Key points:
- The world is now at a dangerous crossroads in the longtime battle against AIDS and HIV stigma, writes the Rev. Dr. Donald W. Messer.
- The dismantling of most U.S. international aid and political maneuvering has endangered the most vulnerable, especially on the African continent.
- As Dec. 1 marks another World AIDS Day, Messer urges United Methodists to step up in their HIV response and live into the denomination’s vision to “love boldly, serve joyfully and lead courageously.
Photo by David Stucke, Dakotas Conference.
Commentaries
Nearly 40 years after the first World AIDS Day, decades of progress toward curbing the global AIDS pandemic are under threat. Funding cuts, political maneuvering and systemic neglect leave vulnerable children and adolescents at risk.
The early 2020s brought hope. HIV infections were falling, deaths declining and promising new medications, such as the twice-yearly injectable lenacapavir, offered transformative prevention. Today, the world is at a dangerous crossroads.
Roland Fernandes, the top executive of the United Methodist Board of Global Ministries, reported that the 90% reduction in the U.S. foreign aid budget resulted in “an estimated 460,000 deaths reported by mid-2025, including 317,000 children.” Projections estimate 14 million deaths by 2030, including 4.5 million children, due to the dismantling of the U.S. Agency for International Development programs.
The United Methodist Church has long partnered in the global HIV response through United Methodist Committee on Relief, mission hospitals, Imagine No Malaria, HIV ministries and collaborations with UNAIDS and the U.S. President’s Emergency Plan for AIDS Relief, known as PEPFAR. These initiatives have saved millions, embodying Wesleyan theology in practice: faith expressed through service to those in greatest need. But political pressures are straining these partnerships.
In September, during UN Week in New York, a global health prayer breakfast I attended illustrated the danger of presenting faith as theater rather than truth-telling. In previous years, humanitarian programs were developed by UNAIDS and the World Council of Churches. Sponsored solely by the U.S. State Department this year, the event praised American leadership and highlighted a new “America First Global Health Strategy.” PEPFAR is being drastically reconfigured, raising concerns about whether it is prioritizing people in need or nationalistic policies. There was no acknowledgment of funding gaps, service disruptions in African clinics or the voices of the communities most affected, including LGBTQ+ people, sex workers and children living with HIV.
Ironically, the U.S. Secretary of State Marco Rubio was cited that very week on ABC claiming, “No one has died because the United States has cut aid.” Columnist Nicholas Kristof and health scientists rebutted that claim. From South Sudan, Kristof wrote that “Within an hour of beginning my reporting … I had found the names of two young children, a 10-year-old boy and an eight-year-old girl, who had died because their medication … had run out and they couldn’t get new sources … I found that kids were beginning to die because of the aid shutdown.” These were immediate, measurable losses, particularly among children dependent on consistent antiretroviral therapy.
The crisis is not abstract. In Honduras, at a home for HIV youth, friends told me that medicine was locked in nearby cabinets, but there was no longer anyone employed to distribute the life-saving drugs. For solely political reasons, South Africa — home to 8 million people living with HIV — has recently been excluded from U.S.-donated lenacapavir. Advocates warn that leaving the country to secure its own supply undermines global prevention efforts, putting high-risk groups at peril. Politics is outweighing science, and the cost is counted in human lives, especially the most vulnerable.
In Maua, Kenya, the Comprehensive Care Clinic at Maua Methodist Hospital has long provided HIV care for adolescents. Recent funding cuts have left the clinic understaffed and with scaled-back vital services. Already, 89 adolescents, ages 12-15, have lost access to psychosocial support, school assistance and medication management. Teenagers, discovering they are HIV positive from birth or because of a new infection, often feel hopeless — even suicidal.
In response, Stanley and Mary Gitari’s Education and Counselling Center has developed a program for desperate HIV adolescents. “The safety net that once protected many youth has collapsed,” Stanley Gitari reports. “Without restored funding or new partners, the most vulnerable are left without lifelines.”
In my 2004 book, “Breaking the Conspiracy of Silence: Christian Churches and the Global AIDS Crisis,” I argued that churches must confront both indifference and inaction. That lesson is painfully relevant today. When political priorities overshadow human need, and people of conscience are apathetic, silence kills.
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United Methodists are called to the ministry of truth-telling by naming suffering without spin or minimization, to defend the vulnerable by standing with adolescents, orphans and marginalized communities, and to advocate for restored and strengthened global health programs. We are called to partner globally by supporting Methodist hospitals, clinics and ministries across Africa, Asia and the Caribbean, and to keep alive the promise of ending AIDS by 2030 — a moral, spiritual and global imperative.
The United Methodist Church’s 2020/2024 Book of Resolutions, in Paragraph 4205, urges congregations to observe World AIDS Day. In Denver, the Rev. Dr. Valerie Jackson and the Center for Health and Hope will host a community gathering Dec. 1 at Park Hill United Methodist Church, with diverse partners including the Denver Islamic Society, Servicios de La Raza, Planned Parenthood, Gilead, Temple Emanuel, Denver’s PFLAG and United Methodist-related Iliff School of Theology. Colorado Attorney General Phil Weiser and Bishop Kristi Stoneking will speak and join in the annual Candlelight Walk.
Church-sponsored World AIDS Day events in the U.S. have declined as Advent celebrations take priority, but Christians in Africa and Asia continue to act. In rural Mukamira, Rwanda, United Methodist pastor Augustine Bahati will host a World AIDS Day event that includes people living with HIV and often-overlooked key populations — gay men, transgender people, married women and people who inject drugs.
It’s too late for 2025, but now is the time for U.S. church leaders to begin planning for 2026. This World AIDS Day, United Methodists face a moral choice. One path leads toward truth-telling, combatting HIV and overcoming stigmatization. The other leads toward blatant falsehoods, broken promises and preventable suffering.
Our bishops are asking us to “love boldly, serve joyfully, and lead courageously in local communities and worldwide connections.” Bold love means standing with those whom the world forgets. Joyful service involves extending resources and advocacy without hesitation. Courageous leadership challenges harmful policies, speaks truth to power, and builds global partnerships rooted in dignity and justice. If not in response to World AIDS Day and the ongoing global HIV crisis, then when?
Messer serves as executive director of the Center for Health and Hope in Centennial, Colorado, and as a member of the United Methodist Global AIDS Committee.
News media contact: Julie Dwyer, news editor, [email protected]. To read more United Methodist news, subscribe to the free UM News Digest.
