Partners In Health is gravely concerned about deep and significant cuts in United States overseas development assistance in the budget proposed by President Donald J. Trump. As much of this aid is for health in some of the world’s poorest countries, these cuts will have a devastating impact on millions of people throughout the world. In short, people will die. Children will lose their parents. And whole communities, economies, and even nation states will be disrupted without the U.S.’s vital support of health programs in the developing world. 

In the last 15 years, through both Republican and Democratic administrations, the U.S. has led a historic and highly successful fight to combat AIDS, malaria, and tuberculosis. The efforts of the U.S. to support health in the developing world have been overwhelmingly bipartisan. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), initiated by President George W. Bush in 2003, and the Global Fund to Fight AIDS, Tuberculosis and Malaria, financed 30 percent by the U.S. government, marked a new era in the global commitment to people-centered development. They are responsible for more than 17 million people receiving life-saving AIDS treatment and millions of new infections averted. These are people who now can work and support their families, gain education and skills, and live long, healthy lives.

For many people around the world, our foreign aid efforts are what make America great.

Thanks to PEPFAR and other pivotal U.S.-supported programs, the new millennium saw significant declines in child and maternal mortality and death from AIDS. The generosity and nobility of the United States has not gone unnoticed. In many fragile states around the world, these programs result in tremendous good will toward the American people. Many experts in foreign policy agree that humanitarian assistance is a critical pillar of U.S. efforts toward peace and security. For many people around the world, our foreign aid efforts are what make America great.

Yet, there is still so much work to do. Preventable causes take the lives of 16,000 children a day. These children need medicines, bed nets, and nutritional supplementation. Only about half of those with HIV are receiving life-saving treatment, even as new tools and treatments to end the HIV epidemic are being developed to build upon the gains of the last 15 years. The West African Ebola epidemic of 2014 claimed tens of thousands of lives. Currently, nimble financial mechanisms are being proposed to rapidly respond to threats like Ebola and bird flu.  

Nurse Dina Mofoka (center) speaks with a multidrug-resistant tuberculosis patient at Botšabelo Hospital in Maseru, Lesotho. Photo by Rebecca E. Rollins / Partners In Health

All of these critical health, development, and global security achievements are under threat, while much unfinished work in global health remains. If we allow the Trump administration and the Republican-led House and Senate to gut these programs in favor of military spending and tax cuts, people will die. Far from cutting U.S. overseas development assistance, it should be expanded if America is to remain a global leader in promoting health and development as part of our humanitarian and diplomatic values,

For 30 years, Partners In Health has been a global leader in the fight for health care for the world’s poorest people. Our efforts in both the provision of care and in shaping the international response to health and disease pandemics have increased access to health care around the world. Because of our long experience providing health care for the world’s poor, we know the impact such cuts will have. And they will be drastic.

The National Institutes of Health finance a significant portion of PIH’s work in places like Peru, where thousands of patients with multidrug-resistant tuberculosis have benefited from research on the most effective treatments for the life-threatening infectious disease. But President Trump’s proposed budget would gut NIH funding by nearly $6 billion—or 20 percent, leaving many patients without hope of a cure.

Because of AIDS advocates’ international coordination in support of continued U.S. funding, President Trump’s budget maintains current levels of funding for PEPFAR and the Global Fund. But there is no guarantee they will remain sacred within the budget passed by Congress in coming months. We must maintain pressure to support these critical initiatives that have saved millions of lives and resulted in enormous good will toward the American people.

Community health worker Lucrecia M. Sherman (left) visits the home of HIV patient Lucy Farr in Harper, Liberia. Farr fell critically ill when her HIV treatment became unavailable during the Ebola epidemic. She is doing better now under the care of PIH. Photo by Rebecca E. Rollins / Partners In Health

Slashing this aid would have an immediate and severe impact on governments PIH collaborates with in Rwanda, Malawi, and Lesotho, where we support each country’s national HIV program, serving more than 17,000 patients.

In Haiti alone, 12,000 patients diagnosed with HIV are on antiretroviral therapy, thanks to PEPFAR and the Global Fund. They would die or develop drug-resistance should their treatment be interrupted. HIV prevention and testing for more than 100,000 people would cease to exist. And 30,000 pregnant women would no longer be screened for HIV, leaving their newborns at risk of contracting the deadly virus.

We have never turned our back on communities fighting ill health and dire poverty.

Despite the protection of AIDS funding, other critical lifesaving programs to care for women and children are at risk because they lack a vocal constituency. The U.S. is also a major donor to family planning efforts. Cuts to this and the reinstatement of the Mexico City Rule will result in unwanted, and even dangerous, pregnancies—particularly among adolescents.

We have never turned our back on communities fighting ill health and dire poverty. We stay for the long haul and have been privileged to see the long-term, intergenerational impact of treating AIDS, saving a child, or preventing maternal death—impact that will be severely compromised if cuts to U.S. assistance occur.

We urge our supporters and all people who care about the health of the poor to call their representatives in Congress and encourage the U.S. government to remain a leader in global health. This leadership must be based on compassion, as well as strategic diplomacy. Trust us. For three decades, we’ve seen the power such a vital investment makes in people’s lives.

This statement was originally published on Medium by Dr. Joia Mukherjee, chief medical officer of Partners In Health.