Rethinking HIV Aid to Africa, by Jared Taylor

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On his first day in office, President Trump announced a 90-day freeze on foreign aid. People screeched that if we stopped paying for AIDS treatment in Africa, hundreds of thousands would die.

The administration quickly turned the spigot back on, and the UN AIDS organization celebrated the “decision to keep funding life-saving HIV treatment.”

Yes, fighting AIDS prolongs lives in Africa. But it also makes it much safer for dangerous sexual practices and increases the number of people infected with HIV — the human immunodeficiency virus.

The number of infections keeps going up because the treatments we pay for don’t cure HIV. If taken correctly, they can suppress the virus so that people stay healthy. Treatment can also reduce the viral load to the point that infected people are unlikely to infect others.

However, patients have to take those drugs their entire lives because drugs don’t completely eliminate the virus.

If patients don’t take medicine religiously, three things can happen. They can infect other people. They can get sick with AIDS, and maybe die. And, they can become a breeding ground for drug-resistant HIV, because it’s like taking antibiotics. If you don’t take all your pills, the bug you are trying to kill can mutate and become harder to kill.

Drug companies stay busy cooking up new, ever-more-expensive anti-HIV drugs because old ones stop working.

Our big HIV-fighting program is called the President’s Emergency Plan for AIDS Relief or PEPFAR, and it was started by George W. Bush.

It costs about $6 billion a year, and with extra funding in 2021 for Covid, and has run up a total bill of $110 billion.

If you look at UN or PEPFAR results, you find graphs like this.

The top curve is world-wide new infections every year, and the lower curve is AIDS-related deaths. Both are coming down, and the drugs you pay for play a role. Annual new cases are down to about 1.5 million, and AIDS deaths are to about 630,000. These are the numbers that justify the common claim that PEPFAR has saved 25 million lives in Africa.

With fewer people dying of AIDS, the life expectancy in black Africa rose five years — from 56 to 61 — in the 13 years from 2010 to 2023.

However, not one person has been actually cured. This is the estimated number of HIV-infected people worldwide.

The number of carriers keeps going up because infected people live longer. Many of them either don’t know they are infected or aren’t taking their medicine, so they keep infecting others.

Here is where they live.

If you add the first and third rows—the two Africa bars—you get nearly 27 million cases, and the bar would stretch close to the right edge of the graph.

Why is Africa such a mess? Reckless behavior. In the United States, the number of new HIV cases peaked 15 years before it did in Africa, because American homosexuals stopped having unprotected anal sex — the most dangerous kind of sex — and with so many partners. Africans kept having dangerous sex despite mountains of free condoms from aid agencies.

Africans are still reckless. The Guttmacher Institute reported that “Heterosexual Anal Sex is Associated with HIV Infection in South Africa.” This article from the International Journal of STD & AIDS suspected that in Africa, “perhaps the majority of HIV transmission” that is due to sexual behavior “could be accounted for by unsuspected and unreported penile–anal intercourse,” both homo- and heterosexual. Some Africans use anal sex as a form of contraception.

This helps explain why so many women and girls in sub-Saharan Africa get HIV: 62 percent of all new HIV infections. In the rest of the world, women get only 27 percent of new cases.

And that’s why so many African babies get HIV from their mothers.

This graph shows that congenital HIV cases are going down, but the two darker blue bars show that sub-Saharans are much, much more likely than anyone else to infect their babies — who then have to go on drugs — or die.

Globally, compared to others, the likelihood of getting HIV is 14 times higher for drug injectors, 23 times higher for men who have sex with men, nine times higher for sex workers, and 20 times higher for trans women.

Besides treatments that reduce viral load, there are drugs that keep you from getting HIV. There’s something called PrEP or Pre-encounter Prevention medicine.

If you know you are taking risks, this stuff has a 90 percent chance of keeping you clean, so long as you take it every day.

If you take PEP, or Post Encounter Prevention, within three days of a dangerous fling and take it religiously for 28 days, your chances of getting HIV are close to zero.

In the United States, these drugs — just like the ones that suppress viral load once you get HIV — are free. PEPFAR passes out millions of doses in Africa, and most African governments distribute free condoms.

Having a foreskin makes it easier for men to get HIV, so in 2022, PEPFAR paid for 2.2 million young African men to be circumcised—bringing PEPFAR’s running total to 30 million.

You might wonder: With all this, how do people still get the virus? Unless they’re born with it, it’s mostly through stupidity and carelessness — or because people claim they’re not infected when they are.

In the US, new HIV infections are heavily male to male: 67 percent. Twenty-two percent are heterosexual, and seven percent are with drug users.

But AIDS-fighting drugs had an unexpected effect. With free, anti-HIV drugs, homosexuals became much less worried about AIDS, and went back to old, dangerous ways. The result was an explosion in syphilis.

It hit a low of 32,000 cases in 2000, but has since shot up 560 percent to 209,000 cases in 2023. Blacks are five times more likely than whites to get syphilis and Hispanics are twice as likely.

Back to HIV. In the US, new cases have bottomed out at about 30,000 a year. Blacks and Hispanics together account for 70 percent of all new cases. Hispanics are nearly five times more likely than whites to get HIV. Blacks are eight times more likely.

Just imagine those racial differences applied to black Africans. They are a lot more likely than other groups not to get tested for HIV, skip their medicine, and to keep having dangerous sex.

Billions of dollars, millions of doses, countless HIV tests, endless efforts to explain things, and the number of HIV carriers keeps growing.

Barring an actual cure, HIV will not be eradicated.

Yes, people with HIV now can live longer. Long enough to infect others and to have children. Some infect their own children.

This continues, thanks to your money and to expensive, exotic drugs that have to be updated.

Anyone who isn’t born with HIV can avoid it 100 percent. Is it our responsibility to protect Africans from the consequences of their carelessness?

We are contributing to something else in Africa: a population explosion.

Look at the green line on this UN projection for world populations. In 1950, there were only half as many Africans as Europeans.

Now, there are twice as many Africans as Europeans, and look at the projections for the end of the century. This would be a huge, destabilizing change in the population balance of the planet.

Is this the result we want from the billions — correction: trillions — of dollars the West has spent on aid to Africa? The main thing we should be sending is contraceptives.