The Ethics of Cutting HIV/AIDS Relief, with Mindy Belz

“If a person is entrusted to care for a building and decides to tear it down, there's a moral imperative to disclose whether there are people inside. There are 20.6 million people and 566,000 children living inside PEPFAR.”

PEPFAR is the President’s Emergency Plan for AIDS Relief. And as of March 25, 2025, its congressional reauthorization has expired.

For more than two decades, its website states, “the U.S. government has invested over $110 billion in the global HIV/AIDS response, the largest commitment by any nation to address a single disease in history—saving 26 million lives, preventing millions of HIV infections, and accelerating progress toward controlling the global HIV/AIDS pandemic in more than 50 countries.”

Now, some estimate that over 20 million people will lose access to antiretroviral drugs, which may result in up to 1,650,000 deaths over the coming year.

In this episode, Mark Labberton speaks with Mindy Belz, an award-winning journalist and longtime war correspondent, to explore the urgent moral and humanitarian implications of PEPFAR’s uncertain future. Drawing on Belz’s deep reporting experience in conflict zones and her time covering global health efforts, their conversation traces the remarkable legacy of the U.S. government’s investment in HIV/AIDS relief, the stakes of congressional inaction, and the broader questions this crisis raises about American moral leadership, Christian charity, and global responsibility.

Together they discuss:

Mindy Belz’s background as a journalist and war correspondent

The significance of PEPFAR in the global battle against HIV/AIDS

The pivotal leadership role the U.S. government has played in supporting AIDS relief efforts for the past two decades

The devastating impact that losing PEPFAR would have on human life around the world, particularly in Africa

And, perspectives on charity, moral conscience, and faith in American Christianity

Helpful Links

mindybelz.com

Mindy’s Article about PEPFAR: “1,650,000: How killing a global program to fight HIV/AIDS kills”: “PEPFAR contracts ended under Trump mean 20 million people on treatment now face HIV disease again. Without more reinstatements that could lead to a death toll of 1.6 million in a year's time.”

About PEPFAR, the “President’s Emergency Plan for AIDS Relief”: Through PEPFAR, the U.S. government has invested over $110 billion in the global HIV/AIDS response, the largest commitment by any nation to address a single disease in history – saving 26 million lives, preventing millions of HIV infections, and accelerating progress toward controlling the global HIV/AIDS pandemic in more than 50 countries.

From ThinkGlobalHealth: “PEPFAR Misses Reauthorization Deadline: What's Next for Global HIV Fight?”

Mindy’s book They Say We Are Infidels: On the Run from ISIS with Persecuted Christians in the Middle East

Follow Mindy on X @mindybelz

Follow Mindy on Substack: Globe Trot

About Mindy Belz

Mindy Belz is an award-winning American journalist. For over two decades, she has covered wars and victims of conflict in Afghanistan, Syria, Iraq, Sudan and the Balkans. She recounts some of her experiences in a 2016 award-winning book, They Say We Are Infidels.

Her work appears in The Wall Street Journal, Plough Quarterly, and other publications. The New York Times calls her “one of the bravest and best foreign correspondents in the country.”

Mindy currently is editor of the 2024 Christianity Today Globe project. Her news roundup, Globe Trot, is read by thousands each week and available on Substack. She speaks internationally and has taught journalism courses in Uganda, India, Hungary, and the United States. She is the former senior editor at World Magazine.

A mother of four and grandmother of three, Mindy was married for 40 years to Nat Belz, who died in 2023. She lives in North Carolina.

Show Notes

Mindy Belz: A Journalist in the Trenches

• Mindy Belz and her career at World Magazine
• Mindy’s coverage of the AIDS pandemic in East Africa and the war in Sudan
• The rise of Islamic extremism, Al-Quaeda, and crossing the Tigris into Iraq
• Her early experiences in journalism and what drew her to war reporting
• How she came to report from the Middle East and other conflict zones
• The challenges Mindy faced as a woman journalist
• “We've all experienced some of the conflict in the world. We've all experienced some terrorism and violence … this is a part of life in a broken and fallen world, and so learning from women, from men, from children incredible resilience in the face of terrible breakdowns is that I just consider a real privilege of my work.”
• Working with a Sudanese NGO—finding starving people, barely surviving
• “For Americans, we always get to walk away. I'm really aware in whatever hard situation I'm in, there's little voice at the back of my brain that's saying, ‘Don't forget you get to go home.’”

What is PEPFAR?

• “ President's Emergency Plan for AIDS Relief,” developed by George W. Bush in 2003
• Trendsetting program to battle HIV/AIDS
• Anti-viral drug program to prevent the spread (but not cure) the disease
• “We still don’t have a real cure for HIV.”
• “You have 20 million people who are currently taking antiretroviral drugs that are funded under PEPFAR and most of those people just suddenly could not have access to their medicine and, and that means that we are watching even now the disease grow.”
• “The Trump administration has basically shuttered the program and they have done so without the oversight of Congress.”
• Nicholas Kristof’s NYT March 15 article estimates that 1.6 million people could die over the next year. Link: “Musk Said No One Has Died Since Aid Was Cut. That Isn’t True.”
• “The scale of the devastation is mind-bending.”
• What can we do?
• “Congress is not exercising its oversight responsibilities right now.”
• “If a person is entrusted to care for a building and decides to tear it down, there's a moral imperative to disclose whether there are people inside. There are 20.6 million people and 566,000 children living inside PEPFAR.”
• What is the role of our government?
• “I've also seen PEPFAR working and working incredibly. I routinely and in lifesaving ways.”
• Understanding moral conscience
• “We are needing to call our nation not to a Christian identity, which I think is the, the false attempt of Christian nationalism, but to a moral identity. That people of faith, little faith, no faith, other faiths, can enter into and share. And I think some element of that has been operational in the United States for a very long time. And now all of that is being dismantled and being labeled, as you say, by a really cheap word like charity, as though there's no wider frame than simply compassionate sentimentality, as opposed to something that's really taking the moral realities of the world and all of their urgency seriously. And not pretending that we need to be (as we've sometimes tried to be as a nation) the healer of the nations, but to say that we should actually be a force for taking these issues with great national seriousness, and not just repudiating it because it's not inside the boundaries of our own country.”
• “Use the influence and the economic force of the United States to fund local programs.”
• “ We have the resources to go and make a difference in this situation. And by doing that we set an example for others to do it.”
• “We  have adopted an attitude of scarcity.”
• The impact and efficacy of antiretroviral drugs to improve the lives of people with HIV/AIDS—”To suddenly cut them off is an act of cruelty.”
• “This is a system, not just medication.”
• “If we’re suddenly saving $5 billion a year, what is that going to be used for?”
• ”If these things are all happening by executive decision, and Congress does not have a meaningful role, then essentially the people are cut out of the conversation.”
• “People who become sicker with HIV will become more likely to have tuberculosis, more likely to be suffering from other diseases than side effects of the virus itself.”

Where Is God in All of This?

• “It's a dangerous world. Go anyway.”
• “We have to trust that the hand of God is there and that it will meet us in the midst of those hard situations.”

Production Credits

Conversing is produced and distributed in partnership with Comment Magazine and Fuller Seminary.