?”It's not a cookie-cutter answer. A systematic review doesn't say, "Here's the intervention. Now just roll it out everywhere." We had to work with the missions — with people who know the local area — to understand, “What is the local context? How do you appropriately adapt this program in a procurement and contextualize it to that country, so that you can hire people to use that evidence?”Our Evidence Generation team was trying to identify knowledge gaps where the agency could lead in producing more knowledge about what works and what doesn't. If there was something innovative that USAID was funding, we were huge advocates of, "Great, let's contribute to the global public good of knowledge, so that we can learn more in the future about what to do, and so others can learn from us. So let's do good, careful evaluations."Being able to demonstrate what good came of an intervention also serves the purpose of accountability. But I've never been a fan of doing really rigorous evaluations just for the sake of accountability. It could discourage innovation and risk-taking, because if you fail, you'd be seen as a failure, rather than as a win for learning that an idea people thought was reasonable didn't turn out to work. It also probably leads to overspending on research, rather than doing programs. If you're doing something just for accountability purposes, you're better off with audits. "Did you actually deliver the program that you said you would deliver, or not?"Awards over $100 million dollars did go through the front office of USAID for approval. We added a process — it was actually a revamped old process — where they stopped off in my office. We were able to provide guidance on the cost-effectiveness of proposals that would then be factored into the decision on whether to proceed. When I was first trying to understand Project 2025, because we saw that as a blueprint for what changes to expect, one of the changes they proposed was actually that process. I remember thinking to myself, "We just did that. Hopefully this change that they had in mind when they wrote that was what we actually put in place." But I thought of it as a healthy process that had an impact, not just on that one award, but also in helping set an example for smaller awards of, “This is how to be more evidence-based in what you're doing.”[Further reading: Here's a position paper Karlan's office at USAID put out in 2024 on how USAID should evaluate cost-effectiveness.]You've also argued that USAID should take into account more research that has already been done on global development and humanitarian aid. Your ideal wouldn't be for USAID to do really rigorous research on every single thing it does. You can get a lot better just by incorporating things that other people have learned.That's absolutely right. I can say this as a researcher: to no one's surprise, it's more bureaucratic to work with the government as a research funder than it is to work with foundations and nimble NGOs. If I want to evaluate a particular program, and you give me a choice of who the funder should be, the only reason I would choose government is if it had a faster on-ramp to policy by being inside.The people who are setting policy should not be putting more weight on evidence that they paid for. In fact, one of the slogans that I often used at USAID is, "Evidence doesn't care who pays for it." We shouldn't be, as an agency, putting more weight on the things that we evaluated vs. things that others evaluated without us, and that we can learn from, mimic, replicate, and scale.We — and the we here is everyone, researchers and policymakers — put too much weight on individual studies, in a horrible way. The first to publish on something gets more accolades than the second, third and fourth. That's not healthy when it comes to policy. If we put too much weight on our own evidence, we end up putting too much weight on individual studies we happen to do. That's not healthy either.That was one of the big pieces of culture change that we tried to push internally at USAID. We had this one slide that we used repeatedly that showed the plethora of evidence out there in the world compared to 20 years ago. A lot more studies are now usable. You can aggregate that evidence and form much better policies.You had political support to innovate that not everybody going into government has. On the other hand, USAID is a big, bureaucratic entity. There are all kinds of cross-pressures against being super-effective per dollar spent. In doing culture change, what kinds of roadblocks did you run into internally?We had a lot of support and political cover, in the sense that the political appointees — I was not a political appointee — were huge fans. But political appointees under Republicans have also been huge fans of what we were doing. Disagreements are more about what to do and what causes to choose. But the basic idea of being effective with your dollars to push your policy agenda is something that cuts across both sides.In the days leading up to the inauguration, we were expecting to continue the work we were doing. Being more cost-effective was something some of the people who were coming in were huge advocates for. They did make progress under Trump I in pushing USAID in that direction. We saw ourselves as able to help further that goal. Obviously, that's not the way it played out, but there isn't really anything political about being more cost-effective.We'll come back to that, but I do want to talk about the 2.5 years you spent in the Biden administration. USAID is full of people with all kinds of incentives, including some folks who were fully on board and supportive. What kinds of challenges did you have in trying to change the culture to be more focused on evidence and effectiveness?There was a fairly large contingent of people who welcomed us, were eager, understood the space that we were coming from and the things that we wanted, and greeted us with open arms. There's no way we would've accomplished what we accomplished without that. We had a bean counter within the Office of the Chief Economist of moving about $1.7 billion towards programs that were more effective or had strong evaluations. That would've been $0 had there not been some individuals who were already eager and just didn't have the path for doing it.People can see economists as people who are going to come in negative and a bit dismal — the dismal science, so to speak. I got into economics for a positive reason. We tried as often as possible to show that with an economic lens, we can help people achieve their goals better, period. We would say repeatedly to people, "We're not here to actually make the difficult choices: to say whether health, education, or food security is the better use of money. We're here to accept your goal and help you achieve more of it for your dollar spent.” We always send a very disarming message: we're there simply to help people achieve their goals and to illuminate the trade-offs that naturally exist.Within USAID, you have a consensus-type organization. When you have 10 people sitting around a room trying to decide how to spend money towards a common goal, if you don't crystallize the trade-offs between the various ideas being put forward, you end up seeing a consensus built: that everybody gets a piece of the pie. Our way of trying to shift the culture is to take those moments and say, "Wait a second. All 10 might be good ideas relative to doing nothing, but they can't all be good relative to each other. We all share a common goal, so let's be clear about the trade-offs between these different programs. Let's identify the ones that are actually getting you the most bang for your buck."Can you give me an example of what those trade-offs might be in a given sector?Sure. Let's take social protection, what we would call the Humanitarian Nexus development space. It might be working in a refugee area — not dealing with the immediate crisis, but one, two, five, or ten years later — trying to help bring the refugees into a more stable environment and into economic activities. Sometimes, you would see some cash or food provided to households. The programs would all have the common goal of helping to build a sustainable livelihood for households, so that they can be more integrated into the local economy. There might be programs providing water, financial instruments like savings vehicles, and supporting vocational education. It'd be a myriad of things, all on this focused goal of income-generating activity for the households to make them more stable in the long run.Often, those kinds of programs doing 10 different things did not actually lead to an observable impact over five years. But a more focused approach has gone through evaluations: cash transfers. That's a good example where “reducing” doesn't always mean reduce your programs just to one thing, but there is this default option of starting with a base case: “What does a cash transfer generate?"And to clarify for people who don't follow development economics, the cash transfer is just, “What if we gave people money?”Sometimes it is just that. Sometimes it's thinking strategically, “Maybe we should do it as a lump sum so that it goes into investments. Maybe we should do it with a planning exercise to make those investments.” Let's just call it “cash-plus,” or “cash-with-a-little-plus,” then variations of that nature. There's a different model, maybe call it, “cash-plus-plus,” called the graduation model. That has gone through about 30 randomized trials, showing pretty striking impacts on long-run income-generating activity for households. At its core is a cash transfer, usually along with some training about income-generating activity — ideally one that is producing and exporting in some way, even a local export to the capital — and access to some form of savings. In some cases, that's an informal savings group, with a community that comes and saves together. In some cases, it's mobile money that's the core. It's a much simpler program, and it's easier to do it at scale. It has generated considerable, measured, repeatedly positive impacts, but not always. There's a lot more that needs to be learned about how to do it more effectively.[Further reading: Here's another position paper from Karlan's team at USAID on benchmarking against cash transfers.]One of your recurring refrains is, “If we're not sure that these other ideas have an impact, let's benchmark: would a cash-transfer model likely give us more bang for our buck than this panoply of other programs that we're trying to run?”The idea of having a benchmark is a great approach in general. You should always be able to beat X. X might be different in different contexts. In a lot of cases, cash is the right benchmark.Go back to education. What's your benchmark for improving learning outcomes for a primary school? Cash transfer is not the right benchmark. The evidence that cash transfers will single-handedly move the needle on learning outcomes is not that strong. On the other hand, a couple of different programs — one called Teaching at the Right Level, another called structured pedagogy — have proven repeatedly to generate very strong impacts at a fairly modest cost. In education, those should be the benchmark. If you want to innovate, great, innovate. But your goal is to beat those. If you can beat them consistently, you become the benchmark. That's a great process for the long run. It's very much part of our thinking about what the future of foreign aid should look like: to be structured around that benchmark.Let's go back to those roundtables you described, where you're trying to figure out what the intervention should be for a group of refugees in a foreign country. What were the responses when you'd say, “Look, if we're all pulling in the same direction, we have to toss out the three worst ideas”?One of the challenges is the psychology of ethics. There's probably a word for this, but one of the objections we would often get was about the scale of a program for an individual. Someone would argue, "But this won't work unless you do this one extra thing." That extra thing might be providing water to the household, along with a cash transfer for income-generating activity, financial support, and bank accounts. Another objection would be that, "You also have to provide consumption and food up to a certain level."These are things that individually might be good, relative to nothing, or maybe even relative to other water approaches or cash transfers. But if you're focused on whether to satisfy the household's food needs, or provide half of what's needed — if all you're thinking about is the trade-off between full and half — you immediately jump to this idea that, "No, we have to go full. That's what's needed to help this household." But if you go to half, you can help more people. There's an actual trade-off: 10,000 people will receive nothing because you're giving more to the people in your program.The same is true for nutritional supplements. Should you provide 2,000 calories a day, or 1,000 calories a day to more people? It's a very difficult conversation on the psychology of ethics. There's this idea that people in a program are sacrosanct, and you must do everything you can for them. But that ignores all the people who are not being reached at all.I would find myself in conversations where that's exactly the way I would try to put it. I would say, "Okay, wait, we have the 2,000,000 people that are eligible for this program in this context. Our program is only going to reach 250,000. That's the reality. Now, let's talk about how many people we're willing to leave untouched and unhelped whatsoever." That was, at least to me, the right way to frame this question. Do you go very intense for fewer people or broader support for more people?Did that help these roundtables reach consensus, or at least have a better sense of what things are trading off against each other?I definitely saw movement for some. I wouldn't say it was uniform, and these are difficult conversations. But there was a lot of appetite for this recognition that, as big as USAID was, it was still small, relative to the problems being approached. There were a lot of people in any given crisis who were being left unhelped. The minute you're able to help people focus more on those big numbers, as daunting as they are, I would see more openness to looking at the evidence to figure out how to do the most good with the resources we have?” We must recognize these inherent trade-offs, whether we like it or not.Back in 2023, you talked to Dylan Matthews at Vox — it's a great interview — about how it's hard to push people to measure cost-effectiveness, when it means adding another step to a big, complicated bureaucratic process of getting aid out the door. You said,"There are also bandwidth issues. There's a lot of competing demands. Some of these demands relate to important issues on gender environment, fairness in the procurement process. These add steps to the process that need to be adhered to. What you end up with is a lot of overworked people. And then you're saying, ‘Here's one more thing to do.'”Looking back, what do you think of those demands on, say, fairness in the procurement process?Given that we're going to be facing a new environment, there probably are some steps in the process that — hopefully, when things are put back in place in some form — someone can be thinking more carefully about. It's easier to put in a cleaner process that avoids some of these hiccups when you start with a blank slate.Having said that, it's also going to be fewer people to dole out less money. There's definitely a challenge that we're going to be facing as a country, to push out money in an effective way with many fewer people for oversight. I don't think it would be accurate to say we achieved this goal yet, but my goal was to make it so that adding cost-effectiveness was actually a negative-cost addition to the process. [We wanted] to do it in a way that successfully recognized that it wasn't a cookie-cutter solution from up top for every country. But [our goal was that] the work to contextualize in a country actually simplified the process for whoever's putting together the procurement docs and deciding what to put in them. I stand by that belief that if it's done well, we can make this a negative-cost process change.I just want to push a little bit. Would you be supportive of a USAID procurement and contracting process that stripped out a bunch of these requirements about gender, environment, or fairness in contracting? Would that make USAID a more effective institution?Some of those types of things did serve an important purpose for some areas and not others. The tricky thing is, how do you set up a process to decide when to do it, when not? There's definitely cases where you would see an environmental review of something that really had absolutely nothing to do with the environment. It was just a cog in the process, but you have to have a process for deciding the process. I don't know enough about the legislation that was put in place on each of these to say, “Was there a better way of deciding when to do them, when not to do them?” That is not something that I was involved in in a direct way. "Let's think about redoing how we introduce gender in our procurement process" was never put on the table.On gender, there's a fair amount of evidence in different contexts that says the way of dealing with a gender inequity is not to just take the same old program and say, "We're now going to do this for women." You need to understand something more about the local context. If all you do is take programs and say, "Add a gender component," you end up with a lot of false attribution, and you don't end up being effective at the very thing that the person [leading the program] cares to do.In that Vox interview, your host says, "USAID relies heavily on a small number of well-connected contractors to deliver most aid, while other groups are often deterred from even applying by the process's complexity." He goes on to say that the use of rigorous evaluation methods like randomized controlled trials is the exception, not the norm.On Statecraft, we talked to Kyle Newkirk, who ran USAID procurement in Afghanistan in the late 2000s, about the small set of well-connected contractors that took most of the contracts in Afghanistan. Often, there was very little oversight from USAID, either because it was hard to get out to those locations in a war-torn environment, or because the system of accountability wasn't built there. Did you talk to people about lessons learned from USAID operating in Afghanistan?No. I mean, only to the following extent: The lesson learned there, as I understand it, wasn't so much about the choice on what intervention to fund, it was procurement: the local politics and engagement with the governments or lack thereof. And dealing with the challenge of doing work in a context like that, where there's more risk of fraud and issues of that nature.Our emphasis was about the design of programs to say, “What are you actually going to try to fund?” Dealing with whether there's fraud in the execution would fall more under the Inspector General and other units. That's not an area that we engaged in when we would do evaluation.This actually gets to a key difference between impact evaluations and accountability. It's one of the areas where we see a lot of loosey-goosey language in the media reporting and Twitter. My office focused on impact evaluation. What changed in the world because of this intervention, that wouldn't otherwise have changed? By “change in the world,” we are making a causal statement. That's setting up things like randomized controlled trials to find out, “What was the impact of this program?” It does provide some accountability, but it really should be done to look forward, in order to know, “Does this help achieve the goals we have in mind?” If so, let's learn that, and replicate it, scale it, do it again.If you're going to deliver books to schools, medicine to health clinics, or cash to people, and you're concerned about fraud, then you need to audit that process and see, “Did the books get to the schools, the medicine to the people, the cash to the people?” You don't need to ask, "Did the medicine solve the disease?" There's been studies already. There's a reason that medicine was being prescribed. Once it's proven to be an effective drug, you don't run randomized trials for decades to learn what you already know. If it's the prescribed drug, you just prescribe the drug, and do accountability exercises to make sure that the drugs are getting into the right hands and there isn't theft or corruption along the way.I think it's a very intuitive thing. There's a confusion that often takes place in social science, in economic or education interventions. They somehow forget that once we know that a certain program generates a certain positive impact, we no longer need to track continuously to find out what happens. Instead, we just need to do accountability to make sure that the program is being delivered as it was designed, tested, and shown to work.There are all these criticisms — from the waste, fraud, and corruption perspective — of USAID working with a couple of big contractors. USAID works largely through these big development organizations like Chemonics. Would USAID dollars be more effective if it worked through a larger base of contractors?I don't think we know. There's probably a few different operating models that can deliver the same basic intervention. We need to focus on, ”What actually are we doing on the ground? What is it that we want the recipients of the program to receive, hear, or do?” and then think backwards from there: "Who's the right implementer for this?" If there's an implementer who is much more expensive for delivering the same product, let's find someone who's more cost-effective.It's helpful to break cost-effective programming into two things: the intervention itself and what benefits it accrues, and the cost for delivering that. Sometimes the improvement is not about the intervention, it's about the delivery model. Maybe that's what you're saying: “These players were too few, too large, and they had a grab on the market, so that they were able to charge too much money to deliver something that others were equally able to do at lower cost." If that's the case, that says, "We should reform our procurement process,” because the reason you would see that happen is they were really good at complying with requirements that came at USAID from Congress. You had an overworked workforce [within USAID] that had to comply with all these requirements. If you had a bid between two groups, one of which repeatedly delivered on the paperwork to get a good performance evaluation, and a new group that doesn't have that track record, who are you going to choose? That's how we ended up where we are.My understanding of the history is that it comes from a push from Republicans in the ‘80s, from [Senator] Jesse Helms, to outsource USAID efforts to contractors. So this is not a left-leaning thing. I wouldn't say it is right-leaning either. It was just a decision made decades ago. You combine that with the bureaucratic requirements of working with USAID, and you end up with a few firms and nonprofits skilled at dealing with it.It's definitely my impression that at various points in American history, different partisans are calling for insourcing or for outsourcing. But definitely, I think you're right that the NGO cluster around USAID does spring up out of a Republican push in the eighties.We talked to John Kamensky recently, who was on Al Gore's predecessor to DOGE in the ‘90s.I listened to this, yeah.I'm glad to hear it! I'm thinking of it because they also pushed to cut the workforce in the mid-90s and outsource federal functions.Earlier, you mentioned a slide that showed what we've learned in the field of development economics over the past 20 years. Will you narrate that slide for me?Let me do two slides for you. The slide that I was picturing was a count of randomized controlled trials in development that shows a fairly exponential growth. The movement started in the mid-to-late 1990s, but really took off in the 2000s. Even just in the past 10 years, it's seen a considerable increase. There's about 4-5,000 randomized controlled trials evaluating various programs of the kind USAID funds.That doesn't tell you the substance of what was learned. Here's an example of substance, which is cash transfers: probably the most studied intervention out there. We have a meta-analysis that counted 115 studies. That's where you start having a preponderance of evidence to be able to say something concrete. There's some variation: you get different results in different places; targeting and ways of doing it vary. A good systematic analysis can help tease out what we can say, not just about the effect of cash, but also how to do it and what to expect, depending on how it's done. Fifteen years ago, when we saw the first few come out, you just had, "Oh, that's interesting. But it's a couple of studies, how do you form policy around that?” With 115, we can say so much more.What else have we learned about development that USAID operators in the year 2000 would not have been able to act upon?Think about the development process in two steps. One is choosing good interventions; the other is implementing them well. The study of implementation is historically underdone. The challenge that we face — this is an area I was hoping USAID could make inroads on — was, studying a new intervention might be of high reward from an academic perspective. But it's a lot less interesting to an academic to do much more granular work to say, "That was an interesting program that created these groups [of aid recipients]; now let's do some further knock-on research to find out whether those groups should be made of four, six, or ten people.” It's going to have a lower reward for the researcher, but it's incredibly important.It's equivalent to the color of the envelope in direct marketing. You might run tests — if this were old-style direct marketing — as to whether the envelope should be blue or red. You might find that blue works better. Great, but that's not interesting to an academic. But if you run 50 of these, on a myriad of topics about how to implement better, you end up with a collection of knowledge that is moving the needle on how to achieve more impact per dollar.That collection is not just important for policy: it also helps us learn more about the development process and the bottlenecks for implementing good programs. As we're seeing more digital platforms and data being used, [refining implementation] is more possible compared to 20 years ago, where most of the research was at the intervention level: does this intervention work? That's an exciting transition. It's also a path to seeing how foreign aid can help in individual contexts, [as we] work with local governments to integrate evidence into their operations and be more efficient with their own resources.There's an argument I've seen a lot recently: we under-invest in governance relative to other foreign aid goals. If we care about economic growth and humanitarian outcomes, we should spend a lot more on supporting local governance. What do you make of that claim?I agree with it actually, but there's a big difference between recognizing the problem and seeing what the tool is to address it. It's one thing to say, “Politics matters, institutions matter.” There's lots of evidence to support that, including the recent Nobel Prize. It's another beast to say, “This particular intervention will improve institutions and governance.”The challenge is, “What do we do about this? What is working to improve this? What is resilient to the political process?” The minute you get into those kinds of questions, it's the other end of the spectrum from a cash transfer. A cash transfer has a kind of universality: Not to say you're going to get the same impact everywhere, but it's a bit easier to think about the design of a program. You have fewer parameters to decide. When you think about efforts to improve governance, you need bespoke thinking in every single place.As you point out, it's something of a meme to say “institutions matter” and to leave it at that, but the devil is in all of those details.In my younger years — I feel old saying that — I used to do a lot of work on financial inclusion, and financial literacy was always my go-to example. On a household level, it's really easy to show a correlation: people who are more financially literate make better financial decisions and have more wealth, etc. It's much harder to say, “How do you move the needle on financial literacy in a way that actually helps people make better decisions, absorb shocks better, build investment better, save better?” It's easy to show that the correlation is there. It's much harder to say this program, here, will actually move the needle. That same exact problem is much more complicated when thinking about governance and institutions.Let's talk about USAID as it stands today. You left USAID when it became clear to you that a lot of the work you were doing was not of interest to the people now running it. How did the agency end up so disconnected from a political base of support? There's still plenty of people who support USAID and would like it to be reinstated, but it was at least vulnerable enough to be tipped over by DOGE in a matter of weeks. How did that happen?I don't know that I would agree with the premise. I'm not sure that public support of foreign aid actually changed, I'd be curious to see that. I think aid has always been misunderstood. There are public opinion polls that show people thought 25% of the US budget was spent on foreign aid. One said, "What, do you think it should be?" People said 10%. The right answer is about 0.6%. You could say fine, people are bad at statistics, but those numbers are pretty dauntingly off. I don't know that that's changed. I heard numbers like that years ago.I think there was a vulnerability to an effort that doesn't create a visible impact to people's lives in America, the way that Social Security, Medicare, and roads do. Foreign aid just doesn't have that luxury. I think it's always been vulnerable. It has always had some bipartisan support, because of the understanding of the bigger picture and the soft power that's gained from it. And the recognition that we are a nation built on the idea of generosity and being good to others. That was always there, but it required Congress to step in and say, "Let's go spend this money on foreign aid." I don't think that changed. What changed was that you ended up with an administration that just did not share those values.There's this issue in foreign aid: Congress picks its priorities, but those priorities are not a ranked list of what Congress cares about. It's the combination of different interests and pressures in Congress that generates the list of things USAID is going to fund.You could say doing it that way is necessary to build buy-in from a bunch of different political interests for the work of foreign aid. On the other hand, maybe the emergent list from that process is not the things that are most important to fund. And clearly, that congressional buy-in wasn't enough to protect USAID from DOGE or from other political pressures.How should people who care about foreign aid reason about building a version of USAID that's more effective and less vulnerable at the same time?Fair question. Look, I have thoughts, but by no means do I think of myself as the most knowledgeable person to say, here's the answer in the way forward. One reality is, even if Congress did object, they didn't have a mechanism in place to actually object. They can control the power of the purse the next round, but we're probably going to be facing a constitutional crisis over the Impoundment Act, to see if the executive branch can impound money that Congress spent. We'll see how this plays out. Aside from taking that to court, all Congress could do was complain.I would like what comes back to have two things done that will help, but they don't make foreign aid immune. One is to be more evidence-based, because then attacks on being ineffective are less strong. But the reality is, some of the attacks on its “effectiveness,” and the examples used, had nothing to do with poorly-chosen interventions. There was a slipperiness of language, calling something that they don't like “fraud” and “waste” because they didn't like its purpose. That is very different than saying, “We actually agreed on the purpose of something, but then you implemented it in such a bad way that there was fraud and waste.” There were really no examples given of that second part. So I don't know that being more evidence-based will actually protect it, given that that wasn't the way it was really genuinely taken down.The second is some boundaries. There is a core set of activities that have bipartisan support. How do we structure a foreign aid that is just focused on that? We need to find a way to put the things that are more controversial — whether it's the left or right that wants it — in a separate bucket. Let the team that wins the election turn that off and on as they wish, without adulterating the core part that has bipartisan support. That's the key question: can we set up a process that partitions those, so that they don't have that vulnerability? [I wrote about this problem earlier this year.]My counter-example is PEPFAR, which had a broad base of bipartisan support. PEPFAR consistently got long-term reauthorizations from Congress, I think precisely because of the dynamic you're talking about: It was a focused, specific intervention that folks all over the political spectrum could get behind and save lives. But in government programs, if something has a big base of support, you have an incentive to stuff your pet partisan issues in there, for the same reason that “must-pass” bills get stuffed with everybody's little thing. [In 2024, before DOGE, PEPFAR's original Republican co-sponsor came out against a long-term reauthorization, on the grounds that the Biden administration was using the program to promote abortion. Congress reauthorized PEPFAR for only one year, and that reauthorization lapsed in 2025.]You want to carve out the things that are truly bipartisan. But does that idea have a timer attached? What if, on a long enough timeline, everything becomes politicized?There are economic theorems about the nature of a repeated game. You can get many different equilibria in the long run. I'd like to think there's a world in which that is the answer. But we have seen an erosion of other things, like the filibuster regarding judges. Each team makes a little move in some direction, and then you change the equilibrium. We always have that risk. The goal is, how can you establish something where that doesn't happen?It might be that what's happened is helpful, in an unintended way, to build equilibrium in the future that keeps things focused on the bipartisan aspect. Whether it's the left or the right that wants to do something that they know the other side will object to, they hold back and say, "Maybe we shouldn't do that. Because when we do, the whole thing gets blown up."Let's imagine you're back at USAID a couple of years from now, with a broader latitude to organize our foreign aid apparatus around impact and effectiveness. What other things might we want to do — beyond measuring programs and keeping trade-offs in mind — if we really wanted to focus on effectiveness? Would we do fewer interventions and do them at larger scale?I think we would do fewer things simpler and bigger, but I also think we need to recognize that even at our biggest, we were tiny compared to the budget of the local government. If we can do more to use our money to help them be more effective with their money, that's the biggest win to go for. That starts looking a lot like things Mark Green was putting in place [as administrator of USAID] under Trump I, under the Journey to Self-Reliance [a reorganization of USAID to help countries address development challenges themselves].Sometimes that's done in the context of, "Let's do that for five or ten years, and then we can stop giving aid to that country." That was the way the Millennium Challenge Corporation talked about their country selection initially. Eventually, they stopped doing that, because they realized that that was never happening. I think that's okay. As much as we might help make some changes, even if we succeed in helping the poorest country in the world use their resources better, they're still going to be poor. We're still going to be rich. There's still maybe going to be the poorest, because if we do that in the 10 poorest countries and they all move up, maybe the 11th becomes the poorest, and then we can work there. I don't think getting off of aid is necessarily the objective.But if that was clearly the right answer, that's a huge win if we've done that by helping to prove the institutions and governance of that country so that it is rolling out better policies, helping its people better, and collecting their own tax revenue. If we can have an eye on that, then that's a huge win for foreign aid in general.How are we supposed to be measuring the impact of soft power? I think that's a term that's not now much in vogue in DC.There's no one answer to how to measure soft power. It's described as the influence that we gain in the world in terms of geopolitics, everything from treaties and the United Nations to access to markets; trade policy, labor policy. The basic idea of soft power manifests itself in all those different ways.It's a more extreme version of the challenge of measuring the impact of cash transfers. You want to measure the impact of a pill that is intended to deal with disease: you measure the disease, and you have a direct measure. You want to measure the impact of cash: you have to measure a lot of different things, because you don't know how people are going to use the cash. Soft power is even further down the spectrum: you don't know exactly how aid is helping build our partnership with a country's people and leaders. How is that going to manifest itself in the future? That becomes that much harder to do.Having said that, there's academic studies that document everything from attitudes about America to votes at the United Nations that follow aid, and things of that nature. But it's not like there's one core set: that's part of what makes it a challenge.I will put my cards on the table here: I have been skeptical of the idea that USAID is a really valuable tool for American soft power, for maintaining American hegemony, etc. It seems much easier to defend USAID by simply saying that it does excellent humanitarian work, and that's valuable. The national security argument for USAID seems harder to substantiate.I think we agree on this. You have such a wide set of things to look at, it's not hard to imagine a bias from a researcher might lead to selection of outcomes, and of the context. It's not a well-defined enough concept to be able to say, "It worked 20% of the time, and it did not in these, and the net average…" Average over what? Even though there's good case studies that show various paths where it has mattered, there's case studies that show it doesn't.I also get nervous about an entire system that's built around [attempts to measure soft power]. It turns foreign aid into too much of a transactional process, instead of a relationship that is built on the Golden Rule, “There's people in this country that we can actually help.” Sure, there's this hope that it'll help further our national interests. But if they're suffering from drought and famine, and we can provide support and save some lives, or we can do longer term developments and save tomorrow's lives, we ought to do that. That is a good thing for our country to do.Yet the conversation does often come back to this question of soft power. The problem with transactional is you get exactly what you contract on: nothing more, nothing less. There's too many unknowns here, when we're dealing with country-level interactions, and engagements between countries. It needs to be about relationships, and that means supporting even if there isn't a contract that itemizes the exact quid pro quo we are getting for something.I want to talk about what you observed in the administration change and the DOGE-ing of USAID. I think plenty of observers looked at this in the beginning and thought, “It's high time that a lot of these institutions were cleaned up and that someone took a hard look at how we spend money there.”There was not really any looking at any of the impact of anything. That was never in the cards. There was a 90-day review that was supposed to be done, but there were no questions asked, there was no data being collected. There was nothing whatsoever being looked at that had anything to do with, “Was this award actually accomplishing what it set out to accomplish?” There was no process in which they made those kinds of evaluations on what's actually working.You can see this very clearly when you think about what their bean counter was at DOGE: the spending that they cut. It's like me saying, "I'm going to do something beneficial for my household by stopping all expenditures on food." But we were getting something for that. Maybe we could have bought more cheaply, switched grocery stores, made a change there that got us the same food for less money. That would be a positive change. But you can't cut all your food expenditures, call that a saving, and then not have anything to eat. That's just bad math, bad economics.But that's exactly what they were doing. Throughout the entire government, that bean counter never once said, “benefits foregone.” It was always just “lowered spending.” Some of that probably did actually have a net loss, maybe it was $100 million spent on something that only created $10 million of benefits to Americans. That's a $90 million gain. But it was recorded as $100 million. And the point is, they never once looked at what benefits were being generated from the spending. What was being asked, within USAID, had nothing to do with what was actually being accomplished by any of the money that was being spent. It was never even asked.How do you think about risky bets in a place like USAID? It would be nice for USAID to take lots of high-risk, high-reward bets, and to be willing to spend money that will be “wasted” in the pursuit of high-impact interventions. But that approach is hard for government programs, politically, because the misses are much more salient than the successes.This is a very real issue. I saw this the very first time I did any sort of briefing with Congress when I was Chief Economist. The question came at me, "Why doesn't USAID show us more failures?" I remember thinking to myself, "Are you willing to promise that when they show the failure, you won't punish them for the failure — that you'll reward them for documenting and learning from the failure and not doing it again?" That's a very difficult nut to crack.There's an important distinction to make. You can have a portfolio of evidence generation, some things work and some don't, that can collectively contribute towards knowledge and scaling of effective programs. USAID actually had something like this called Development Innovation Ventures (DIV), and was in an earmark from Congress. It was so good that they raised money from the effective altruist community to further augment their pot of money. This was strong because a lot of it was not evaluating USAID interventions. It was just funding a portfolio of evidence generation about what works, implemented by other parties. The failures aren't as devastating, because you're showing a failure of some other party: it wasn't USAID money paying for an intervention. That was a strong model for how USAID can take on some risks and do some evidence generation that is immune to the issue you just described.If you're going to do evaluations of USAID money, the issue is very real. My overly simplistic view is that a lot of what USAID does should not be getting a highly rigorous impact evaluation. USAID should be rolling out, simple and at scale, things that have already been shown elsewhere. Let the innovation take place pre-USAID, funded elsewhere, maybe by DIV. Let smaller and more nimble nonprofits be the innovators and the documenters of what works. Then, USAID can adopt the things that are more effective and be more immune to this issue.So yeah, there is a world that is not first-best where USAID does the things that have strong evidence already. When it comes to actual innovation, where we do need to take risks that things won't work, let that be done in a way that may be supported by USAID, but partitioned away.I'm looking at a chart of USAID program funding in Fiscal Year 2022: the three big buckets are humanitarian, health, and governance, all on the order of $10–12 billion. Way down at the bottom, there's $500 million for “economic growth.” What's in that bucket that USAID funds, and should that piece of the pie chart be larger?I do think that should be larger, but it depends on how you define it. I don't say that just because I'm an economist. It goes back to the comment earlier about things that we can do to help improve local governance, and how they're using their resources. The kinds of things that might be funded would be efforts to work with local government to improve their ability to collect taxes. Or to set up efficient regulations for the banking industry, so it can grow and provide access to credit and savings. These are things that can help move the needle on macroeconomic outcomes. With that, you have more resources. That helps health and education, you have these downstream impacts. As you pointed out, the earmark on that was tiny. It did not have quite the same heartstring tug. But the logical link is huge and strong: if you strengthen the local government's financial stability, the benefits very much accrue to the Ministry of Health, the Ministry of Education, and the Ministry of Social Protection, etc.Fighting your way out of poverty through growth is unambiguously good. You can look at many countries around the world that have grown economically, and through that, reduced poverty. But it's one thing to say that growth will alleviate poverty. It's another to say, "Here's aid money that will trigger growth." If we knew how to do that, we would've done it long ago, in a snap.Last question. Let's say it's a clean slate at USAID in a couple years, and you have wide latitude to do things your way. I want the Dean Karlan vision for the future of USAID.It needs to have, at the high level, a recognition that the Golden Rule is an important principle that guides our thinking on foreign aid and that we want to do unto others as we would have them do unto us. Being generous as a people is something that we pride ourselves in, our nation represents us as people, so we shouldn't be in any way shy to use foreign aid to further that aspiration of being a generous nation.The actual way of delivering aid, I would say, three things. Simpler. Let's focus on the evidence of what works, but recognize the boundaries of that evidence and how to contextualize it. There is a strong need to understand what it means to be simpler, and how to identify what that means in specific countries and contexts.The second is about leveraging local government, and working more to recognize that, as big as we may be, we're still going to be tiny relative to local government. If we can do more to improve how local government is using its resources, we've won.The third is about finding common ground. There's a lot. That's one of the reasons why I've started working on a consortium with Republicans and Democrats. The things I care about are generally non-partisan. The goal is to take the aspirations that foreign aid has — about improving health, education, economic outcomes, food security, agricultural productivity, jobs, trade, whatever the case is — and how do we use the evidence that's out there to move the needle as much as we can towards those goals? A lot of topics have common ground. How do we set up a foreign aid system that stays true to the common ground? I'd like to think it's not that hard. That's what I think would be great to see happen. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.statecraft.pub

Antiparasitic drug Ivermectin has been shown to reduce malaria transmission by making the blood of treated persons deadly to the mosquitoes that carry the disease. Journalist Layal Liverpool explores the impact this new approach could have.Six months on from President Trump's dramatic cuts to US foreign aid, the HIV/AIDS relief fund PEPFAR hangs in the balance. We hear how the cuts have impacts one HIV clinic in Thailand and Devex correspondent Andrew Green unpacks the bigger picture.Could a temporary tattoo help combat drink spiking? We hear how it works and consider if anyone would actually wear one. A new neuroscience project is training non-specialists in India and Tanzania to gather brain data using portable headsets. Dr Tara Thiagarajan from Sapien Labs explains how diversifying brain data sets, which are often biased towards western populations, might improve health outcomes. How we sweat and why it matters. Layal and Claudia unpick new research that suggests sweat rises like a tide inside our skin.Presenter: Claudia Hammond Producer: Hannah Robins Assistant Producer: Alice McKee

In this episode, Faith Driven Movement's co-founder, Henry Kaestner, sits down with Ndidi Okonkwo Nwuneli, CEO of the ONE Campaign and serial social entrepreneur from Nigeria. With a background spanning McKinsey, Harvard Business School, and founding multiple organizations including LEAP Africa and Sahel Capital, Ndidi brings a unique perspective on Africa's role in the global economy.Key Topics DiscussedThe current state of global advocacy and the retreat from international cooperationHow the flattening of USAID affects Africa and global stabilityThe power of individual voices in shaping policy (PEPFAR example)Investment opportunities in Africa's food ecosystemWhy Africa is the continent of the future with 2.5 billion people by 2050The role of faith-driven investors in transforming African agricultureNotable Quotes"You interact with Africa every day, whenever you have a cup of coffee, when you have a chocolate bar, it's not a continent of lack, it's a continent of opportunity.""We've been too dependent on a few men and their ideologies, and we've kind of drifted away from the foundations of our faith.""$1 invested today saves $103 in defense action."Key TakeawaysEvery individual has a voice that can influence policy decisionsAfrica's food ecosystem presents significant investment opportunities across the spectrumThe continent's young workforce (70% under 35 by 2050) represents the future global workforceFaith-driven partnerships can create sustainable change beyond government programs

Friday, July 25th, 2025Today, two days after signing a $1.5B deal with Paramount; South Park torches Trump and the network in the season 27 premiere; attorney for Epstein survivors Bradley Edwards tells Lawrence O'Donnell that the Epstein birthday book is with Epstein's estate and can be easily subpoenaed; Columbia University bends the knee to the Trump administration; an appeals court finds that Donald's birthright citizenship order is unconstitutional; the US quietly drafts a plan to end PEPFAR; the White House has denied Maryland's request for disaster assistance; Amy Sherald cancels her Smithsonian show citing censorship; Trump's approval rating hits a new low; and Allison and Dana deliver the good news.Thank You, PacagenFor 15% off your order and a special gift, head to Pacagen.com/DAILYBEANS and use code DAILYBEANS.Guest: John FugelsangTell Me Everything - John Fugelsang, The John Fugelsang PodcastJohn Fugelsang - Substack@johnfugelsang.bsky.social - Bluesky, @JohnFugelsang -TwitterSeparation of Church and Hate by John Fugelsang - Pre-order StoriesKhanna planning to subpoena Epstein estate for ‘birthday book' | The HillColumbia Agrees to $200 Million Fine to Settle Fight With Trump | The New York TimesU.S. Quietly Drafts Plan to End Program That Saved Millions From AIDS | The New York TimesWhite House rejects Maryland's request for disaster assistance after flooding in May, Gov. Moore says | CBS Baltimorehttps://www.nytimes.com/2025/07/24/arts/design/amy-sherald-smithsonian-censorship.html | New York TimesTrump's birthright citizenship order is unconstitutional, appeals court says | CBS NewsGood Trouble Call your Reps in the House and tell them to subpoena the birthday book! Find Your Representative | house.govFrom The Good NewsIndivisible Greater VancouverFriends Across BordersNova Scotia - Camp TidnishAPPEARANCES – DANA GOLDBERGReminder - you can see the pod pics if you become a Patron. The good news pics are at the bottom of the show notes of each Patreon episode! That's just one of the perks of subscribing! patreon.com/muellershewrote Donate to the MSW Media, Blue Wave California Victory FundMSW Media, Blue Wave California Victory Fund | ActBlueWhistleblowerAid.org/beans Federal workers - feel free to email AG at fedoath@pm.me and let me know what you're going to do, or just vent. I'm always here to listen. Find Upcoming Actions 50501 Movement, No Kings.org, Indivisible.orgDr. Allison Gill - Substack, BlueSky , TikTok, IG, TwitterDana Goldberg - BlueSky, Twitter, IG, facebook, danagoldberg.comCheck out more from MSW Media - Shows - MSW Media, Cleanup On Aisle 45 pod, The Breakdown | SubstackShare your Good News or Good TroubleMSW Good News and Good TroubleHave some good news; a confession; or a correction to share?Good News & Confessions - The Daily Beanshttps://www.dailybeanspod.com/confessional/ Listener Survey:http://survey.podtrac.com/start-survey.aspx?pubid=BffJOlI7qQcF&ver=shortFollow the Podcast on Apple:The Daily Beans on Apple PodcastsWant to support the show and get it ad-free and early?The Daily Beans | SupercastThe Daily Beans & Mueller, She Wrote | PatreonThe Daily Beans | Apple Podcasts

Sandra Peoples, author of "Accessible Church," offers some Gospel-centered ideas for helping your church be more supportive and welcoming of families with special needs members.  Journalist Mindy Belz updates us on the plight of Afghans who fled their home country when the US military pulled out in 2021, and now are not welcome in other countries, including now the US. Mindy also updates us on the status of PEPFAR. Faith Radio podcasts are made possible by your support. Give now: Click here  

En El Brieff para este jueves exploramos la tensa relación México-EE. UU. por los drones, el drama del caso Epstein y su vínculo con Trump, la redefinición de los aranceles globales, la crisis humanitaria en Gaza, las protestas anticorrupción en Ucrania y las negociaciones de paz, la amenaza de cierre del programa PEPFAR contra el VIH, la innovadora atenuación del alumbrado público en Pittsburgh, la caída histórica de ingresos de Tesla y las controversias de Elon Musk, la demanda por difamación de los Macron y las maniobras militares de Rusia. Este episodio es traído a ti por nuestro patrocinador del día: STRTGY y su solución EVA Supply Chain Manager. Gestionar inventarios con precisión ya no es una opción: es la base de una cadena de suministro rentable. Conoce más en www.strtgy.ai o agenda un demo en arturo@strtgy.aiRecibe gratis nuestro newsletter con las noticias más importantes del día.Si te interesa una mención en El Brieff, escríbenos a arturo@brieffy.com Hosted on Acast. See acast.com/privacy for more information.

Bongani Bingwa speaks to Jens Pedersen, Director at the Africa First Advisory, about the far-reaching consequences of recent US funding cuts to HIV and TB programmes in Africa. For over 20 years, the PEPFAR initiative had bipartisan support and saved more than 25 million lives, including many in South Africa. However, in February, the Trump administration abruptly announced funding reductions that led to the closure of several clinics, disproportionately affecting vulnerable groups such as adolescent girls, young women, sex workers, trans people, injecting drug users, and LGBTQ+ communities. While pregnant and breastfeeding mothers continue to receive support, others have been left behind. Following strong activist pushback, there has been a limited reprieve, but the future of critical HIV services remains uncertain as political agendas increasingly interfere with global health aid. 702 Breakfast with Bongani Bingwa is broadcast on 702, a Johannesburg based talk radio station. Bongani makes sense of the news, interviews the key newsmakers of the day, and holds those in power to account on your behalf. The team bring you all you need to know to start your day Thank you for listening to a podcast from 702 Breakfast with Bongani Bingwa Listen live on Primedia+ weekdays from 06:00 and 09:00 (SA Time) to Breakfast with Bongani Bingwa broadcast on 702: https://buff.ly/gk3y0Kj For more from the show go to https://buff.ly/36edSLV or find all the catch-up podcasts here https://buff.ly/zEcM35T Subscribe to the 702 Daily and Weekly Newsletters https://buff.ly/v5mfetc Follow us on social media: 702 on Facebook: https://www.facebook.com/TalkRadio702 702 on TikTok: https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/Radio702 702 on YouTube: https://www.youtube.com/@radio702 See omnystudio.com/listener for privacy information.

Jeffrey Grieco, President & CEO of the Afghan-American Chamber of Commerce and Advisory Council Member at ISOA, joins host Mike Shanley to talk about the NATO 5% spend target and what it means for business development and growth teams in the government services sector. They discuss the current European security situation, how NATO's increased investment impacts contractors, and the growing opportunities for industry BD teams. Grieco also shares takeaways from the ISOA Europe & ATO Bucharest Conference, and why now is a pivotal moment for companies to engage.   RESOURCES: GovDiscovery AI Federal Capture Support: https://www.govdiscoveryai.com/  https://www.linkedin.com/in/jeffreygrieco/ https://www.linkedin.com/in/gov-market-growth/   BIOGRAPHY:  Jeffrey J. Grieco, President and Chief Executive Officer (CEO), Afghan-American Chamber of Commerce (AACC) and International Stability Operations Association (ISOA) Advisory Council Member and Chair of the ISOA Ukraine and Greater Middle East Working Groups. Mr. Grieco has served on the AACC Board of Directors since 2011 and has served as President and CEO since 2017. He travels to Afghanistan and the region frequently and speaks on behalf of the AACC at major donor and government events, think tanks and AACC Afghanistan-related private sector programs and conferences. He is also a Board Member Emeritus of the ISOA and currently serves on its Advisory Council. Mr. Grieco also serves as an independent foreign policy consultant with senior leadership experience within the U.S. Government and private sector providing a unique mix of leadership in the areas of: foreign policy, national security, international business development, U.S and international government relations, Congressional and public affairs and international assistance. As a consultant, he provides international investment, banking, finance and government relations services to multinational corporations and global non-profit organizations. Utilizing an extensive network of professional contacts, Mr. Grieco meets frequently with Administration and Congressional leadership and professional staff concerning U.S. and international assistance policies. He is a frequent speaker and panelist at foreign policy, national security, Congressional hearings and international development conferences. Mr. Grieco has also led his own businesses and consulted for Fortune 500 companies in international business development, foreign direct investment and associated government relations services for companies including: AT&T, Raytheon, Westinghouse ESG, Lucky Goldstar, Hyundai Motors, General Dynamics, and many more. In addition to maintaining language proficiencies in French and Korean, he has technical expertise working within international markets in such sectors as defense, ICT, manufacturing, air transportation systems and services, agriculture, energy development and finance. As a U.S. Senate-confirmed Presidential Appointee he served as Assistant Administrator for Legislative and Public Affairs at the U.S. Agency for International Development/U.S. Department of State until 2009. Mr. Grieco managed all agency global communications, media and public affairs and U.S. Congressional relations through a particularly difficult period in the post-9-11 foreign policy environment and was involved in standing-up the Millennium Challenge Corporation (MCC), PEPFAR and various other successful Presidential Initiatives. LEARN MORE: Thank you for tuning into this episode of the GovDiscovery AI Podcast with Mike Shanley. You can learn more about working with the U.S. Government by visiting our homepage: Konektid International and GovDiscovery AI. To connect with our team directly, message the host Mike Shanley on LinkedIn. https://www.govdiscoveryai.com/ https://www.konektid.com/ https://www.linkedin.com/in/gov-market-growth/

Lester Kiewit speaks to Mia Malan, the founder and editor in chief of Bhekisisa, about how the US President’s Emergency Plan for Aids Relief, or Pepfar, has been spared a $400-million funding cut by the US government. But what will it mean for the local network of Hiv/Aids programs and workers that have already been impacted? Good Morning Cape Town with Lester Kiewit is a podcast of the CapeTalk breakfast show. This programme is your authentic Cape Town wake-up call. Good Morning Cape Town with Lester Kiewit is informative, enlightening and accessible. The team’s ability to spot & share relevant and unusual stories make the programme inclusive and thought-provoking. Don’t miss the popular World View feature at 7:45am daily. Listen out for #LesterInYourLounge which is an outside broadcast – from the home of a listener in a different part of Cape Town - on the first Wednesday of every month. This show introduces you to interesting Capetonians as well as their favourite communities, habits, local personalities and neighbourhood news. Thank you for listening to a podcast from Good Morning Cape Town with Lester Kiewit. Listen live on Primedia+ weekdays between 06:00 and 09:00 (SA Time) to Good Morning CapeTalk with Lester Kiewit broadcast on CapeTalk https://buff.ly/NnFM3Nk For more from the show go to https://buff.ly/xGkqLbT or find all the catch-up podcasts here https://buff.ly/f9Eeb7i Subscribe to the CapeTalk Daily and Weekly Newsletters https://buff.ly/sbvVZD5 Follow us on social media CapeTalk on Facebook: https://www.facebook.com/CapeTalk CapeTalk on TikTok: https://www.tiktok.com/@capetalk CapeTalk on Instagram: https://www.instagram.com/ CapeTalk on X: https://x.com/CapeTalk CapeTalk on YouTube: https://www.youtube.com/@CapeTalk567 See omnystudio.com/listener for privacy information.

Send us a textIn this important and timely episode, I welcome back journalist, author, and friend of the podcast, Peter Wehner. We dig into his provocative and widely discussed article in The Atlantic: “Why Evangelicals Turned Their Back on PEPFAR.”PEPFAR—President George W. Bush's historic global AIDS relief program—has saved over 26 million lives and prevented millions of HIV infections. Once championed by American evangelicals, the program is now in crisis. Under Donald Trump's second term, PEPFAR was effectively shut down. Clinics have closed, aid has stalled, and more than 75,000 lives have already been lost—with millions more at risk.So why the silence from the evangelical community?Peter and I explore the cultural, political, and theological reasons behind this shift—from compassion to indifference—and why this issue, which should unite pro-life Christians, has instead fallen off the radar. We also reflect on how partisan loyalty, fear of division, and moral inconsistency have muted the response to one of the most effective humanitarian programs in U.S. history.This conversation is urgent, eye-opening, and deeply relevant to anyone who cares about faith, politics, and the real-world impact of silence. I hope you'll join us. This is one you don't want to miss. SHOW NOTESMSNBC Morning JoeRNS on PEPFARRNS - Nashville's Christian music stars join activists in push to save PEPFARHoly Post talks about PEPFARSupport the showBecome a Patron - Click on the link to learn how you can become a Patron of the show. Thank you! Ken's Substack Page The Podcast Official Site: TheBeachedWhiteMale.com

After an all-night marathon of amendments, the U.S. Senate voted to advance President Donald Trump's $9 billion rescissions package this week. While the country's flagship HIV/AIDS initiative PEPFAR was saved during the process, the package will still claw back nearly $8 billion in previously approved funding for foreign aid. To dig into this story, and others, Senior Editor Rumbi Chakamba sits down with reporters Michael Igoe and Elissa Miolene for the latest episode of our weekly podcast series. Sign up to the Devex Newswire and our other newsletters: https://www.devex.com/account/newsletters

In his rescissions request to Congress last month, President Donald Trump asked that the hundreds of millions dollars budgeted for the President's Emergency Plans for AIDS Relief, or PEPFAR, be cancelled.Senate Republicans have decided that PEPFAR is safe from cuts for now, but those fighting the global epidemic are worried.We talk about what these funding cuts would mean for those actually doing the research, and more importantly, for those living with HIV.Want to support 1A? Give to your local public radio station and subscribe to this podcast. Have questions? Connect with us. Listen to 1A sponsor-free by signing up for 1A+ at plus.npr.org/the1a.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

The Senate narrowly approved the Trump administration's request to claw back about $9 billion for humanitarian foreign aid projects and the Corporation for Public Broadcasting — but refused to cut funding for the international AIDS/HIV program PEPFAR. The House has a Friday deadline to approve the rescissions bill, or the funding remains in place. Meanwhile, a federal appeals court ruled that West Virginia can ban the abortion pill mifepristone, which could allow states to block other drugs approved by the FDA. Shefali Luthra of The 19th, Sandhya Raman of CQ Roll Call, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine join KFF Health News' Julie Rovner to discuss these stories and more. Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: Julie Rovner: The New York Times' “UnitedHealth's Campaign to Quiet Critics,” by David Enrich. Joanne Kenen: The New Yorker's “Can A.I. Find Cures for Untreatable Diseases — Using Drugs We Already Have?” by Dhruv Khullar. Shefali Luthra: The New York Times' “Trump Official Accused PEPFAR of Funding Abortions in Russia. It Wasn't True,” by Apoorva Mandavilli. Sandhya Raman: The Nation's “‘We're Creating Miscarriages With Medicine': Abortion Lessons from Sweden,” by Cecilia Nowell. Hosted on Acast. See acast.com/privacy for more information.

John Maytham speak to Mark Heywood, prominent AIDS activist and co-founder of the Treatment Action Campaign, to unpack whether PEPFAR will remain, and the potential impact it will have on South Africa. Presenter John Maytham is an actor and author-turned-talk radio veteran and seasoned journalist. His show serves a round-up of local and international news coupled with the latest in business, sport, traffic and weather. The host’s eclectic interests mean the program often surprises the audience with intriguing book reviews and inspiring interviews profiling artists. A daily highlight is Rapid Fire, just after 5:30pm. CapeTalk fans call in, to stump the presenter with their general knowledge questions. Another firm favourite is the humorous Thursday crossing with award-winning journalist Rebecca Davis, called “Plan B”. Thank you for listening to a podcast from Afternoon Drive with John Maytham Listen live on Primedia+ weekdays from 15:00 and 18:00 (SA Time) to Afternoon Drive with John Maytham broadcast on CapeTalk https://buff.ly/NnFM3Nk For more from the show go to https://buff.ly/BSFy4Cn or find all the catch-up podcasts here https://buff.ly/n8nWt4x Subscribe to the CapeTalk Daily and Weekly Newsletters https://buff.ly/sbvVZD5 Follow us on social media: CapeTalk on Facebook: https://www.facebook.com/CapeTalk CapeTalk on TikTok: https://www.tiktok.com/@capetalk CapeTalk on Instagram: https://www.instagram.com/ CapeTalk on X: https://x.com/CapeTalk CapeTalk on YouTube: https://www.youtube.com/@CapeTalk567 See omnystudio.com/listener for privacy information.

The IRS has decided churches are no longer prohibited from endorsing political candidates. Is this a win for free speech or a reason for some churches to become even more partisan? The Department of Homeland Security has released a creepy new promotional video that uses the Bible to frame border security as a mission from God. The Christian who gave George W. Bush the idea of “compassionate conservatism” says the passing of the Big Beautiful Bill marks the end of an era for the GOP. Professor Ryan Burge is back with data about the religious outlook of Gen Z. Some see evidence of a revival, but Burge says it's probably wishful thinking. Also this week, animal fashion news: chimp drip edition.   World Relief: https://worldrelief.org/advocate/   Holy Post Plus: Bonus Interview with Ryan Burge: https://www.patreon.com/posts/134198348/   Ad-Free Version of this Episode: https://www.patreon.com/posts/134204161/   0:00 - Show Starts   3:22 - Theme Song   3:44  - Sponsor - Rocket Money - Find and cancel your old subscriptions with Rocket Money at https://www.rocketmoney.com/HOLYPOST   4:48 - Sponsor - Hiya Health - Go to https://www.hiyahealth.com/HOLYPOST to receive 50% off your first order   5:55 - Chimp Fashion!   12:56 - Christian in Government with PEPFAR   16:07 - The Johnson Amendment   29:24 - Bible Verse in an ICE Recruitment Ad   40:59 - Why Is the Church So Libertarian?   55:33 - Sponsor - BetterHelp - This episode is sponsored by BetterHelp. Give online therapy a try at https://www.betterhelp.com/HOLYPOST and get 10% off your first month   56:42 - Sponsor - AG1 - Heavily researched, thoroughly purity-tested, and filled with stuff you need. Go to https://www.drinkag1.com/HOLYPOST   58:00 - Interview   1:00:45 - Why Are They Saying It's a “Revival?”   1:09:05 - Can Revival Be Predicted?   1:16:50 - Church and Loneliness   1:29:46 - End Credits   Links from News Segment: Chimps and Grassy Fashion! https://www.iflscience.com/chimps-are-sticking-grass-in-their-ears-and-rears-as-they-embrace-pointless-fad-79910   Other Resources: Ryan Burge's Article on Gen Z Revival: https://www.graphsaboutreligion.com/p/is-there-a-religious-revival-occurring   Holy Post website: https://www.holypost.com/   Holy Post Plus: www.holypost.com/plus   Holy Post Patreon: https://www.patreon.com/holypost   Holy Post Merch Store: https://www.holypost.com/shop   The Holy Post is supported by our listeners. We may earn affiliate commissions through links listed here. As an Amazon Associate, we earn from qualifying purchases.  

Today's host was Michael Wear, Founder, President, of Center for Christianity and Public Life.  Thanks for listening to The Morning Five! Please subscribe to and rate The Morning Five on your favorite podcast platform. Learn more about the work of the Center for Christianity and Public Life at www.ccpubliclife.org. Scripture: John 6:51-58 Top Headlines: 1) Russia Rejects Trump's Ultimatum  2) PEPFAR Left Out of Trump's $9 Billion Cuts 3) Labor Department Report Shows U.S. Inflation Rising as Tariffs Take Effect Today's host was Michael Wear, Founder, President, and CEO of the Center for Christianity and Public Life.  Join the conversation and follow us at: Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@michaelwear⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, @ccpubliclife Twitter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@MichaelRWear⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, @ccpubliclife and check out ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@tsfnetwork⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Music by: King Sis #politics #faith #prayer #Russia #PEPFAR #Senate #economy #inflation Learn more about your ad choices. Visit megaphone.fm/adchoices

Congress is working to cancel billions of dollars in previously approved funding in a recission package. Cami Mondeux, Congressional Correspondent with the Deseret News brings the latest details on the recission package and what will be impacted.  As foreign aid is being chopped in the rescissions package, one component has apparently been saved and that's PEPFAR, the program that has saved millions of lives in the last 20 years. Holly breaks down the fate of PEPFAR.

The White House backed off $400 billion in immediate cuts it was proposing in the global fight against HIV and AIDS and potentially other high-profile health programs. It's part of the package of cuts facing the Senate over the next two days. Lisa Desjardins reports. PBS News is supported by - https://www.pbs.org/newshour/about/funders

Senate Republicans make changes to the rescissions bill to gain necessary Republican support ahead of the first procedural vote, restoring $400 million for PEPAR, the global anti-AIDS program and protecting funding for some rural public broadcasters; Inflation report from the Labor Dept – up 0.3% in June, an annual rate of 2.7%, highest since February and maybe a sign President Trump's tariffs are leading to increases prices; House Republicans vote down a Democratic motion to make public FBI files on the late sex offender Jeffrey Epstein, after the Trump Admin stated Epstein did not keep a client list and did commit suicide in prison, which some of the president's MAGA supporters are questioning, while President Trump tells reporters General Pam Bondi should release "whatever she thinks is credible" on Jeffrey Epstein; U.S. Ambassador to the United Nations nominee Mike Waltz testifies before Senate Foreign Relations Committee about reforming the UN and on the Signal Chat controversy when he was National Security Adviser; NATO Secretary General Mark Rutte meets with Senators on Capitol Hill about supporting Ukraine in the war with Russia. Learn more about your ad choices. Visit megaphone.fm/adchoices

On today's program: Dr. Roger Marshall, U.S. Senator from Kansas, responds to the pressure to pass the president's rescissions package and comments on the breaking news that the woke elements of PEPFAR funding have been reinstated. Dr. Corey

The White House backed off $400 million in immediate cuts it was proposing in the global fight against HIV and AIDS and potentially other high-profile health programs. It's part of the package of cuts facing the Senate over the next two days. Lisa Desjardins reports. PBS News is supported by - https://www.pbs.org/newshour/about/funders

The White House backed off $400 million in immediate cuts it was proposing in the global fight against HIV and AIDS and potentially other high-profile health programs. It's part of the package of cuts facing the Senate over the next two days. Lisa Desjardins reports. PBS News is supported by - https://www.pbs.org/newshour/about/funders

President Donald Trump is pressuring Congress to approve $9.4 billion in spending cuts, targeting public broadcasting and foreign aid programs like PEPFAR. The House narrowly approved the plan, but GOP senators from rural and Native communities are pushing back. At stake: funding for more than 1,500 local public stations and billions in humanitarian aid. Subscribe to our newsletter to stay informed with the latest news from a leading Black-owned & controlled media company: https://aurn.com/newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, Mike, Russell, and Clarissa discuss evangelicals abandoning support for PEPFAR with Peter Wehner. Then, the IRS says churches can endorse political candidates. Is that okay? Finally, the ‘One Big Beautiful Bill Act' has officially passed. Ingrid Delgado of the Society of St. Vincent de Paul stops by to help us understand the implications for the vulnerable.    REFERENCED IN THIS EPISODE: “Why Evangelicals Turned Their Back on PEPFAR”—The Atlantic This month's episode of Tuesday Night Live with Mike & Clarissa. GO DEEPER WITH THE BULLETIN:  Take our survey for a chance to win a free sweatshirt.  Join the conversation at our Substack.  Find us on YouTube.  Rate and review the show in your podcast app of choice.   ABOUT THE GUESTS:   Peter Wehner is a contributing writer at The Atlantic and a senior fellow at the Trinity Forum. He was formerly a speechwriter for George W. Bush and a senior fellow at the Ethics and Public Policy Center. Wehner is a contributing opinion writer for The New York Times, and his work also appears in publications including The Wall Street Journal, The Washington Post, and National Affairs. Ingrid Delgado is the national director of public policy and advocacy at the Society of St. Vincent de Paul USA, an organization that seeks to raise the profile of issues such as homelessness and protection for the most vulnerable. She previously worked for the US. Conference of Catholic Bishops as associate director of government relations and, before then, as a domestic policy advisor.  ABOUT THE BULLETIN:  The Bulletin is a twice-weekly politics and current events show from Christianity Today moderated by Clarissa Moll, with senior commentary from Russell Moore (Christianity Today's editor in chief) and Mike Cosper (director, CT Media). Each week, the show explores current events and breaking news and shares a Christian perspective on issues that are shaping our world. We also offer special one-on-one conversations with writers, artists, and thought leaders whose impact on the world brings important significance to a Christian worldview, like Bono, Sharon McMahon, Harrison Scott Key, Frank Bruni, and more.    The Bulletin listeners get 25% off CT. Go to https://orderct.com/THEBULLETIN to learn more.    “The Bulletin” is a production of Christianity Today Producer: Clarissa Moll Associate Producer: Alexa Burke Editing and Mix: TJ Hester Music: Dan Phelps Executive Producers: Erik Petrik and Mike Cosper   Senior Producer: Matt Stevens Learn more about your ad choices. Visit podcastchoices.com/adchoices

Joe Grogan, former senior official of the George W. Bush administration and the first Trump administration, operates an active consultancy, hosts a podcast, writes commentaries for USC Schaeffer Center, and is an active member of the CSIS Bipartisan Alliance for Global Health Security. Drug shortages remain a real problem, with the potential to scale and impose political costs. What to make of the Big Beautiful Bill? It might provoke a backlash. How to understand the rising vulnerability of the aging foundational programs—PEPFAR, Gavi, the Global Fund? And how to understand what happened during Covid-19? It was a “toxic brew.” We need to be “radically transparent.” 

The last time Peter Wehner, who I've always imagined as America's conscience, appeared on the show to talk about the “ethical darkness” that has fallen upon America, I suggested that this was an “important” interview. Today's conversation is much more important than being simply important. Based on Wehner's recent Atlantic piece about why MAGA evangelicals have turned their back on PEPFAR, the American relief agency saving the lives of millions of Africa's AIDS victims, this is a conversation about America's heart of moral darkness. It's not just Trump who has African blood on his hands, Wehner argues, but most of his evangelical supporters who are unmoved by the destruction of PEPFAR. For the first time in my many conversations with Wehner, he was visibly moved by both the cruelty of Trump and the indifference of his supposedly Christian supporters. 1. Trump's Destruction of PEPFAR is "Wanton Cruelty" "This to me was an act of wanton cruelty. You really had to go out of your way to think how can I kill millions of people quickly inefficient. And they found one way to do it, which is to shatter USAID, which is the main implementing agency for PEPFAR."2. The Scale of Death is Staggering and Real-Time "There is an adult being lost every three minutes, a child every 31 minutes. And ending PEPFAR could result in as many as 11 million additional new HIV infections and nearly 3 million additional AIDS-related deaths by the end of the decade."3. Trump's Hold on Evangelicals is Unlike Anything in American Politics "I think it is closer to a cult of personality than it is to a normal political party... I think in some senses, the truest thing Donald Trump said in the 2016 campaign was when he said that he could go on Fifth Avenue and shoot somebody and he wouldn't lose support. And I think that turned out to be not hyperbole but prophetic."4. Evangelical Silence Reveals Their True Moral Priorities "In 2014, World Vision announced that they would hire at some levels of the organization, people who were in same sex marriages. And it was like a bomb going off in the evangelical world... Between 3,000 and 3,500 sponsors of kids primarily in Africa... Were ended... And now you have a situation... about what destruction of PEPFAR has done and will do and you can get barely get a peep out of them."5. This is About Mass Death, Not Policy Disagreement "Yeah, no, that is what I'm saying. I'm saying there will be a lot, lot more before this is done. There will be millions... We're talking really, really significant numbers. And that's an enormous amount of death, an enormous of suffering, and it's completely unnecessary."I hate the term “moral urgency”. But this is a morally urgent conversation about America's descent into a heart of darkness. Wehner exposes the cruelty and stupidity of destruction of the PEPFAR program. Even in the time you've spent reading this, a couple of African children will have died because of the callousness of MAGA disregard for human life. Keen On America is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit keenon.substack.com/subscribe

When George W. Bush created the PEPFAR program in 2003, it was celebrated by evangelical leaders and has saved more than 26 million lives in Africa from HIV/AIDS. So why weren't evangelicals outraged when Donald Trump killed PEPFAR, which has already resulted in over 75,000 deaths since January? Phil, Skye, and Kaitlyn unpack the arguments for and against PEPFAR, and how evangelical support for “small government” only applies to some programs. Then, Katilyn talks to Sharon Hodde Miller about what the self-esteem movement gets wrong about insecurity, and how we can recover the Christian virtue of service and self-forgetfulness. Also this week, rotten butter ants invade Europe.   Holy Post Plus: Bonus Interview with Rachel Martin: https://www.patreon.com/posts/133604080/   Ad-Free Version of this Episode: https://www.patreon.com/posts/133671224/   0:00 - Show Starts   3:22 - Theme Song   3:45 - Sponsor - Blueland - Get up to 25% off your first order by going to https://www.Blueland.com/HOLYPOST   4:50 - Sponsor - Sundays Dog Food - Get 40% off your first order of Sundays. Go to https://www.SundaysForDogs.com/HOLYPOST or use code HOLYPOST at checkout.   5:58 - Stinky Ants in Europe!   11:41 - PEPFAR and Evangelicals   21:00 - Spiritual Formation of Small Government Politics   25:35 - Addressing Anti-PEPFAR arguments   48:55 - Sponsor - Policy Genius - Secure your family's tomorrow so you have peace of mind today. Go to https://www.policygenius.com/HOLYPOST to find the right life insurance for you   50:12 - Interview   55:54 - Insecurity and Ministry   1:08:20 - The Emptiness of Self-Esteem   1:14:30 - Transactional Relationships   1:25:14 - End Credits   Links from News Segment: Super Ants Invade! https://www.thetimes.com/world/europe/article/super-ants-germany-8wp8n83zm   Why Evangelicals Turned Their Back on PEPFAR: https://www.theatlantic.com/ideas/archive/2025/07/pepfar-evangelical/683418/   Other Resources: Holy Post website: https://www.holypost.com/   Holy Post Plus: www.holypost.com/plus   Holy Post Patreon: https://www.patreon.com/holypost   Holy Post Merch Store: https://www.holypost.com/shop   The Holy Post is supported by our listeners. We may earn affiliate commissions through links listed here. As an Amazon Associate, we earn from qualifying purchases.  

This episode was first published as a bonus episode for our Planet Money+ listeners. Today, we're making it available for everyone! U.S. aid helped Eswatini and Lesotho, two small countries in southern Africa, in their efforts to treat and curb the spread of HIV. Will President Trump's "America First" foreign policy threaten years of progress there against the virus? In this bonus episode, we're featuring an extended conversation between Darian Woods and Jon Cohen, senior correspondent with Science magazine. They talk about Jon's reporting trip to Eswatini and Lesotho in May and the early impacts he saw of the Trump administration's foreign aid cuts. We also hear about the critical role of PEPFAR (the U.S. President's Emergency Plan For AIDS Relief) in the global response to HIV/AIDS and some other things we couldn't fit into the original episode.You can read Jon's recent article in Science magazine here.To hear more bonus episodes like this, and get Planet Money and The Indicator without sponsor messages, support the show by signing up for Planet Money+. This summer, we're also giving Planet Money+ supporters early access to new episodes. Another reason to join! Sign up via Apple Podcasts or at plus.npr.org.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Foreign aid is dead — long live foreign aid. On July 1st, 2025, the U.S. Agency for International Development — USAID — shut its doors for good. An institution born under Kennedy to be America's moral halo and Cold War firewall, it fed, healed, and built half the Global South for 60 years. Some say it saved 91 million lives; The Lancet says its closure could mean 14 million more deaths by 2030, a third of them kids. Bush calls that a tragedy. Obama calls it a colossal mistake. Bono writes a poem and cries. But the truth is harder to swallow: aid is a lifeline — but it's also a leash. And America just yanked it.This is realpolitik with a humanitarian face. Kennedy made foreign aid a Trojan Horse of goodwill and soft control. You keep kids alive, you keep regimes in your orbit. Bush knew it — PEPFAR, his AIDS relief plan, was moral triage and evangelical diplomacy. Obama, ever the grown-up, saw it as soft power's last best card: stabilizing failed states while creating new markets. But even he knew it was a moral leasehold — borrowed time for the world's poorest, funded by taxpayers whose mercy has an expiration date.And then came the burn-it-down populists. Reagan once said the scariest words in the English language were: “I'm from the government and I'm here to help.” Elon Musk put that on a T-shirt, ran USAID through his “Department of Government Efficiency,” and called it fraud. Trump shrugged and told the base: why send 17 cents a day to Sudan when you can buy votes at home? Musk called it a criminal racket. And the landlord foreclosed.So here's the raw question: is it better to live forever on a drip of pity — or drown free? AID is like AIDS meds: once you start, you can't stop, or you die. In Sudan, five million lose healthcare overnight. In sub-Saharan Africa, PEPFAR's cut means HIV deaths could spike again, kids orphaned by a policy pivot. Some will say America murdered them. But maybe they were already living on borrowed time.You can rage at the empire's moral hypocrisy. You should. But also ask: would you build your family's survival on the grace of someone else's Congress, someone else's donor mood, someone else's tax politics? Would you build your castle on soft ground? In Hawaii, they'd say: never build on leased land owned by a Queen's trust. Because the trust can pull the ground out any day.This is a story about the hard edge under the soft empire. It's about the village that was saved — but never finished its own well. It's about the landlord with the mercy kill switch. It's about the moment the halo flickered out and the people left holding the bag realized they'd always been on the moral leash.So if I sound like an asshole for saying it — AITA? Probably. But the ground is still soft. And pity, like funding, always expires.Listen, think, argue — but ask yourself: what do you build when the lifeline's gone?

Jon Cohen, senior correspondent with Science, reports on how countries that suffer high rates of HIV/AIDS are coping now that USAID funding has dried up, and how local governments, especially in places like Lesotho, are attempting to figure out solutions. Plus, Wafaa El-Sadr, MD, Columbia University professor of epidemiology and medicine and director of ICAP, a global health center at the school of public health, discusses ICAP's work in implementing PEPFAR (the President's Emergency Plan for AIDs Relief) in sub-Saharan Africa, and discusses the future of PEPFAR under the Trump administration.

James Fitzpatrick, Army veteran and the director of the Center to Advance Security in America (CASA), an organization dedicated to improving the safety and security of the American people. CASA uncovered evidence that the U.S. Government is funding foreign prostitution and sex workers through the PEPFAR program. That includes over $80M to an organization called LVCT Health, which is based in Kenya. They fund orgs such as Bar Hostess, which highlights itself as an organization “working in bars and sex workers in Kenya.

Have a comment? Send us a text! (We read all of them but can't reply). Email us: Will@faithfulpoliticspodcast.comLaunched in 2003, PEPFAR has saved over 25 million lives and stood as one of America's most celebrated bipartisan achievements. But under the Trump administration's second term, this global health initiative faces near-total collapse. In this urgent conversation, Peter Wehner—a veteran of three Republican administrations and a key PEPFAR advocate—explains how executive orders, the gutting of USAID, and MAGA-driven misinformation have jeopardized millions. Wehner, a senior fellow at the Ethics and Public Policy Center and contributor to The Atlantic and The New York Times, also reflects on the unraveling of U.S. soft power, the erosion of moral clarity in the evangelical world, and how Christians should respond to mass suffering abroad.From the devastation of Africa's healthcare infrastructure to the ideological reshaping of the GOP, this episode is a powerful wake-up call for anyone concerned with human dignity, public health, or the soul of American politics.

Jenny Dyer, founder of the 2030 Collaborative and artist and music producer Charlie Peacock were part of a coalition of experts, artists, and policymakers such as Bono, Senator Bill Frist, and many others that were instrumental in building the awareness around the AIDS epidemic in Africa, and the consensus needed to keep the President's Emergency for AIDS Relief Plan or PEPFAR, which has saved over 26 millions lives from HIV/AIDS since its inception in 2003 moving forward. Dr. Dyer and Charlie joined Strategerist host Andrew Kaufmann to discuss PEPFAR's success and how art can truly help change the world.

American evangelical Christians ought to care about the dismantling of PEPFAR. Russell reads a piece from his newsletter every Monday on the podcast but there's more to be found in the weekly email! Sign up ⁠⁠⁠here⁠⁠⁠. Learn more about your ad choices. Visit podcastchoices.com/adchoices

This episode is sponsored by: My Financial CoachYou trained to save lives—who's helping you save your financial future? My Financial Coach connects physicians with CFP® Professionals who specialize in your complex needs. Whether it's crushing student loans, optimizing investments, or planning for retirement, you'll get a personalized strategy built around your goals. Save for a vacation home, fund your child's education, or prepare for life's surprises—with unbiased, advice-only planning through a flat monthly fee. No commissions. No conflicts. Just clarity.Visit myfinancialcoach.com/physiciansguidetodoctoring to meet your financial coach and find out if concierge planning is right for you.____________In this episode, Dr. Tyler Evans,  joins host Dr. Bradley Block to unpack the dangerous implications of the Trump administration's public health funding cuts. Referencing historical pandemics like cholera, Hong Kong flu, and COVID-19, Dr. Evans illustrates how slashing programs such as PEPFAR ($6 billion), Ryan White (part of HRSA's $1.7 billion cut), and refugee health ($2 billion) dismantles global disease surveillance and response systems. These cuts, he warns, could allow outbreaks in regions like Central Africa to spread to American cities, overwhelming hospitals and disrupting economic stability. Dr. Evans critiques the politicization of health policy, including Medicaid reductions and attacks on evidence-based HIV initiatives, which exacerbate poverty and disease spread. Despite these challenges, he finds hope in humanity's ability to unite across divides, urging physicians to frame global health investments as personal and economic protection for their patients. With another pandemic likely within five years, this episode empowers physicians to advocate for resilient public health systems.Three Actionable Takeaways:Connect Global to Local Risks – Educate patients that funding global health programs like PEPFAR prevents diseases from reaching their neighborhoods, ensuring hospital access.Emphasize Economic Stability – Highlight how public health cuts threaten financial markets and personal 401(k)s by causing pandemic-driven instability, advocating for prevention.Push for Evidence-Based Policy – Counter divisive rhetoric by promoting programs like Ryan White to community members, emphasizing their role in community health.About the Show:The Physician's Guide to Doctoring covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school!About the Guest:Dr. Tyler Evans is an infectious disease and public health physician and CEO and co-founder of Wellness and Equity Alliance. He has led initiatives at Curative Incorporated, Marin County Health, and New York City's COVID-19 response, overseeing delivery of over 2 million vaccine doses nationwide. His work with Doctors Without Borders and the AIDS Healthcare Foundation spans HIV/AIDS, refugee health, and global infectious diseases. Dr. Evans is the author of Pandemics, Poverty, and Politics: Decoding the Social and Political Drivers of Pandemics from Plague to COVID-19, set for release in August 2025.Website: https://www.tylerevansmd.com/LinkedIn: https://www.linkedin.com/in/tyler-b-evans-md-ms-mph-aahivs-dtmh-fidsa-767ba738/About the host:Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts The Physician's Guide to Doctoring podcast, focusing on personal and professional development for physiciansWant to be a guest? Email Brad at brad@physiciansguidetodoctoring.com  or visit www.physiciansguidetodoctoring.com to learn more!Socials:@physiciansguidetodoctoring on Facebook@physicianguidetodoctoring on YouTube@physiciansguide on Instagram and Twitter  Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance.

The opinions expressed by Dr. Beyrer are his own and not those of his employer. In this episode, Therese Markow and Dr. Chris Beyrer discuss the importance of USAID, highlighting its role in global health and development, particularly through programs like PEPFAR, which has saved 25 million lives and prevented millions of HIV infections. Dr. Beyrer emphasizes that the economic and security benefits of USAID, whose support amounts to less than 1% of the total US federal budget, have had important benefits at home in the United States.  It protects us from infectious diseases like Ebola and MPOX.  Cuts to USAID could lead to a resurgence of HIV, polio, malaria, and other diseases. Finally, Dr. Beyrer advocates for listeners to become informed, to understand what is happening, and to engage in their citizenship rights for the benefit of all.     Key Takeaways: By law, USAID was only allowed to buy food from US farmers, but stopping USAID has thrown farmers into crisis due to the unstable purchasing now.  Until January 20, 2025, USAID was supporting about 21 million people worldwide on antiviral therapy. It was also one of the biggest funders and supporters of HIV prevention because treatment is not enough - you must reduce new infections to get out from under the treatment burden. The only group right now that we are supporting PrEP for is pregnant or lactating, breastfeeding mothers who are at risk for HIV. Everybody else who is on PrEP has been abruptly halted. 2025 could be the year that we see the beginning of the second wave of the AIDS pandemic.    "These programs really save lives. They have saved millions of lives. We know that; we've documented it carefully. It is so important to be informed, to stay informed, to understand what is happening, and really to engage. Now, more than ever, engage in your citizenship rights." —  Dr. Chris Beyrer   Connect with Dr. Chris Beyrer: Professional Bio: https://globalhealth.duke.edu/people/beyrer-chris    Connect with Therese: Website: www.criticallyspeaking.net Threads: @critically_speaking Email: theresemarkow@criticallyspeaking.net   Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it. 

Welcome to a world where medicine meets politics: a space that brings together scientific research, government wrangling, public push-back and healthcare conspiracies…Dr Anthony Fauci was the Director of America's National Institute of Allergy and Infectious Diseases for nearly four decades, during which time he not only helped study, treat and prevent viruses such as HIV/AIDS and Covid-19; he also advised seven US Presidents, from Ronald Regan through to Joe Biden.Along the way, Tony Fauci's picked up a public profile and taken a fair amount of flack; not least because of his complicated relationship with President Donald Trump. But he's also made great strides in medical research and policy, from working with activists who initially challenged him on the government response to HIV/AIDS - to spearheading the USA's PEPFAR project to share vital medication with developing nations.In a candid conversation with Professor Jim Al-Khalili, Tony discusses his childhood in Brooklyn, the dark early days of the HIV/AIDS epidemic, lessons from the Covid-19, his hopes and fears for the future of American health policy – and his reaction to that pre-emptive pardon from President Biden.Presented by Jim Al-Khalili Produced for BBC Studios by Lucy Taylor

A Lancet study warns of consequences for HIV prevention if PEPFAR loses funding, potentially millions of new pediatric HIV cases and increased AIDS-related deaths. Medicare Part D is highlighted, with research linking subsidy loss to higher mortality rates. A report from BMJ notes a 3.1% decline in U.S. drug overdose deaths, signaling a possible peak in the fentanyl crisis.

Global reproductive rights and investment in the agencies and organizations that support reproductive rights have often been used as a political football. The bodies of women, girls, and LGBTQI+ persons have been used to push and pull power for decades—and this anti-rights, anti-choice framework has become increasingly exported around the world. Beth Schlachter, Senior Director for U.S. and External Engagement for MSI Reproductive Choices, talks to us about how attacks to human rights frameworks and funding will further endanger global reproductive health and rights.Some apparatuses the U.S. have been using to redefine human rights, and therefore, redefine access to sexual and reproductive healthcare services, include the Commission on Unalienable Rights, the International Ministerial Conference on Freedom of Religion or Belief, and the Geneva Consensus Declaration. These frameworks and tools then get internationally exported. MSI has a host of programs around the world that will be impacted by these tools, frameworks, and funding attacks. MSI's programs support maternal health and access to other reproductive health services. In addition, these attacks will likely and broadly impact child marriage programs, the PEPFAR program, the Sustainable Development Goals, and more.For more information check outThe Nocturnists: https://thenocturnists.org/Support the showFollow Us on Social: Twitter: @rePROsFightBack Instagram: @reprosfbFacebook: rePROs Fight Back Bluesky: @reprosfightback.bsky.social Email us: jennie@reprosfightback.comRate and Review on Apple PodcastThanks for listening & keep fighting back!

In this episode of Going anti-Viral, Mary Fisher joins host Dr Michael Saag to discuss Communicating the Importance of Science and Research to the Public. Ms Fisher is an artist, author, and activist, who has spent a lifetime giving voice to the voiceless. Her historic speech at the 1992 Republican Convention, A Whisper of AIDS, has been named one of “forty famous speeches that have had long-term effect on society.” In this episode, Ms Fisher discusses her history of activism including her work in Africa before and after the arrival of PEPFAR and the concern for the many communities she worked with given the termination of USAID. Ms Fisher also discusses her new book Uneasy Silence: An activist seeks justice and courage over a lifetime of change where she and Dr Saag stress the importance of speaking out for scientific research given the impact it has on patient care and saving lives. 0:00 – Introduction1:17 – History of Ms Fisher's activism 4:11 – Impact of Ms Fisher's work in Africa and discussion of the quality of life before and after PEPFAR 10:05 – The impact of the elimination of USAID on people with HIV, nutrition, and other diseases 14:36 – Discussion of Ms Fisher's book Uneasy Silence: An activist seeks justice and courage over a lifetime of change20:12 – Why scientific research is important and the impact of cuts to the research budget at NIAID28:55 – The need to speak out for science, the practice of medicine, and care for those in need of careRelated Resources:Uneasy Silence: An activist seeks justice and courage over a lifetime of change Amazon  A Whisper of AIDS YouTube Project Angel FoodEpisode 43 YouTube | Apple Podcasts with Dr Izukanji SikazweVoices in HIV Research and Global Health, from the Scientists, the Labs, and the Community YouTube __________________________________________________Produced by IAS-USA, Going anti–Viral is a podcast for clinicians involved in research and care in HIV, its complications, and other viral infections. This podcast is intended as a technical source of information for specialists in this field, but anyone listening will enjoy learning more about the state of modern medicine around viral infections. Going anti-Viral's host is Dr Michael Saag, a physician, prominent HIV researcher at the University of Alabama at Birmingham, and volunteer IAS–USA board member. In most episodes, Dr Saag interviews an expert in infectious diseases or emerging pandemics about their area of specialty and current developments in the field. Other episodes are drawn from the IAS–USA vast catalogue of panel discussions, Dialogues, and other audio from various meetings and conferences. Email podcast@iasusa.org to send feedback, show suggestions, or questions to be answered on a later episode.Follow Going anti-Viral on: Apple Podcasts YouTubeXFacebookInstagram...

This episode, we talk with Jenny Dyer, founder of the 2030 Collaborative, about her involvement raising awareness for HIV/AIDS - from working with Bono and the ONE Campaign to championing global health in Washington and beyond. Jenny breaks down how U.S. programs like PEPFAR have saved millions of lives—and why hardly anyone talks about it anymore. We dig into what's at risk as funding dries up and how churches can step in to advocate. If you're curious about how faith communities can make a real impact in global health, this episode is packed with practical ways to speak up and get involved.  LINKS -  (10:08) Haunted by Hopelessness: 12 Zambians share their stories as HIV drugs run out - Haunted by hopelessness: 12 Zambians share their stories as HIV drugs run out  (15:57) Find your senators to contact - senate.gov (17:04) Contact your legislators through One.org and receive a template of what to say - one.org   Read More From Jenny Dyer: The aWAKE Project : Uniting against the African AIDS Crisis The Mother and Child Project: Raising Our Voices for Health and Hope The End of Hunger: Renewed Hope for Feeding the World     About Jenny Dyer - Jenny is the founder of The 2030 Collaborative, which focuses on promoting awareness, providing education, and encouraging advocacy for the 17 U.N. Sustainable Development Goals (SDGs). She also directs the Faith-Based Coalition for the Global Fund to Fight AIDS, Tuberculosis, and Malaria. She has previously worked for former Senate Majority Leader Bill Frist to mobilize advocacy for PEPFAR and other HIV/AIDS intervention from Christian leaders, and written many different pieces on the intersection between religion and global health. She lives in Franklin, Tennessee with her husband, John, and two boys, Rhys and Oliver. —-- The Better Samaritan podcast is produced by the Humanitarian Disaster Institute at Wheaton College, which offers an M.A. in Humanitarian & Disaster Leadership and a Trauma Certificate. To learn more and apply, visit our website. Get your application fee to the HDL M.A. program waived with code TBS25. Jamie Aten, Ph.D., and Kent Annan, M.Div., co-direct the Humanitarian Disaster Institute at Wheaton College and are the Co-Founders of Spiritual First Aid. This episode was produced by WildfireCreative  Theme Song: “Turning Over Tables” by The Brilliance Subscribe: Apple Podcasts | Google Podcasts | Spotify | TuneIn | Stitcher | RSS Follow us on Twitter:  @drjamieaten |  @kentannan Follow on Instagram: @wildfirecreativeco @wheaton_hdi (Note to the listener: In this podcast, sometimes we'll host Evangelicals, and sometimes we won't. Learning how to “do good, better” involves listening to many perspectives with different insights and understanding. Sometimes, it will make us uncomfortable; sometimes, we'll agree, and sometimes, we won't. We thi Learn more about your ad choices. Visit podcastchoices.com/adchoices

About this episode: In 2003, George W. Bush's President's Emergency Plan for AIDS Relief (PEPFAR) was the largest commitment to a single disease in U.S. history. Renewed under every subsequent presidency since, PEPFAR has saved more than 25 million lives and prevented some 5 million perinatal infections globally. But now, policy changes that effectively end PEPFAR have the potential to completely reverse course and the world could see HIV/AIDS infections on par with a time even before effective antivirals existed. In this episode: Dr. Chris Beyrer talks about his recent Lancet essay, “On Going Backwards,” why any retreat now will make it harder to regain lost ground, and how this policy change has the potential to impact millions of lives. Guest: Dr. Chris Beyrer is the past president of the International AIDS Society and an expert in global health and human rights. Host: Stephanie Desmon, MA, is a former journalist, author, and the director of public relations and communications for the Johns Hopkins Center for Communication Programs at the Johns Hopkins Bloomberg School of Public Health. Show links and related content: On Going Backwards—The Lancet (Perspectives) By executive order: The likely deadly consequences associated with a 90-day pause in PEPFAR funding—Journal of the International AIDS Society Transcript information: Looking for episode transcripts? Open our podcast on the Apple Podcasts app (desktop or mobile) or the Spotify mobile app to access an auto-generated transcript of any episode. Closed captioning is also available for every episode on our YouTube channel. Contact us: Have a question about something you heard? Looking for a transcript? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on Bluesky @‌JohnsHopkinsSPH on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed Note: These podcasts are a conversation between the participants, and do not represent the position of Johns Hopkins University.

This is a free preview of a paid episode. To hear more, visit andrewsullivan.substack.comByron is a political journalist. He was a news producer for CNN in the early years, a reporter for The American Spectator, and the White House correspondent for National Review. He's currently the chief political correspondent for Washington Examiner and a contributor to Fox News. His most recent book is the 2020 bestseller, Obsession: Inside the Washington Establishment's Never-Ending War on Trump. We chewed over the recent political past and then got on to Trump, where things got stickier but still friendly.For two clips of our convo — on Clinton Derangement Syndrome in the ‘90s, and Trump bungling his gains on immigration — pop over to our YouTube page.Other topics: raised in Alabama; his dad a pioneer star in local TV news; the GOP takeover of the South; George Wallace; the Nation of Islam and AIDS; GOP fusionism in the Cold War; Mickey Kaus' courage; David Brock's war on the Clintons; Bill's triangulation and the DLC; Vince Foster; Lewinsky and impeachment; Ken Starr; Iraq and WMD; covering Dubya for National Review; that mag marginalized since Trump; Birtherism and demonizing Obama; McCain and the market crash; Obamacare; the Santorum candidacy; Pat Buchanan; Trump vs Jeb on 9/11; Trump blowing up GOP orthodoxies; Hillary in 2016; Russiagate; pardoning all January 6-ers; Trump's impeachments and McConnell; open borders under Biden; CHIPS and IRA; Trump hypocrisy on E-Verify; authoritarianism and self-deportation; Tom Homan; Bukele; the Alien Enemies Act; the SCOTUS standoff; judge shopping; DEI; Musk and DOGE; USAID and PEPFAR; Zelensky in the Oval; NATO; Chris Krebs; the tariff war; Trump's yips; and the looming empty shelves.Browse the Dishcast archive for an episode you might enjoy (the first 102 are free in their entirety — subscribe to get everything else). Coming up: Claire Lehmann on the woke right, David Graham on Project 2025, Jake Tapper and Alex Thompson on the Biden years, Robert Merry on President McKinley, Sam Tanenhaus on Bill Buckley, Walter Isaacson on Ben Franklin, and Paul Elie on his book The Last Supper: Art, Faith, Sex, and Controversy in the 1980s. Please send any guest recs, dissents, and other comments to dish@andrewsullivan.com.

Peter Selwyn, one of today's guests, has been caring for people living with HIV for over 40 years.  In that time, care of people with HIV has changed dramatically.  Initially, there was no treatment, then treatments with marginal efficacy, complex schedules, and a tremendous burden of side effects and drug-drug interactions.  The average age at death was in the 30s. Now, more people in the US die with HIV rather than from HIV.  Treatment regimens are simplified, and the anti-viral drugs are well tolerated.  People are living with HIV into advanced ages.  The average age at death is likely in the 60s.  Nearly half of people living with HIV are over age 55.  One in 10 people with newly diagnosed HIV is an older adult.  Our second guest, Meredith Greene, is a geriatrician and researcher who focuses on care of older adults living with HIV, in the US and Africa. On today's podcast we discuss: Implications of aging with HIV for clinical care Loneliness and social isolation among older adults living with HIV Persistence of stigma Need to consider HIV in the differential diagnosis for older adults Screening for HIV Screening for osteoporosis in people living with HIV Dementia and cognitive impairment risk in people living with HIV When to stop anti-virals near the end of life Toward the end we speak to the moment.  More older adults live with HIV in SubSaharan Africa and the global South than anywhere else in the world.  Funding for research and clinical care is at risk, as USAID and PEPFAR (which is under USAID), are shuttered.  Millions of lives are at stake.  Meredith wore a shirt that said Silence=death. Eric gave me the hook during my live cover of One, by U2, a song released in 1992 whose proceeds went entirely to AIDS research.  I couldn't help it, forgive me dear listeners, I had to do a longer than usual cut at the start! -Alex Smith   Useful links: Peter's article on the evolution of HIV: https://link.springer.com/article/10.1007/s11524-011-9552-y Peter's book Surviving the Fall: Personal Journey of an AIDS Doctor PEPFAR:  Global Health Policy | KFF   Articles: Geriatric Syndromes in Older HIV-Infected Adults - PMC Loneliness in Older Adults Living with HIV Management of Human Immunodeficiency Virus Infection in Advanced Age https://pmc.ncbi.nlm.nih.gov/articles/PMC3684249/ About Act-up for those who might know the Silence=Death t-shirt reference: https://www.npr.org/2021/06/16/1007361916/act-up-a-history-of-aids-hiv-activism https://www.newyorker.com/magazine/2021/06/14/how-act-up-changed-america

Two-time Pulitzer Prize–winning journalist Nicholas Kristof (opinion columnist, the New York Times) reflects on his career of reporting from the front lines of injustice and human suffering, discussing hope, human resilience, and the urgency of responding to global injustice. An advocate for empathy-driven journalism that holds power accountable and communicates the stories of the most vulnerable, Kristof joins Mark Labberton in this episode to discuss his life's work of reporting from the world's most troubled regions—from Gaza to Congo, from rural Oregon to global centres of power. Known for his unsparing storytelling and deep empathy, Kristof shares the family roots and personal convictions that have shaped his lifelong pursuit of justice and hope. They also explore how despair and progress coexist, the role of faith and empathy in healing, and how local acts of courage can ripple globally. Grounded in gritty realism, but inspired by everyday heroes, Kristof invites us to resist numbness and embrace a hope that fights to make a difference. Stories from Gaza, Congo, Pakistan, and beyond Balancing heartbreak and hope in humanitarian reporting Why empathy must be cultivated and practiced The global impact of Christian activism and its complexities Episode Highlights “Side by side with the worst of humanity, you find the very best.” “We focus so much on all that is going wrong, that we leave people feeling numb and that it's hopeless … but people don't want to get engaged in things that are hopeless.” “Empathy is something that, like a muscle, can be nurtured.” “The worst kinds of evil and the greatest acts of courage are often just one decision apart.” “We are an amazing species—if we just get our act together.” “You can be sex positive and rape negative. I don't think there's an inconsistency there.” About Nicholas Kristof Nicholas Kristof is a two-time Pulitzer Prize–winning journalist, and is an opinion columnist for the New York Times, **where he was previously bureau chief in Hong Kong, Beijing, and Tokyo. Born, raised, and still working from his rural Oregon home, Yamhill, he is a graduate of Harvard and was a Rhodes Scholar at Oxford. He is the co-author, with his wife Sheryl WuDunn, of five previous books: Tightrope, A Path Appears, Half the Sky, Thunder from the East, and China Wakes. In 2024, he published a memoir, *Chasing Hope: A Reporter's Life.* Books by Nicholas Kristof Tightrope A Path Appears Half the Sky Thunder from the East China Wakes Chasing Hope: A Reporter's Life Helpful Resources International Justice Mission Dr. Denis Mukwege – Nobel Peace Prize PEPFAR: The U.S. President's Emergency Plan for AIDS Relief Tim Keller's Final Interview with Kristof (NYT) Show Notes A voice of conscience How a global orientation for journalism developed Kristof reflects on his humble roots in Yamhill, Oregon, as the son of two immigrants “My dad was a Armenian refugee from Eastern Europe. His family had spied on the Nazis during World War II. They got caught. Some were executed by the Nazis, others were executed by the Soviet communists, and my dad was very lucky to make it out alive and was sponsored by a family in the US in 1952.” “I think that one fundamental mistake that bleeding hearts make, whether they're bleeding hearts in journalism or in the non-profit community or in advocacy, is that we focus so much on all that is going wrong that we leave people feeling numb and feeling that it's hopeless, so there's no point in engaging. And there's pretty good evidence from social-psychology experiments that people don't want to get engaged in things that are hopeless. They want to make a difference. And so I think that we need to both acknowledge all the challenges we face but also remind people that there can be a better outcome if they put their shoulder to the wheel.” Extraordinary changes for justice and what's going right David Brooks: “A deeply flawed country that also managed to do good in the world.” ”It just breaks my heart that kids are dying unnecessarily.” On losing PEPFAR foreign aid: “I hope that this damage can be repaired and that bleeding hearts of the left and the right can work together to try to help restore some of these initiatives.” The tragedies that followed from dismantling USAID Kristof's book Chasing Hope “The fact is that I've seen some terrible things, and I think I may have a mild case of PTSD from, you know, seeing too much.” Nicholas Kristof on Gaza: “I don't see Israel and Hamas as morally equivalent, but I absolutely see an Israeli child, a Palestinian child, and an American child as moral equivalents.  And we don't treat them that way.” “What human beings share is that when terrible things happen, some people turn into psychopaths and sociopaths, and other people turn into heroes.” Cowardice and malevolent tendencies Empathy can be nurtured Children dying without anti-retroviral drugs in South Sudan Empathy Project in Canada Mass literature to inspire perspective taking Uncle Tom's Cabin Black Beauty and animal rights/well-being Kristof's run for Oregon governor Eastern Congo and UNICEF “A child is raped every thirty minutes in Eastern Congo.” Dr. Denis Mukwege, Nobel Peace Prize laureate treating women brutally injured by militia rape in Bukavu, a city in eastern Democratic Republic of the Congo. Small gestures of compassion as an empathy grower for local communities “One of the lessons I think of Congo is that violence can be and inhumanity can be terribly contagious.” Genocide in Rwanda in 1994 The global sex-trafficking crisis “We don't have the moral authority to tell other countries to do better unless we clean up our own act.” The American sex-trafficking crisis: systemic failures such as foster care pipelines into trafficking “There are no statistics, but I think it's plausible that a girl in foster care is more likely to emerge to be trafficked than she is to graduate from a four-year college.” American sex-trafficking practices by PornHub and X-Videos: “Their business model is monetizing kids.” “You can be sex positive and rape negative. I don't think there's an inconsistency there, and I, I think we've just blurred that too often.” Christianity's disappointing response to injustice Nicholas Kristof's engagement with the activism and theology of the Christian church William Wilberforce's anti-slavery movement in the 1780s President Bush's establishment of PEPFAR in 2003: “This incredible program to reduce the burden of AIDS that has saved 26 million lives so far. It's the most important program of any country in my adult lifetime in terms of saving lives.” “Evangelicals are very good in terms of tithing and donating money to good causes, but they've often opposed government programs  that would create opportunity and address these problems.” “Liberals are personally stingy, but much more supportive of government programs that that make a difference.” Criticizing the dismantling of global aid programs like USAID: “How can you read the Gospels and think this is good?” “I think being part of a religious community has led people to do good works together.” Christian advocacy for freedom of religion Kristof on scripture and belief: “We read the Bible and develop our religious views, and I think so often just reflects our priors rather than what the text says.” A closing example of hope: The Afghan war “We are an amazing species if we just get our act together.” Production Credits Conversing is produced and distributed in partnership with Comment magazine and Fuller Seminary.

The Atlantic's Peter Wehner offers insights into the transformation of the GOP from the party that passed PEPFAR to the MAGA warriors of today. The Mona Charen Show is a weekly, one-on-one discussion that goes in depth on political and cultural topics. New shows drop Mondays. Find this show wherever you get your podcasts and on YouTube. Go to Hungryroot.com/CHAREN and use code CHAREN to get 40% off your first box and a free item of your choice for life. REFERENCES: Peter's recent work at The Atlantic Jesus and John Wayne by Kristin Kobes Du Mez The Closing of the American Mindby Allan Bloom The Power of the Powerless and Summer Meditations by Václav Havel The Gulag Archipelago by Aleksandr Solzhenitsyn 1984 by George Orwell

How Can We Create Faith-Driven Solutions for a World in Need?   Host Curtis Chang sits down with Dana Wichterman, a former USAID and Department of Commerce development expert, and Bill Wichterman, a former special assistant to President George W. Bush, to explore how faith-driven impact investing can help fill the gap left by reduced U.S. government aid to the “least of these.” They unpack practical ways Jesus followers can align their financial resources with their values, support global humanitarian efforts, and drive lasting change. Discover how people of all income levels can turn generosity into powerful, faith-fueled action.   Good Faith Live “Watch Party”: Russell Moore, David French, & Curtis Chang: Trump's First 100 Days   Resources mentioned in this episode: Timeline of USAID dismantling An oral history of PEPFAR with Gov. Bill Frist (video) The Europe cuts foreign aid and development Department of State to resume PEPFAR programming Conspiracy theories are fuelling attacks on NGOs and aid workers The State of Church Giving: Church Trends and Statistics [2025] I Peter 4:10 (all translations) 2 Corinthians 9:5-15 NLT Historical Poverty Tables: People and Families:1959 to 2023 Eric Ha (for TIME): Foreign Aid Is Retreating. The Church Must Not John Porter tells the story of Masaka Creamery (video) Haiti: Where Has All the Money Gone? Impact Investing Has Come of Age Why Christians Should Never Retire by Chris Cagle Philanthropic and Investable Organizations Mentioned: TRUSTBRIDGE Global International Justice Mission The Gathering of Christians in Philanthropy Masaka Farms Impact Foundation Verdant Frontiers (Scott Friesen) More from Dana & Bill Wichterman: www.stewardsnotowners.com Dana & Bill Wichterman's book Stewards Not Owners: The Joy of Aligning Your Money with Your Faith Follow Us: Good Faith on Instagram Good Faith on X (formerly Twitter) Good Faith on Facebook   Sign up: Redeeming Babel Newsletter