Expert quits US HIV role, rebukes Trump's global health approach

Highlights:

• US science officer criticises aid cuts and use of health funding as leverage over developing nations
• State Department says Reid left after admitting he could not provide non-partisan scientific advice
• Reid warns of reduced funding, oversight issues and shift towards military spending over health aid

The chief science officer for the US flagship HIV/AIDS programme left his role this week and criticised the Trump administration's cuts to foreign assistance and what he said was its use of aid as leverage for US commercial interests.

Republican President Donald Trump last year dismantled the US Agency for International Development, which previously oversaw most foreign aid programmes, but officials said life-saving work mainly in developing African nations under the President's Emergency Plan for AIDS Relief (PEPFAR), a bipartisan initiative created under George W. Bush's presidency, would continue.

Mike Reid, a practising infectious disease physician who served as chief science officer for PEPFAR in the State Department's Bureau of Global Health Security and Diplomacy, said in a post on Substack on Monday he had stayed in the job for the past 18 months in hopes of preserving at-risk programmes.

But he said funding for health programmes overseas was being used as leverage over developing countries, citing a New York Times report last month that said the State Department was considering withholding assistance to help people with HIV in Zambia to push the country to sign a favourable critical-minerals deal with the US.

"When access to treatment or prevention becomes entangled with access to critical minerals or geopolitical positioning, the work is no longer what it claims to be," he wrote.

The work of global health was "inherently anti-fascist" and incompatible with the administration's "authoritarian" domestic trajectory, he added.

'America first' health strategy

The State Department, after seeing the post on Monday, told Reid his employment was being ended immediately, he told Reuters in a phone interview on Tuesday.

Asked about Reid's post, the State Department said it was continuing to spend the money appropriated for PEPFAR by the US Congress and said it had offered Zambia a "generous multi-year package of US assistance," but did not address the claim that the US sought economic concessions in exchange.

A department spokesperson said Reid departed by mutual agreement after he "admitted he could no longer provide non-partisan scientific advice."

"As in every administration, the president and his team set policy, and it is the duty of every person affiliated with the department to faithfully execute that policy," the spokesperson said.

The State Department last week published data showing that the number of people being tested for HIV dropped sharply last year amid interruptions to PEPFAR, which has been credited with saving 26 million lives and preventing HIV infections in 7.8 million babies born to HIV-infected mothers since its start in 2003.

The State Department spokesperson said Trump and Secretary of State Marco Rubio were "building to end the HIV/AIDS epidemic as they champion the transformational work happening under the America First Global Health Strategy," and noted that Reid praised some parts of the Trump administration's policy in his Substack post.

That referred to Reid's acknowledgement that the Trump administration's strategy seeks to have poorer nations take ownership of the fight against HIV/AIDS and other diseases in their countries through bilateral agreements.

Reid also wrote, however, that the US was doing so while reducing overall funding to those countries as US military spending has increased and as Trump has launched a war with Iran.

Reid told Reuters that moving funding to government health bodies instead of non-governmental organisations was the right approach, but that it was coming after many of the US officials who previously monitored for corruption and other misuse of funds had lost their jobs.

The State Department spokesperson said the bilateral health agreements included "extensive new government-to-government accountability and compliance frameworks... in addition to utilising third party auditors," but did not address the cuts to staffing.

"I am concerned at the speed and the lack of oversight," Reid said.