A new health agreement between the U.S. and the Philippines has raised questions among HIV/AIDS service providers.

A joint declaration signed by the U.S. and the Philippines on April 7 sets out a plan for closer health cooperation, aimed at transitioning the Philippines toward greater autonomy and “self-reliance” in its health systems, according to a State Department statement released.

In practice, “self-reliance” in health systems refers to a country’s ability to fund, manage, and deliver care without heavy dependence on external donors. In the Philippines, programs serving LGBTQ people — particularly those focused on HIV prevention, testing and treatment — have relied in part on international funding and technical support, including from the U.S., according to UNAIDS. 

The Philippine Department of Health has led the national response to the pandemic.

The joint declaration of intent was signed under the Trump-Vance administration’s “America First Global Health Strategy.” The State Department said the agreement would involve co-funding of mutually agreed global health objectives under bilateral health cooperation between the U.S. and the Philippines in the near future.

The declaration also outlines areas of cooperation beyond financing: workforce development, health information systems, and emergency preparedness. The State Department said the framework is intended to strengthen coordination between U.S. and Philippine institutions while supporting the Philippines’ capacity to manage public health challenges independently over time. The statement does not specifically address LGBTQ health.

Similar agreements in other regions have drawn scrutiny from LGBTQ advocacy groups. 

In Africa, community organizations have warned that a shift from donor-funded, community-led health programs to government-to-government frameworks could affect access for marginalized populations, including LGBTQ people. The Washington Blade found that such changes may reduce reliance on specialized clinics that have historically provided stigma-free care, raising concerns about discrimination, privacy, and continuity of services.

Desi Andrew Ching, president of HIV & AIDS Support House in the Philippines, said the partnership presents a significant opportunity, but added that, like any large-scale international agreement, its success for the LGBTQ community will depend on how it is implemented on the ground.

“On one hand, it’s a positive move. Increased cooperation on health systems can lead to better technical support and potentially more resources for HIV/AIDS prevention and mental health — areas that deeply impact our community,” Ching told the Blade. “If the government and civil society work closely together, we could see some real progress.”

Ching said community concerns often center on where those resources ultimately go. Ching added there is a risk funds could remain within “usual” government-aligned channels or traditional implementers that may not have the trust or reach of grassroots LGBTQ organizations.

The Philippines is facing one of the fastest-growing HIV epidemics in the Asia-Pacific region, with UNAIDS statistics indicating new infections increased by about 543 percent between 2010 and 2023.

The epidemic is concentrated among key populations, particularly men who have sex with men and transgender women who account for a vast majority of new infections. A 2023 analysis found that key populations represented about 92 percent of new HIV cases in the country, underscoring the disproportionate impact on LGBTQ communities. At the same time, stigma, limited access to testing and gaps in healthcare delivery continue to shape outcomes for these groups.

Ching said that for the partnership to be effective, support would need to be closely targeted to reach those most at risk, including individuals who often avoid government facilities because of stigma and fear of judgment. 

“If the partnership prioritizes ‘community-led’ monitoring and direct support to local organizations, it will be a game-changer. If it stays at the top tier of administration, we might just see the same results as before,” Ching said.

Community-led organizations have been central to the Philippines’ HIV response, particularly in reaching LGBTQ populations often underserved by formal healthcare systems. UNAIDS notes groups such as LoveYourself have expanded testing and treatment access through community-based clinics and online outreach, including during the COVID-19 pandemic, when movement restrictions limited access to government facilities.

“To be honest, in these high-level agreements, ‘guarantees’ are hard to come by on paper. The real safeguards lie in the mechanics of implementation,” said Ching. “From the community’s perspective, we believe the best way to prevent services from being diluted is through direct involvement in the planning phase. We would like to see the funding groups and government stakeholders sitting at the same table as the community to game out the specific work plans. It should not be a top-down approach; it needs to be co-designed.”

Ching said oversight would be a critical layer of protection, adding that a dedicated point of contact, such as a U.S Agency for International Development technical lead or a similar monitor, would be needed to track how funds are used.

USAID officially shut down on July 1, 2025, after the Trump-Vance administration dismantled it.

Ching added community-led monitoring would also be necessary in addition to government oversight. He said safety and trust cannot be guaranteed by policy alone but must be built through experience, noting that community-led organizations have consistently reached the most marginalized populations. 

“Safety and trust aren’t things you can just write into a policy; they have to be built through experience,” Ching said, adding that community-based sites are often seen as more accessible and safer because they are “for us, by us.” 

He said the partnership should direct substantial support to grassroots organizations that have demonstrated an ability to overcome stigma, while strengthening coordination with government clinics. The most effective approach, he added, would combine government infrastructure with community-led delivery, allowing trusted local groups to serve as the primary point of access.

’We want a seat at the table’

According to a report by the World Health Organization on the Philippines, prevention efforts account for only about 6 percent of total HIV spending, despite a sharp rise in cases. The report said the gap has been compounded by a recent pause in U.S. funding, which has delayed the development and implementation of prevention programs and community-led responses.

Asked whether community-led LGBTQ organizations would be funded and included in implementation or sidelined under a government-led approach, Ching said that remained the central question for the community, adding that no detailed plan has yet been made public.

“But we have to be realistic about the politics — both within the government and even within civil society — that can sometimes slow things down,” said Ching. “A good baseline to look at is the UNAIDS 30-80-60 targets. These milestones are specifically designed to put community-led responses at the center of the HIV fight. If we’re being honest, as a country, we are still finding our footing in meeting those specific targets. There is a very real risk of being sidelined if the execution defaults to a standard ‘government-only’ approach.”

The UNAIDS set global targets to guide the HIV response, most notably the “95-95-95” goals for 2025. 

The framework calls for 95 percent of people living with HIV to know their status, 95 percent of those diagnosed to receive sustained treatment and 95 percent of those on treatment to achieve viral suppression. The targets were designed to reduce transmission and improve health outcomes, while also highlighting gaps in access to testing, treatment, and prevention services.

“We view this new partnership with the U.S. as a chance to course-correct. If the intention is to end AIDS as a public health threat, the data shows it simply cannot be done without the community in the driver’s seat for service delivery,” said Ching. “Our hope is that the implementation isn’t just government-led, but government-enabled. We want a seat at the table not just for the sake of being there, but to ensure the resources are actually hitting the ground where they matter most. We’re looking for a partnership that honors those 2025 milestones by making community-led organizations formal, funded partners in this roadmap.”

Delaware is widely known for its firsts. It’s the first state to ratify the U.S. Constitution, the first to join the Union, and the first to decide that no sales tax would be levied on its citizens.  

Another historic first to come from Delaware is Sarah McBride. McBride is the first and only transgender member of Congress. The Blade sat down for an exclusive interview with the congresswoman to discuss a wide array of topics — from the Trump administration’s attacks on transgender service members to her current obsession with the reality TV show “The Traitors” — as well as her legislative work, which has already made her one of the busier members of her freshman class.

Her office in the Longworth House Office Building reflects the nuances of her political identity: deeply serious policymaking paired with an unmistakable sense of personality. Photographs of McBride with friends, family, and political heroes line the walls. A windowsill is filled with crystals. A “Bridgerton” pillow sits on her office couch — small artifacts that soften the institutional weight of Capitol Hill without diminishing it.

When asked how she was feeling more than a year into her first term, McBride acknowledged the climate she was elected into — marked by what she described as toxicity and division under Trump-era politics — but explained that she remains energized by the work ahead.

“I am more energized and motivated now than I was a year and a half ago,” said McBride from her Longworth office. “I’m also more hopeful than I was when I first started here. It was a couple of weeks before Donald Trump was sworn in – the chaos, the cruelty, and the fear was pretty pronounced.”

That sense of hope, she made clear, is not necessarily shaped by the noise inside Congress—including attacks from colleagues like Rep. Nancy Mace (R-S.C.) and Rep. Keith Self (R-Texas)— but instead by what she sees from the constituents she represents back home.

“I have seen the goodness of my neighbors, the goodness of people across Delaware who remind me, day in and day out, that the division and the toxicity we see online are not actually representative of real life. That social media can impact real life, but it’s not representative of it, and that is, for me, incredibly comforting, and I think, a profound reminder that we can still have conversations across disagreement, we can still persuade people, and we can still grow our ranks.”

That belief — that persuasion is still possible — serves as the through line for how McBride views both her role in Congress and the broader political moment. It also frames her sharp criticism of the Trump-Vance administration, which she argues is rooted less in governance than in destruction.

“Donald Trump is not a conservative, he is not a traditional Republican. Trump wants to destroy. His billionaire donors want to destroy. They thrive in a culture of cynicism. They want to destroy our attention span and mine what little remains for parts. They want to destroy jobs and health care so they can consolidate power for themselves, and in this moment, they want to destroy the international moral order so that the strong can plunder the weak.”

Still, she argues, that approach may be backfiring politically, something she says has only strengthened her sense of optimism.

“We have seen public opinion turn against the cruelty and incompetence of this administration, we’ve seen outrage and rightful opposition. One of the things that I feared early on was that this administration’s momentum would only grow, but instead what we’ve seen is that the cult of personality has begun to break. A growing and very large majority of Americans oppose what they’re seeing from this administration, and that is hope inducing for me. But beyond all of that, I am more motivated because of the change that I’ve been able to witness here in this office and on behalf of my constituents.”

That motivation is not abstract. It is measured in casework, legislative negotiations, and tangible dollars flowing back to Delaware. Alongside broader efforts, McBride co-sponsored the bipartisan “Equal Opportunity for All Investors Act” (H.R. 3339), which passed the House unanimously in 2025 while referred to the Committee on Banking, Housing, and Urban Affairs. The legislation broadened access to investment opportunities by allowing individuals to qualify as accredited investors based on expertise rather than wealth alone.

“Our office has returned roughly $5 million to individual Delawareans and secured roughly $150 million in critical investments for Delaware. I’ve been able to introduce more bipartisan bills here in Congress than any other freshman, and we’ve been able to prevent every single anti-trans bill or major provision from becoming law. That is something that I don’t know that I would have believed was possible, but it’s been a byproduct of the strategy that we have undertaken. In short, what I’ve seen is that we can still win hearts and minds and that you can still deliver for people here in Congress.”

That emphasis on strategy over spectacle defines much of McBride’s approach to politics. It also informs how she navigates her identity as the first openly transgender member of Congress. While her presence carries symbolic weight, she resists the idea that symbolism alone is sufficient.

“No single person can be the voice of any one community, certainly not a community as diverse as the entirety of the LGBT community. I believe that part of my responsibility as a trans person who has the privilege of serving here is to guarantee that while I may be a first, I’m not the last. One of the reasons why anti-trans politics has been so successful is because the right wing has characterized trans people, and one of the greatest things that I can contribute is helping to diversify the public’s understanding of who trans people are. That does far more to change the public’s perception and political dynamics than anything else that I could do.”

Much of that work, she emphasized, happens away from cameras and headlines. It’s an approach that has at times drawn criticism from some LGBTQ advocates who favor more confrontational tactics, but one she frames as essential to long-term change.

“In a social media age, we perceive advocacy to look like one very loud thing, but a lot of my work is also behind the scenes. Speaking out and posting a clip is not the only way to advocate for people; in fact, it’s often the avenue of last resort if you actually want to deliver results. Despite a campaign that spent $200 million in anti-trans ads and an administration obsessed with trans people, not a single anti-trans bill or provision has become law. That’s not by coincidence, it’s by hard work and a strategic approach to defending the LGBTQ community.”

That same discipline carries into how she handles political attacks and public scrutiny.

“When you are a first, people will be out in force to try to bait you into fights to prove that people like you don’t belong. If you respond to provocations, they will turn you into a caricature and say you’re the aggressor. My job is to be a proud Delawarean and a damn good legislator, and the rest will follow from that. When you don’t take the bait, you protect your ability to deliver results.”

That approach has helped her build unlikely alliances across the aisle.

“I made it clear that I was willing to work with anyone if we could find common ground to help my constituents. As a byproduct, a number of my Republican colleagues came up to me and said welcome to Congress and let’s find opportunities to work together. That has resulted in me being able to introduce more bipartisan bills than any other freshman. We’ve been able to secure investments and pass legislation that opens up more capital to entrepreneurs from underrepresented backgrounds.”

Looking ahead to the midterms, McBride is both cautious and pragmatic.

“I feel cautiously optimistic that if the election were held today, that Democrats would win a majority in the House, but the problem is that the election is not held today. Republicans will be out in force with a boatload of money and will continue to try to use people like me as a political wedge issue. We have to meet all voters where they are and keep our eyes focused on the universal needs that our constituents have. It’s going to require us to have a big tent from our left to our right so that we can meet this moment.”

“We should not put anything by the Republicans; they will seek to suppress the vote and undermine the will of the people. That reinforces the need for us to win by such a margin that our win is too big to contest. It’s going to require us to reach voters who didn’t vote for us and compete in places we have written off. If the stakes are as high as we say they are, then we need all of the help that we can get.”

Her focus on long-term party-building is equally central to her vision — one that would be willing to take a leadership position on if given the chance.

“I’m really grateful that our leadership has offered me opportunities to have my voice heard and to represent the caucus. I am eager to find any opportunity to elevate the voices of my constituents and contribute. My background was in communications, and I believe our party can find new ways to communicate with voters. Our caucus is going to be the tip of the spear in helping to rebrand our party and build a governing majority.”

“We need to deliver universal child care, a higher minimum wage, Medicare for all who want it, and millions of new homes. Winning the next election is not the end; we have to continue building toward a durable majority. I’m eager to contribute to that vision in any way that my caucus sees fit. That includes potentially serving in leadership if that’s where I can be most helpful.”

On foreign policy, she is equally direct. The ongoing war with Iran was something she, as a member of the House Foreign Affairs Committee, is not only familiar with but completely opposed to.

“The war is illegal, but it’s also stupid, and it is a catastrophe for the United States. [The Trump administration] has not achieved any of their stated goals, and everything that has been destroyed can be rebuilt. Iran now has more leverage globally, including control of the Strait of Hormuz. This war raised costs, lost lives, and achieved what was already achieved a decade ago without any of that.”

That frustration echoes in what she hears from voters at home.

“Delawareans are pissed, and they’re pissed because this president promised he would end wars and lower costs. He has broken both of those promises, costs are higher and there are more wars. They are facing higher costs when they were already struggling, and they see that his policies have made that crisis worse. People across this country are angry that those promises were broken.”

Concerns about political violence and digital radicalization also weigh heavily on her. Last week’s attack at the White House Correspondents’ Dinner is one instance of politically motivated violence continuing to fester and instill fear in the American political sphere.

“I was horrified when I heard that there were shots fired, and the rising tide of political violence is a cancer for our democracy. Social media is radicalizing people and fostering misinformation and conspiracy theories. When people see a world where everyone is either 100% with them or against them, they begin to believe persuasion is impossible. That is fertile ground for violent extremists and it is unsustainable for democracy.”

“Democracy requires faith in other people’s capacity to change, and when that belief is lost, peaceful politics breaks down. People are not as divided as the algorithms make it seem, and most people are good and decent. We can tap people’s better angels, but we have to be willing to be in conversation with them. You cannot tell me that change is impossible, I have seen it and lived it.”

That belief underpins her support for regulating social media platforms, though she is careful to stress that policy alone is insufficient. The congresswoman constantly faces threats, repulsive comments, and detestable words from people on her social media channels for her identity alone.

“There’s no question that we need regulation of social media platforms, social media is the 21st century big tobacco. Whether it’s liability, age limits, or transparency of algorithms, there are a host of solutions we need to pursue. But policy solutions alone will not solve this problem. We have to get offline and have conversations in person.”

“When we have conversations in person, we realize we have much more in common than we think. We are currently having political conversations in the most toxic place possible, online. That has to change if we want to sustain democracy. You will come away more hopeful when you engage with people face to face.”

Her LGBTQ priorities remain anchored in policy and humanism— something she references repeatedly.

“I helped draft the Equality Act and I would love to see it become law. In the nearer term, we should prioritize reversing the ban on transgender troops. These are decorated service members who have been fired for no other reason than their gender identity. They deserve to be treated with dignity and fairness and judged on their merits.”

She continued at length about the transgender service members removed under Executive Order 14183, emphasizing both their service and their erasure.

“These are individuals who are not just qualified, but more than qualified, who have been decorated service members, who have received promotions with unanimous and unqualified endorsement by their superior officers who have been fired from service to this country for no other reason than their gender identity. And I believe in this moment… there is no more effective representation of our community than the transgender service members who have put their lives on the line to serve this country and who have been treated with nothing but disrespect from this administration. They deserve to be treated with dignity and fairness and judged on their merits.”

Even in partisan fights, she returns to her guiding principle of discipline and restraint.

“Sometimes in politics you have to throw a punch with grace. Republicans initiated a mid-decade redistricting effort to gerrymander and pad their majority. They expected Democrats to fold, but those days are over. We fought back and we’re not going to let them steal elections in advance.”

When the conversation turns to how she maintains balance amid the chaos of national politics, McBride returns to unexpected sources of grounding — television, pop culture, and humor.

“I’ve watched every season of ‘The Traitors,’” she said.

When asked if she would ever take a trip to the Scottish Highlands to visit Alan Cumming’s castle, she said it would have to be after her work is done in Congress.

“If I was ever on ‘The Traitors,’ I would never be able to be a traitor. I would get too nervous and overwhelmed. I would have to be a faithful. But I think if there is a future where I am on that show, it will be after I’m in elected office.”

And through it all, she draws parallels between reality television and political life itself.

“If you want to understand how many in Congress work, the best tutorial is ‘The Real Housewives’ … There are people whose sole purpose is to get attention… If you throw wine back, they will just keep coming back for more … I’m not going to allow someone to get attention at my expense … I think all you need to understand is [Capitol Hill] is like an episode of ‘Real Housewives.’”

Still, for McBride, even amid the spectacle of Washington, the focus ultimately returns home.

“I am excited for beach season and I love Rehoboth and Baltimore Avenue,” she says. “It is the professional privilege of my lifetime to represent Delaware. I represent a district that is urban, suburban, and rural, and I get to see the full diversity of this country every day. Delaware shows that a different kind of politics is possible.”

The Office of the U.S. Attorney for D.C., which prosecutes criminal cases in the District, has decided not to reinstate a hate crime designation filed by D.C. police against a man arrested in February for allegedly assaulting a gay man while using “homophobic slurs.”

After prosecutors with the U.S. Attorney’s Office initially dropped the hate crime designation filed by police shortly after the alleged attacker was arrested on Feb. 7, a spokesperson for the office told the Washington Blade the case was still under investigation, and additional charges could be filed.

“We continue to investigate this matter and make no mistake: should the evidence call for further charges, we will not hesitate to charge them,” a statement released by the office in February said. 

But D.C. Superior Court records show the case against defendant Dean Edmundson, 26, of Germantown, Md., who is now charged with Simple Assault without a hate crime designation, is scheduled to go to trial on Aug. 18.

The U.S. Attorney’s Office this week did not immediately respond to a message from the Blade asking why it chose not to reinstate the hate crime designation.

An affidavit in support of the arrest filed in court by D.C. police appears to support the charge of a hate crime designation. It says the incident occurred around 7:45 p.m. on Feb. 7 at the intersection of 14^th and Q Streets, N.W., which is near two D.C. gay bars.

“The victim stated that they refused to High-Five Defendant Edmundson, which, upon that happening, Defendant Edmundson started walking behind both the victim and witness, calling the victim bald, ugly, and gay,” the arrest affidavit states.

“The victim stated that upon being called that, Defendant Edmundson pushed the victim with both hands, shoving them, causing the victim to feel the force of the push,” the affidavit says, adding, “The victim stated that they felt offended and that they were also gay.”     

Under D.C.’s Bias Related Crimes Act of 1989, penalties for crimes motivated by prejudice and hate against individuals based on race, religion, sexual orientation, gender identity disability, and homelessness can be enhanced by a judge upon conviction by one and a half times greater than the penalty of the underlying crime.