Devex Newswire: Is 5 words all PEPFAR gets from President Joe Biden?

Some HIV advocates had hoped U.S. President Joe Biden would give more than just a mention to the U.S. President's Emergency Plan for AIDS Relief, or PEPFAR, during his annual address before Congress this week. For example, a boost in funding. Also in today’s edition: French President Emmanuel Macron may have just sounded the death knell for a major international agreement, and one NGO points a finger at U.K. aid cuts for cholera’s rapid spread in Malawi. PEPFAR from enough Known as PEPFAR, the emergency plan for AIDS relief turned 20 a couple of weeks ago. Former President George W. Bush’s launch of the initiative during his 2003 State of the Union address was a game changer for the fight to address the global HIV and AIDS epidemic — one that some even reckon was his true legacy, overshadowed by the war in Iraq and that time he said “Brownie, you're doing a heckuva job.” Many hoped that Biden would make some grand gesture in his speech to the U.S. Congress this week, maybe urge lawmakers to reauthorize the program and increase its funding. But Biden’s PEPFAR tribute came down to five words, writes my colleague Jenny Lei Ravelo. “It’s been a huge success,” was all he said. Then he moved swiftly to curing cancer and the Jan. 6 attack on Congress. Although advocates had hoped for more — and are still hoping that the program’s flat funding will be increased — getting a mention is still “precious real estate,” according to Jennifer Kates of the Kaiser Family Foundation, and signals “that this is truly a bipartisan legacy that carries on.” While it remains to be seen whether PEPFAR will be reauthorized, it can still operate and receive money. But in the current U.S. political climate, a funding increase will be difficult for Biden to achieve. And that’s a big problem for the world’s hopes to defeat HIV entirely. According to PEPFAR’s own figures, the program has helped save the lives of some 25 million people, 20 million people with HIV have received antiretroviral treatment, and 5.5 million babies with HIV-positive mothers were born free of the virus. But millions continue to be infected with HIV every year, and many don’t know they’ve contracted it, and thus don’t get speedy antiretroviral therapy. UNAIDS estimates 1.5 million people were newly infected with HIV in 2021, and 5.9 million had no clue about their HIV positive status. Read: What Biden's State of the Union address means for PEPFAR + Sign up to Devex CheckUp, our free, weekly global health newsletter. PEPFAR’s spending unpacked Total PEPFAR expenditures have steadily increased over the years, breaking $4 billion in 2018 but down slightly to $3.8 billion at the start of the COVID-19 pandemic in 2020, according to its data portal. Spending has remained steady at $4.1 billion in the past two years. My colleague Miguel Antonio Tamonan provides a rundown of where that money was spent and PEPFAR’s top 10 partners last year. Read: Who were PEPFAR’s top partners in 2022? (Pro) + Try out Devex Pro Funding today with a free five-day trial, and explore funding opportunities from over 850 sources in addition to our analysis and news content. Post-Cotonou post-mortem French President Emmanuel Macron issued what is likely the coup de grâce to a long-running, little-known yet broad-ranging partnership agreement between the European Union and 79 African, Caribbean, and Pacific countries Thursday night in Brussels. The Post-Cotonou deal — agreed between the European Commission and ACP countries in April 2021 but blocked from entering into provisional application ever since by Hungary — was pitched by the commission as a “game-changing” new “political, economic and sectorial cooperation framework.” But no one could really say why it was necessary. And when South Africa left the ACP group last year on the grounds that it was superfluous to its relationship with the EU, the writing was on the wall. Just after 3 a.m. local time on Friday, after a long EU leaders’ summit, Devex’s Vince Chadwick asked Macron at a press conference whether the pact was still fit for purpose. The answer, from the man who sometimes single-handedly tilts the weather vane of EU (especially development-related) politics, was: “I think certain frameworks are a bit tired today, and so it’s going to be necessary to go beyond.” Vince’s lightning-round analysis is right here, but we’ll have a more in-depth story on the news shortly. Cholera makes a comeback Cholera cases on the African continent are spiraling and vaccines are in short supply. The World Health Organization said cases just in January – 26,000 across 10 countries – are more than 30% of the infections Africawide for all of last year. The uptick is fueled by extreme climatic events, such as drought and flooding, which contaminate water sources, my colleague Sara Jerving explains. If this steep rise continues, this year could surpass 2021, Africa’s worst year for cholera in almost a decade. ICYMI: Cholera thrives in a warming world Deadly trickle-down Africa’s worst-hit country when it comes to cholera is Malawi, where a major outbreak has already killed more than 1,000 people. NGO leader Nick Hepworth has publicly blamed the U.K. for contributing to those deaths. The complaint stems from U.K. government cuts to the £90 million Building Resilience and Adaptation to Climate Extremes and Disasters program, known as BRACC in Malawi, which provides rapid response and crisis prevention. The U.K. famously cut its aid budget from 0.7% to 0.5% of gross national income, throwing the sector into chaos. Malawi’s 11-month cholera epidemic has infected nearly 40,000 people and spread in places previously targeted by BRACC, writes my colleague William Worley. The outbreak worsened after climate change-related flooding following the 2022 Tropical Storm Ana, according to Hepworth of Water Witness International. “There’s an obvious question as to whether we’d have seen the cholera epidemic that we have seen if that rapid response had been available,” Hepworth says. “That system was set up specifically to control events like this cholera epidemic. The fact that it was removed … it doesn’t take a genius to work out that it could have been an excerbatic factor in the epidemic.” Read: UK aid cuts contributed to major cholera epidemic, says NGO Yellen into the void U.S. Treasury Secretary Janet Yellen yesterday piled more pressure on the World Bank to enact reforms and increase lending for climate, pandemics, and other messy global concerns. But she sweetened her tone and praised progress made since she launched a campaign to overhaul the anti-poverty lender. “We have begun the evolution of the World Bank,” Yellen said at the Center for Strategic and International Studies in Washington. “We have made real progress over the past four months.” Regional development banks would come under scrutiny next, she warned. The secretary, who recently spent a week in Africa, also appeared responsive to concerns by low-income countries that their needs on fighting poverty could get brushed aside if the banks are encouraged to focus on climate. “They don’t want global challenges addressed at the expense of poverty reduction and the sustainable development goals,” Yellen said, referring to her conversations with African ministers. Read: Yellen hails ‘progress’ on World Bank reform, but demands more action + Sign up to Devex Invested, our free, weekly newsletter, to get the insider brief on business, finance, and the SDGs. In other news Rumors about aid flights to quake-hit Turkey prompted a rush to the airport by people who want to get out of Afghanistan, where millions live in dire conditions under Taliban rule. [The Washington Post] Six trucks carrying U.N. relief supplies arrived Thursday in Syria through the aid crossing from Turkey, while the U.S. government pledged $85 million for earthquake victims in both countries. [Al Jazeera and BBC] Schools in Haiti have seen a ninefold increase in acts of violence in a year, severely impacting children’s access to education in the country, UNICEF has warned. [VOA] Sign up to Newswire for an inside look at the biggest stories in global development.