One year ago, the United States was winning the global fight against HIV/AIDS. Thanks largely to American leadership, infections and deaths from HIV/AIDS have dropped precipitously over the past 20 years, ever since the U.S. government made combating the disease a global priority. Some once–hard-hit countries in sub-Saharan Africa were even on track to become AIDS-free by 2030.

But then, suddenly and without warning, Donald Trump issued an executive order on January 24, 2025 that all but ended U.S. funding for global HIV/AIDS relief. One year on, people have lost access to treatment, and the specter of a resurgence of HIV/AIDS—after years of steady decline—now looms. Meanwhile, the Trump administration is cutting bilateral deals with countries like Zambia, releasing health and development assistance in exchange for access to natural resources and mining concessions.

Joining me from rural Zambia is journalist Andrew Green, who is in the midst of a reporting project documenting the impact of these cuts on HIV/AIDS prevention efforts around the world. We kick off by discussing the historic role the United States played in the fight against HIV/AIDS before turning to what has been lost—and how countries across sub-Saharan Africa are responding.