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Comment by Red_Tarsius | Hacker News Reader

For context: Tuberculosis treatment requires strict, months-long medication adherence. Even a brief disruption means patients may not complete their courses, allowing drug-resistant TB to emerge. These strains are far harder and more expensive to treat, spreading across borders and undoing decades of progress.

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The brief (?) interruption to PEPFAR (Bush's HIV/AIDS aid program) has major impacts too. One of the plainest ones is that infants with HIV can, if anti-retrovirals are paused, die more or less right away.

- "In children who acquired H.I.V. at birth, the infection can progress very quickly to illness, with death occurring as early as eight to 12 weeks after birth — shorter than the 90-day pause on foreign aid."

https://www.nytimes.com/2025/02/05/health/trump-usaid-pepfar... ("Foreign Aid Freeze Leaves Millions Without H.I.V. Treatment")

This article by Scott Alexander (Money Saved By Canceling Programs Does Not Immediately Flow To The Best Possible Alternative) talks a fair bit about how effective this program is: https://www.astralcodexten.com/p/money-saved-by-canceling-pr...

It also makes the point that, under some reasonable assumptions, you could assume that any domestic program you could theoretically redirect the funding to would likely be ~100x less effective than PEPFAR, which is an abnormally effective aid program.

Reasonable assumptions would not assume you to assuming the US' top medical bureaucrat being a conspiracy theorist who denies the existence of HIV (and asserts AIDS is environmental and that anti-retroviral drugs are dangerous toxins).

https://en.wikipedia.org/wiki/Robert_F._Kennedy_Jr.#HIV/AIDS... ("Robert F. Kennedy Jr.#HIV/AIDS denialism")

https://en.wikipedia.org/wiki/The_Real_Anthony_Fauci

https://www.motherjones.com/politics/2024/11/rfk-aids-hiv-hh...

https://www.nytimes.com/2025/02/13/opinion/kennedys-views-on...

Yes, given the new health secretary, it's likely to be much more than 100x worse, if the money is redirected to any sort of positive end at all.

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