Opinions
AIDS 2012: Measuring progress by lives saved
President Obama committed to the fight to create an AIDS-free generation
By DR. GRANT COLFAX & DR. ERIC GOOSBY
As the two people who worked as physicians in the early years of the HIV/AIDS epidemic before the miracle of antiretroviral drug (ARV) therapy, and who now have the honor of leading the domestic and global HIV/AIDS programs for the Obama administration, we look back in awe of the American leadership that has transformed the epidemic in the 22 years since the International AIDS Conference was last held on U.S. soil. As we remember the lives lost to this disease and commit to the vision of an AIDS-free generation, it’s worth reflecting on how U.S. leadership and U.S. investments to combat HIV/AIDS domestically and internationally are saving lives and turning the tide against the disease.
Here at home, we have more than tripled the life expectancy of people living with HIV/AIDS since 1993. More than half a million persons living with HIV receive care and treatment through the Ryan White program, established in 1990 and maintained with consistent bipartisan congressional support through four administrations. Successful prevention efforts have averted more than 350,000 new infections and mother-to-child transmission of HIV has dropped by more than 90 percent since the early 1990s. HIV prevention has also generated substantial economic benefits. A recent study estimated that HIV prevention efforts in the United States have saved $129.9 billion in medical costs.
In 2010, President Obama released the first-ever National HIV/AIDS Strategy, and he has made implementing the strategy a top priority by requesting increased funding for HIV treatment and care services every fiscal year. In Fiscal Year (FY) 2013, the president’s domestic budget for HIV/AIDS is $22.25 billion, including requesting a $40 million increase for the Centers for Disease Control and Prevention (CDC) HIV prevention efforts, and an additional $74 million to increase treatment and care services for our nation’s veterans living with HIV. The president has also increased federal investments for AIDS Drug Assistance Programs (ADAPs) to expand access to life-saving medications and assist states with ADAP waiting lists. A shared federal-state program, federal funding for ADAPs has increased every year of the Obama administration, rising from $815 million in FY 2009 to $933 million in FY 2012. In FY 2013, the president proposed a total of $1 billion for ADAPs, a $67 million increase above FY 2012. These steps have concrete results — ADAP waitlists have declined by 80 percent since September 2011, dropping from more than 9,000 to approximately 2,000 today, and the federal budget provides sufficient resources to end the waitlists once and for all, if states also step up and do their part.
In addition, people living with HIV have much to gain from the Affordable Care Act. People with HIV are more likely to be uninsured, are more likely to face barriers in accessing medical care, and often experience higher rates of stigma and discrimination than other groups. The Affordable Care Act seeks to expand Medicaid for the lowest income people; it strengthens and improves Medicare, and makes private insurance work better for all Americans, including people with HIV. The Act also prohibits discrimination on the basis of HIV status, bans lifetime limits on insurance coverage and is phasing out annual limits in coverage.
Globally and building on the strong foundation laid by President George W. Bush, the Obama administration has made unprecedented progress in the fight against AIDS. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has expanded its prevention, care and treatment programming, and now has significant investments in more than 80 countries in several regions worldwide. Since FY 2008, PEPFAR has increased the number of people supported on treatment by more than 2.1 million and the number of individuals receiving HIV testing and counseling by almost 19.9 million, supporting nearly four million people on treatment HIV testing and counseling for more than 40 million people in 2011 alone. And on World AIDS Day 2011, President Obama announced a new treatment goal of reaching six million people by the end of 2013.
Since taking office, President Obama has requested more than $26 billion in funding for global HIV/AIDS, including both bilateral U.S. government PEPFAR programs and our contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria. In his FY 2013 Budget, the president fulfilled his historic commitment to request $4 billion over three years for the Global Fund. We are grateful for the bipartisan support that PEPFAR has received from Congress since its inception and the continued bipartisan support for the Global Fund.
In FY 2013, we made the decision to re-allocate resources from within PEPFAR and take an exceptional step at a unique moment to strengthen the Global Fund. Because of the interdependence of the two programs, strengthening the Global Fund now will also help ensure the success of PEPFAR; equally as important, U.S. contributions to multilateral institutions like the Global Fund allow us to leverage increased contributions from other countries. In recent months, new and existing donors, including Saudi Arabia, Japan, Germany and the Gates Foundation, have stepped up their contributions. We know that other donors are also planning to do the same.
The fact of the matter is that our achievements are continuing to grow rapidly. This is due to greater efficiencies borne of driving our programming with evidence of impact, the growing commitment of governments and citizens in the developing world, the reduced costs of treatment, and the growing impact of prevention. With our current budget request PEPFAR will meet the President’s World AIDS Day goals for treatment, care and prevention, including the dramatic increase in people supported on treatment from 4 to 6 million. Along with complementary efforts to strengthen the Global Fund, this will accelerate progress toward the goal of an AIDS-free generation.
While tough budget decisions come with the job, President Obama has committed us to achieving more in the fight to create an AIDS-free generation in the U.S. and across the globe, and we’re succeeding. That continues the legacy of American leadership on HIV/AIDS that should make us all proud.
Dr. Grant Colfax is director of the Office of National AIDS Policy and Dr. Eric Goosby is the nation’s Global AIDS Coordinator.
Commentary
Religion, spirituality, and humanity: finding meaning in a complex world
LGBTQ refugees find hope in faith, common humanity
Religion and spirituality continue to shape the lives of billions of people around the world. Whether expressed through organized faith traditions, personal beliefs, cultural practices, or philosophical reflection, they remain powerful influences on how people understand themselves, others, and the world around them.
As a displaced person, I have seen firsthand how religion and spirituality affect people’s lives during times of uncertainty, hardship, and hope. In communities facing displacement, poverty, illness, conflict, and long waits for resettlement opportunities, questions about meaning, purpose, resilience, and belonging are not abstract concepts. They are part of everyday survival.
Religion and spirituality are often discussed together, yet they are not identical. Religion generally involves organized systems of belief, sacred texts, rituals, and communities. Spirituality is often more personal and may involve an individual’s search for meaning, connection, and inner peace without necessarily belonging to a specific faith tradition.
Despite their differences, both seek to answer some of humanity’s oldest questions: Why are we here? How should we live? How do we cope with suffering? What gives life meaning?
A search shared across cultures
Human beings have always searched for answers to the mysteries of existence. Across continents and throughout history, people have developed different ways of understanding life, death, nature, and the universe.
Christians may turn to the Bible. Muslims may seek guidance from the Quran. Jews may draw wisdom from the Torah. Hindus, Buddhists, Sikhs, Indigenous peoples, and many others have their own spiritual traditions and teachings.
Recently, an Australian reader, Eveline Goy, shared a thoughtful reflection after reading one of my earlier articles. She noted that while some people may speak of “false prophets” based on their religious beliefs, others may find truth and wisdom in entirely different traditions. She also highlighted the rich spiritual heritage of Australia’s First Nations peoples, whose stories of the Rainbow Serpent continue to shape cultural identity and understanding of creation.
Her reflection reminded me that while beliefs vary widely, the desire to understand our place in the universe appears to be deeply human.
Religion, love, and LGBTQ people
For many LGBTQI+ people, religion can be both a source of comfort and a source of pain.
Throughout history, faith communities have offered people hope, belonging, and moral guidance. Yet many LGBTQI+ individuals have also experienced rejection, exclusion, or condemnation from religious institutions because of their sexual orientation or gender identity.
As a queer refugee, I know how deeply these experiences can affect a person’s sense of self-worth and belonging. Many LGBTQI+ refugees I work with were not only rejected by society but also by families and faith communities they once trusted. Some were told they were sinful, broken, or unworthy of love. Others were forced to hide their identities in order to remain accepted.
Yet this is not the whole story.
Across the world, there are also religious leaders, churches, mosques, synagogues, temples, and faith communities that embrace LGBTQI+ people and affirm their dignity. Many believers interpret their faith through the values of compassion, justice, mercy, and love rather than exclusion.
At its heart, love is one of the most universal values found across spiritual traditions. Whether expressed through faith, friendship, family, or community, love has the power to heal wounds, build bridges, and restore dignity.
For many LGBTQI+ people, the challenge is not choosing between faith and identity but finding spaces where both can coexist.
Religion and spirituality in difficult times
We live in a world facing numerous challenges. Wars continue across several regions. Climate change affects communities through droughts, floods, and extreme weather events. Economic uncertainty impacts millions of families. Refugees and displaced people face uncertain futures.
In such circumstances, many people turn to religion or spirituality for comfort and guidance.
Here in Gorom Refugee Settlement Camp, I see this every day. Some gather for prayer. Others find strength in sacred texts. Some find comfort in collective worship, while others seek peace through personal reflection and meditation.
For many, faith provides hope when circumstances seem hopeless.
Yet I have also observed something equally important. Not everyone draws strength from religion. Some find resilience through friendship, mutual support, activism, creativity, and the determination to keep moving forward despite adversity.
This reminds us that while religion and spirituality can be sources of strength, so too can our shared humanity.
The human values that unite us
One of the most remarkable aspects of religion and spirituality is that despite their differences, many traditions promote similar values: Compassion, kindness, forgiveness, generosity, honesty, and respect for others.
These values are not exclusive to any single religion or philosophy. They appear across cultures, faiths, and secular worldviews.
Living in a refugee community has reinforced this lesson. Some of the most generous people I have met are deeply religious. Others are not religious at all. What matters most is not necessarily what people believe, but how they treat one another.
When someone shares food with a hungry neighbor, that is compassion.
When a person comforts a frightened child, that is humanity.
When communities stand together despite differences, that is solidarity.
These actions often speak louder than doctrine.
Building bridges in a diverse world
Religion and spirituality have inspired extraordinary acts of kindness throughout history. Yet they have also contributed to division when people become convinced that only their own beliefs are valid.
In today’s interconnected world, we encounter a greater diversity of perspectives than ever before. This diversity can enrich societies, but it also requires humility, curiosity, and respect.
No individual, community, or tradition possesses all the answers to life’s mysteries.
The challenge is not to eliminate differences but to learn how to coexist peacefully despite them.
For LGBTQI+ people, refugees, people of faith, and those without religious beliefs, dialogue and mutual respect remain essential. We all benefit when societies create space for people to live authentically while respecting the dignity of others.
Religion and spirituality continue to play important roles in human life. They help many people find meaning, resilience, comfort, and community during difficult times.
At the same time, the values that often matter most compassion, dignity, kindness, justice, and love are not confined to any single religion or belief system.
My experiences as a queer refugee have shown me that hope can emerge from many places. Some find it in prayer. Some find it in philosophy. Some find it in activism. Some find it in human connection.
Perhaps what ultimately matters is not which path we follow, but whether that path encourages us to become more compassionate, understanding, and caring human beings.
In an uncertain world marked by division and conflict, our shared humanity may be the strongest foundation upon which we can build a more peaceful, inclusive, and loving future for LGBTQI+ people, for people of faith, and for all humanity.
Aby lives in the Gorom Refugee Settlement Camp in South Sudan.
Africa
African leaders once again trade African family values for American family values
Anti-LGBTQ conference backed by US-based groups took place this month in Ghana
At the moment, some religious and political leaders in Africa are pushing for a charter on family values, lobbying lawmakers, African state institutions, and the African Union to formally adopt it. In the past number of years, they have been holding conferences across Africa with the support and funding of Western religious donors who, in their own countries, are definitely perceived as racist, hateful, and against women. Most recently, they convened the African Regional Interparliamentary Conference on Family Values and Sovereignty in Accra, Ghana. All this raises critical questions about foreign influence and agendas. At this critical time, when Africa faces so many problems, why do people insist on pushing an agenda that is neither ours nor relevant to our prosperity?
The African leaders who claim to protect African family values and sovereignty, unsurprisingly, exhibit traits similar to those of the historical enslavers and similar collaborators. Contrary to what they claim as “pushing back against foreign influence on the African family” and the infamous sovereignty claims, it has been proven that these leaders are directly linked and backed by the conservative “foreign” groups, including the U.S.-based hate organization, Family Watch International, which is closely linked to the anti-rights authors of Trump’s Project 2025, Heritage Foundation; and the Netherlands-based Christian nationalist organization, Christian Council International, another group closely linked to organizations supporting the Trump administration and its continued hate-based policies and atrocities. One might even argue that they serve these groups, their mandates, and their Western agenda, instead of what they want African people to believe: that they are doing this for the good and prosperity of Africa and its sovereignty. The truth, however, is that their so-called African values, culture, traditions, etcetera, could not be further removed from true African cultural values but instead mimic those outlined in America’s Project 2025. Meanwhile, the very same people who are pushing for these family values under Project 2025 are the very same people pushing for the exploitation of Africa’s natural resources, without any care for the impact their actions have on African people and their livelihoods. Adopting their policies verbatim in Africa and claiming them as our own could easily be seen as counterintuitive and self-betrayal.
Africa’s rich history of family, diversity, womanhood, and matriarchy is too beautiful to erase. Africans, especially women and girls, deserve to know about the likes of Queen Modjadji of the Balobedu people, a fierce leader who is traditionally believed to have rainmaking abilities and notably a distinctively matriarchal dynasty where the reign is passed down from woman to woman, from mother to daughter; or Queen Nzinga of modern-day Angola, who led an army that resisted and fought against the Portuguese colonizers. Queer folks and African spiritualists alike deserve to know how women and gender diverse persons held some of the highest spiritual positions in society, like Mbuya Nehanda of Zimbabwe, who was a deeply respected spirit medium and a leader of the resistance against early colonial rule in Zimbabwe, and the transgender priests, the respected agule and okule, female-to-male and male-to-female shamans of the Lugbara, now the Democratic Republic of Congo and Uganda, who led spiritual ceremonies. Even though the mudoko dako of the Langi people in Uganda were known to have been assigned male at birth, they were recognized as a distinct gender that was allowed to marry men. Africans must also know about woman-to-woman marriages that existed in pre-colonial Africa, which, according to research and oral histories, were recognised and served various purposes, from economic and social functions to lineage preservation. Similar practices include those from the Bapedi and Balobedu cultures, ngwetsi ya lapa, which still exists today, where a woman is married into a family or household to raise an heir for the family or to continue the family name, not necessarily the lineage.
As well-intentioned as it may appear, evidence suggests that the African leaders’ draft charter, because of its existing ties to Western ultraconservative partnerships, is neither original nor in good faith. The pace at which they have been moving and their true subsequent agenda should indisputably be questioned and criticised. Regardless of the inclusion of desirable language and terms such as minerals sovereignty and the Ubuntu philosophy, beneath the surface, the charter does not truly reflect these concepts. The charter, instead, does a disservice to African people by misrepresenting Africa’s diversity and disregarding its history as it relates to the diversity of families. The West has no business drafting or helping draft African legislation, especially if the whole of Africa is at risk of their negative impact. One would think the common goal would be to address bread-and-butter issues, such as poverty, unemployment, diseases, and health, to name but a few, instead of pushing the distractive agenda of those responsible for robbing Africa in the first place. No single group is the sole custodian of African knowledge. Africa belongs to all of us, with our diverse families and values, which cannot be defined through a single, narrow lens and are instead very individual issues that will differ from family to family.
Daniel Digashu is a consultant at the Southern Africa Litigation Center (SALC). SALC promotes and advances human rights and the rule of law in Southern Africa, primarily through strategic litigation and capacity-strengthening support to lawyers and grassroots organizations.
Opinions
US no longer refuge for LGBTQ refugees
More than 30 percent of Rainbow Railroad’s 2025 requests for help came from US
I have spent the past eight years leading programs at Rainbow Railroad that support LGBTQI+ people fleeing persecution and violence. What began as a small, volunteer-led effort has grown over the past two decades into an international organization that has supported more than 50,000 people around the world. That growth reflects what is possible when communities choose solidarity in the face of rising hate.
Yet the forces that make Rainbow Railroad’s work necessary have not diminished. In many places, they are accelerating, including in countries like the United States that have historically been viewed as places of refuge for LGBTQI+ people.
In 2025, Rainbow Railroad received a record 20,215 requests for help from people around the world. Over 30 percent of these requests came from people living in the U.S., making it the top country of origin for LGBTQI+ people seeking assistance for the second year in a row. It’s a trend that began following the 2024 presidential election, when 1,177 people reached out for support the day after the results were finalized. That single day generated more than twice the number of requests for help we had received from across the United States during the previous 10 months combined.
The fears reflected in the requests for help we received during those first hours were well-founded. With the stroke of a pen, on his first day in office, the president suspended the US Refugee Admissions Program (USRAP), upending the lives of refugees who were already processed and approved for resettlement in the U.S. Many of these individuals remain in limbo.
Months later, the president authorized a cap of just 7,500 refugees to resettle in the U.S. for fiscal year 2026 and ordered a review of refugees admitted under former President Joe Biden. At the same time, he cut asylum-related services and legal support, making it even harder for vulnerable migrants to navigate an increasingly complex system.
Despite these barriers and increasing hostility, LGBTQI+ individuals continue to seek safety in the United States, often relying on their own resources and determination to flee to the pockets of safety in cities and states that protect their rights.
It is in that spirit that I’ve witnessed the community stepping up to support LGBTQI+ migrants.
Following the collapse of federal programs such as Welcome Corps, which allowed Americans to sponsor refugees looking to resettle in the U.S. Rainbow Railroad launched Communities of Care, a volunteer-driven ecosystem of post-relocation services for LGBTQI+ migrants. Across
the country, volunteers are helping newcomers navigate unfamiliar systems, build social connections, and begin rebuilding their lives.
While volunteers’ commitment has been extraordinary, community-led efforts cannot replace the infrastructure governments have dismantled. Volunteers can offer community, guidance and practical support, but they cannot replace refugee resettlement programs, legal services, or a functioning asylum system. As need grows and public support shrinks, the gap between what communities can provide and what governments should provide continues to widen.
I think often about the LGBTQI+ people Rainbow Railroad helped reach safety in the U.S. over the years. For many, the United States represented possibility, a place where they could finally live openly and without fear. To now see the U.S. become the country generating more requests for help than any other is profoundly alarming.
The question on my mind this Pride month is whether we will collectively meet this moment with the urgency it demands. Governments must restore and strengthen refugee and asylum protections. Volunteers must step up to provide connections to care and community. Donors must support organizations in filling critical gaps. And all of us must recognize that welcoming LGBTQI+ people seeking safety is a responsibility we all share.
Devon Matthews is the chief programs officer for Rainbow Railroad.
