On January 24, 2025, President Trump temporarily halted all U.S. foreign aid, including funding for the President’s Emergency Plan for AIDS Relief. Launched in 2003, PEPFAR is responsible for saving more than 26 million lives. In dozens of countries, the program helps fund nearly every aspect of their HIV response.

That response is now in crisis. Some services have resumed, while others have been erased completely.

This abrupt and ongoing disruption of PEPFAR services is a betrayal. It is the forsaking not just of the many millions of people in Africa and elsewhere who depend on these programs for their life-saving services, but of the many millions more who have offered their scant resources to help create and sustain PEPFAR over the past 22 years.

Forsaken is my attempt to document the Trump administration’s overhaul of PEPFAR through the experience of the people it will impact the most. Thanks to a generous fellowship from the Alicia Patterson Foundation, I have the resources to embed myself in PEPFAR-supported countries and gather those experiences over the coming months.

I believe it is critical that some effort is made to catalogue, to whatever degree is possible, the harm being done. To hold this reality up against attempts to elide or misrepresent the impact of Washington’s actions. And to report on the new future people are beginning to envision for an HIV response that is no longer grounded in the promise of PEPFAR.