PEPFAR, Global Fund, and the future of HIV care

The international aid system has long operated on the ideal of "neutrality," but our latest episode of This Week in Global Development, sponsored by the Urgent Action Sister Funds, challenges this deeply embedded notion. Devex Executive Editor and Executive Vice President Kate Warren is joined by the Urgent Action Sister Funds’ Jean Kemitare and Johnny Tohme, as well as Lucy Martin of the Centre for Applied Human Rights at the University of York, for the conversation. Over the course of the episode, our guests discuss the idea that no crisis happens in a vacuum. Instead, crises are shaped by history, power dynamics, and the strategic allocation of resources. By pretending aid is neutral, the current system risks repeating the same patterns that leave communities vulnerable in the first place.The centerpiece of the discussion is the Feminist Crisis Response Model, a flagship research initiative that highlights how grassroots feminist movements are uniquely equipped to navigate the entire "crisis continuum" — from prevention and survival to long-term transformation. Unlike traditional models that treat crises as isolated events to be managed, the feminist lens views them as visible ruptures of long-term structural issues such as patriarchy, colonialism, and economic injustice. This approach shifts the center of gravity from large external institutions to local partners who are already embedded in their communities and accountable to them. By recognizing that "every crisis is political," the model encourages donors to move beyond simple quantifiable metrics, such as the number of aid parcels delivered, and instead invest in intangible yet critical resources such as community care, solidarity, and structural systemic change. Listen to this episode of This Week in Global Development to hear the whole discussion. On April 26, 2026, the Urgent Action Sister Funds and the Centre for Applied Human Rights will launch a report that fully explicates the Feminist Crisis Response Model: “Resourcing Strategies in an Age of Permacrisis: Critical Lessons from Feminist Philanthropy.”

This week, we discuss the United States’ new highly targeted approach to humanitarian aid, showcased in a $2 billion agreement with the U.N. Office for the Coordination of Humanitarian Affairs, or OCHA. Designed for rapid impact, the funds are strictly earmarked for direct, lifesaving assistance over a short six-month window across 18 crisis-affected countries. We explore the implications of this strategy, which signals a significant shift in U.S. foreign aid toward fast-tracked, tightly scoped interventions focused on immediate survival. During the conversation, we also take a look at the details of the Trump administration’s budget request, which calls for a 30% cut to foreign affairs spending and increased funding to rebuild and secure critical mineral supply chains. To dig into these stories, and others, Devex Business Editor David Ainsworth sits down with Adva Saldinger and Elissa Miolene for the latest episode of our weekly podcast series. To find out more about how the U.S. budget works, check out our special explainer episode. Sign up to the Devex Newswire and our other newsletters.

In this special episode of This Week in Global Development, we explore breast cancer not just as a health challenge, but as a critical development challenge. In low- and middle-income countries, or LMICs, a breast cancer diagnosis can have a devastating ripple effect that extends far beyond the clinic, impacting households, communities, and entire systems. Hosted in partnership with The Pfizer Foundation, Devex Executive Vice President and Executive Editor Kate Warren speaks with Darren Back, Dr. Loice Sitienei, and Dr. Patrick Loehrer to explore why integrated breast cancer care strengthens both health systems and economic resilience, ultimately improving outcomes for women facing this disease.The conversation underscores the systemic barriers to breast cancer care in LMICs, where limited infrastructure and high costs often lead to delays in diagnosis. The Pfizer Foundation's Action and Impact initiative, a philanthropic investment now totaling $25 million across five sub-Saharan African countries, aims to expand access to timely breast cancer diagnosis, treatment, and care. By supporting partners working with local and national governments to advance access to care, the initiative seeks to not only improve breast cancer outcomes but also strengthen overall health systems and long-term prosperity.To hear more, listen to this on This Week in Global Development.The Pfizer Foundation is a charitable organization established by Pfizer Inc. and is a separate legal entity with distinct legal restrictions. To learn more about The Pfizer Foundation, click here.

We dig into the key findings of a report published by the Organisation for Economic Co-operation and Development on philanthropic funding. As traditional donors continue to slash their aid budgets, we examine where philanthropy can help plug the global development funding gap and provide resources for areas the private sector is not focusing on.We also discuss the United Kingdom’s new aid strategy. As the country looks to cut official development assistance spending to 0.3% of its gross national income, the government plans to shift from a donor role to an investor role, while focusing its aid on fragile and conflict-affected states.As we look ahead to the World Bank and International Monetary Fund Spring Meetings this month, we explore the former’s new water strategy, which aims to shift away from a narrow focus on infrastructure toward a broader, more integrated approach.To discuss these stories, and others, Senior Reporter Adva Saldinger sits down with Managing Editor Anna Gawel and Global Development Reporter Danielle Kaye for the latest episode of our weekly podcast series.Sign up to the Devex Newswire and our other newsletters.

As governments and funders invest in AI for development, a critical question remains: what actually delivers impact? In this episode of Global Progress in the AI Era, experts explain that funding evidence — not just innovation — will determine whether AI improves lives or reinforces existing gaps.

In this week’s edition of This Week in Global Development, we unpack the precarious state of the U.S. President's Emergency Plan for AIDS Relief, or PEPFAR. Despite ongoing congressional support, a significant disconnect between allocated funds and State Department disbursements has left major implementing agencies such as the U.S. Centers for Disease Control and Prevention operating on less than half their usual budget. As bridge funding begins to dry up and transition plans for bilateral health deals stall, the real-world consequences are starting to emerge — from shuttered drop-in centers in Nairobi to drastic service cuts in Uganda — and are putting key populations at immediate risk.When it comes to on-the-ground implementation, the Global Fund to Fight AIDS, Tuberculosis and Malaria is increasingly expected to fill the vacuum left by the dismantling of USAID projects. This shift toward using the Global Fund’s infrastructure for large-scale health transitions has been fraught with technical hurdles, however, including performance issues with the fund’s wambo.org procurement platform and the looming policy implications of the expanded global gag rule. To dig into these stories, Editor Rumbi Chakamba sits down with Devex reporters Andrew Green and Jenny Lei Ravelo for the latest episode of our weekly podcast series.

In this episode of Global Progress in the AI Era, Nick Allardice explains how GiveDirectly is using AI to deliver faster, more direct aid — from anticipatory cash transfers in Bangladesh to near real-time responses in crisis zones. The conversation explores what it takes to move from theory to practice, and how AI is forcing new trade-offs around speed, targeting, and dignity in humanitarian response.

While HIV infections and AIDS-related deaths are declining globally, the Eastern Europe and Central Asia region, or EECA, tells a different story. It is now home to one of the world’s fastest-growing HIV epidemics, with over 2.1 million people living with the virus. Alarmingly, about 20% are unaware of their status, and nearly half remain without treatment. Since 2010, EECA has become the only region globally where AIDS-related deaths have continued to rise, fueled by systemic challenges like stigma, restrictive laws, and the devastating impact of the war in Ukraine.In this special episode of the This Week in Global Development podcast, sponsored by Gilead Sciences and Elton John AIDS Foundation, Devex Executive Editor and Executive Vice President Kate Warren speaks with Denys Denysenko, Eastern Europe and Central Asia portfolio lead at the Elton John AIDS Foundation, to explore how RADIAN, a transformative partnership between Gilead Sciences and the Elton John AIDS Foundation, is turning the tide. Denysenko discusses the power of community-led solutions — from mobile clinics and software that bridges language barriers for refugees to cutting-edge AI tools in Kazakhstan that monitor patient health and prevent treatment interruptions. Discover how these innovative, trust-based models are reaching the most vulnerable communities and offering a roadmap for global health leaders to reverse the trend in this overlooked region.To hear more, listen to this conversation with Denysenko on This Week in Global Development.

A tale of two continents is unfolding in the global development landscape as Latin America embraces a surge of private investment while Africa grapples with severe economic aftershocks from geopolitical conflict in the Middle East. At the recent Inter-American Development Bank meetings, an atmosphere of intense optimism prevailed, fueled by the region's 63% renewable energy matrix and the attendance of over 1,600 private sector leaders. High-impact projects such as the 2,300-mile Bi-Oceanic Corridor, designed to slash trade routes to Asia by 17 days, and the Lac Minerals initiative for lithium processing, signal a robust new era of regional integration and industrial growth.In stark contrast, many African nations face a deepening crisis as volatility in the Middle East has driven fuel prices up by as much as 77% in cities such as Mogadishu. These inflationary pressures are devastating for informal workers and humanitarian efforts, with the World Food Programme facing skyrocketing insurance costs and delayed shipping routes that bypass the Red Sea. With traditional aid from the West decreasing, both regions are increasingly looking toward south-south cooperation and Gulf investments to secure their economic futures.To dig into these stories, Business Editor David Ainsworth sits down with Devex reporters Jesse Chase-Lubitz and Ayenat Mersie for the latest episode of our weekly podcast series.

As AI models scale globally, social enterprises are increasingly working with frontier AI labs to test, adapt, and improve the technology in local contexts. This episode explores how those partnerships could determine whether AI reinforces existing inequalities — or helps close them.