Why the US elections matter for ending AIDS

The US elections matter for those of us working to end AIDS for a number of reasons. Project 2025, a rightwing manifesto authored by Donald Trump’s allies, includes numerous attacks on the sexual and reproductive health and rights which underpin an effective HIV response. Project 2025 proposes reinstating the ‘global gag rule’, a US Executive Order which, when deployed by previous Republican presidencies, has prevented non-US NGOs from receiving global health funding if they use their own, non-US funding to provide abortion services, referrals, counselling, information or advocacy.

Previous research by Frontline AIDS showed that under Donald Trump, the gag had an indirect but extremely disruptive impact not only on abortion access but on essential HIV services, hitting marginalised populations, like men who have sex with men and sex workers, hardest. Even more concerningly, proponents of Project 2025 are already mobilising against PEPFAR, a vital US government initiative which has transformed the global HIV response, saving 25 million lives since it began in 2008. Without PEPFAR funding, millions of people will lose their access to lifesaving HIV treatment, and to HIV prevention services, with devastating consequences.

As well as the seismic threat to funding, we need to consider the ideological impact on the HIV response and particularly on people from key populations. Project 2025 is very clear in its intention to silence the communities who are often most marginalised in society, and most impacted by HIV and AIDS, including people who use drugs, sex workers, and LGBTQ+ people. It threatens an aggressive attack on LGBTQ+ people’s human rights, building on the wave of anti-gay laws and crackdowns that have been rapidly building over the last two years, with encouragement from conservative groups in the US. It also includes proposals to prevent transgender people from accessing information or services relating to gender transition.

Comprehensive sexuality education is also a target, with groups involved in Project 2025 circulating false claims that it sexualises children and is a threat to families and society. Yet all the evidence shows that comprehensive sexuality education saves lives, helps prevent HIV and other sexually transmitted infections and leads to better and more informed choices. It can also reduce unplanned pregnancies, which can have severe negative health and emotional impacts on young people.

“The stakes are so high in this election”, says John Plastow, Executive Director of Frontline AIDS. “The HIV movement needs bold global leadership to withstand anti-rights movements which threaten gains made 40 years into the epidemic. We are at the crossroads of striving forward to achieve progress on sexual and reproductive rights and our mission to end AIDS, or rolling back on the years of progress that we have made. The world is watching.”