Muhammad Junior Zain
FH UI 2022
By the end of 2024, an estimated 40.8 million people are living with HIV. In Indonesia alone, approximately 570,000 people are living with HIV, most of them are included among important demographics (MSM, sex workers, people who inject drugs, and transgender persons) except in Tanah Papua, where the epidemic is generalized. Today, USAID’s funding cut in the sector endangers the rapid development of public health infrastructure, undermines years of progress in HIV control, and leaves vulnerable communities without essential support systems.
Now, with clinics shuttering and outreach programs suspended, communities that were once steadily advancing toward lower infection rates are suddenly thrust back into uncertainty. This retreat has not only put people at risk of getting HIV again and dying from AIDS, but it also makes people throughout the world less trusting of foreign development promises, especially in many low- and middle-income nations, particularly in Sub-Saharan Africa and Southeast Asia. These regions have relied on USAID’s support to be a critical lifeline by funding testing kits, antiretroviral treatments, prevention campaigns, and training for healthcare workers on the ground.
USAID’s recent HIV funding cuts are a moral crisis, not just a budget issue, with dire consequences for global health. The decision to withdraw funding leaves vulnerable populations without access to critical treatment and prevention, jeopardizing decades of progress against the epidemic. This retreat not only costs lives but also unravels the fragile fabric of global health security, proving that a potential HIV epidemic will know no borders.
HIV/AIDS is a transnational epidemic that requires a coordinated worldwide response. The virus spreads through human mobility networks, which include migrant labor, refugees, international travel, and even global commerce lines. Local epidemics can easily escalate into regional crises in areas where cross-border mobility is common and healthcare access varies greatly, such as Sub-Saharan Africa and Southeast Asia.
Furthermore, the implications of HIV/AIDS extend beyond health to economic output, educational attainment, and social stability, causing ripple effects that might reach far beyond the nation of origin. This pandemic cannot be contained by a single nation alone. Multilateral collaboration is required for effective surveillance systems, antiretroviral supply chains, and preventative efforts. Without persistent cross-border coordination, attempts to halt the pandemic risk are hampered by gaps in global coverage, endangering not just vulnerable people but also the collective health security of all countries.
On the other hand, checkpoints and coasts are not the only places where health risks exist. Health security is just as good as its weakest link in a globalized society. For instance, the COVID-19 pandemic has ultimately shown how different nations must cooperate to address rapidly escalating health threats. Countries worked cooperatively to slow the spread of the virus by exchanging vaccines, being open about data, and making sure that travel and health rules were the same for everyone. In the end, they proved that transnational challenges demand transnational solutions, and that no nation can truly be safe until all are protected.
In regions with high mobility and porous borders, a localized HIV crisis can quickly become a regional emergency. HIV transmission is significantly fueled by migration and cross-border mobility, most notably among vulnerable populations such as migrant workers, refugees, truck drivers, and displaced communities.
These groups often lack consistent access to healthcare, testing, and treatment as they move between jurisdictions with varying levels of infrastructure and political will. This makes it difficult for them to receive healthcare, testing, and treatment consistently. These migratory demographics fall between the gaps and end up as both accidental virus carriers and neglect victims in the absence of coordinated regional health policies and international cooperation.
Under international human rights law and global development agreements, states have a shared obligation to prevent foreseeable harm even when it originates outside their borders. Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) explicitly recognizes “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”
Furthermore, General Comment No. 14 by the UN Committee on Economic, Social and Cultural Rights interprets this right as encompassing both domestic obligations and “international assistance and cooperation,” particularly in health-related matters. This means that states must not only develop their own health systems, but also avoid actions such as abrupt aid withdrawals that could jeopardize access to crucial healthcare in other countries.
For decades, the United States has positioned itself as a global pioneer in combating HIV/AIDS, particularly through projects such as the Global Fund and programs under the USAID. These initiatives were more than simply ways to provide resources to needy countries; they were also ways to build confidence, legitimacy, and moral authority in U.S. foreign policy. The U.S. might lose that goodwill by backing down now, especially in places like Sub-Saharan Africa and Southeast Asia, where American help has built entire public health systems.
The Global Fund and USAID are vital pillars of global HIV prevention, empowering communities and providing peer support. The Global Fund committed $102 million for 178 HIV priority regions between 2024 and 2026, while the U.S. invested $11 million in Indonesia’s HIV response for 2024–2025.
This funding directly supports on-the-ground interventions by groups like EPIC/FHI360 and provides technical assistance from U.S. and multilateral agencies like JSI/Think Well and UNAIDS. Abandoning these advances now would be a catastrophic mistake, jeopardizing lives and the integrity of the global development system.
The U.S. must recognize that global health is not charity but a strategic pillar of diplomacy, stability, and shared prosperity. A retreat on HIV support would signal that American commitments are political gestures rather than binding obligations. This is the moment to act, before the costs of withdrawal are measured not only in lives lost but in diminished credibility. History will record who stepped back when leadership was most required.
Referensi
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