A loving father and his daughter (who is HIV+) wait to visit/visit a doctor at the Bukoba Regional Hospital, Tanzania.
USAID: The End of a Lifeline in Africa
In 2014, I documented HIV, tuberculosis, and malaria treatment programs, as well as nurse and doctor training initiatives across Africa, focusing on how investments in health had significantly improved well-being across the continent. What I witnessed was remarkable—unlike anything I had seen in my many years working there. Investments in equipment and infrastructure had transformed entire hospitals, equipping them with modern technology and hygienic facilities. My work reflected not just a continent in need but one progressing toward prosperity, even as challenges remained.
These photos capture that progress—many of those pictured were living with HIV yet leading healthy, fulfilling lives, a testament to the impact of sustained investment in public health. The majority, if not all of these locations received funding from USAID and no longer do.
A decade earlier, at the height of the HIV pandemic, I had seen entire villages devastated and was deeply critical of my own nation’s inaction. Yet, under a president with whom I profoundly disagreed, a transformation in global public health took shape. Through the President’s Emergency Plan for AIDS Relief (PEPFAR), launched by George W. Bush, along with USAID, I saw firsthand the immense return on investment—lives saved, medical infrastructure built, and goodwill toward the United States heightened. Beyond being sound public policy, these efforts were also a strategic move at a time when multiple global actors sought to diminish the U.S.
Rural Health Motivators visited homes in remote areas, engaging women in conversations about health. When the COVID-19 pandemic struck, these same healthcare workers walked those familiar roads, playing a crucial role in slowing the spread of the virus.A young man is tested for HIV. (Rapid test result: negative.) Rural outreach teams goto great lengths to test people for HIV in their homes and council them on how to live healthy lives surrounding the Lake Victoria region.A blood sample for tuberculosis. Modern, refrigerated facilities have made tests much more accurate and even feasible, as equipment before USAID investments was lacking.The Nicoadala District Mobile Clinic with decals of participating organizations from the United States and globally.The laboratory room with GeneXpert machine (rapid test TB) and lab technician in the TB clinic at TEBA headquarters in Maseru.The x-ray room in Mwanyamala Hospital, Dar es Salaam, Tanzania.Student training at Mwanyamala Hospital, Dar es Salaam, Tanzania.
Bishoftu Hospital, Ethiopia.
Bishoftu Hospital, Ethiopia
A pregnant woman receives a checkup from a male midwife at Bishoftu Hospital, Ethiopia.A community-based ARV distribution program in Nicoadala District, Mozambique, operated through a network of women who gathered weekly to collect antiretrovirals and distribute them to surrounding villages. This system later proved essential during the COVID-19 pandemic, as the established networks helped curb the spread of the virus and deliver aid to those who fell ill.A rural patient is given ARV refills at a clinic in Berea District, Leshoto.A woman and her daughter is visited by a TEBA Care supporter in her house. Households are visited of those miners that are diagnosed with TB. HCW’s also visit family members who might be infected because they share the house with the infected miner. TEBA Supporters also sign up people with a cell phone so that they can easily be reached to check their status and see if they are taking their medications.A woman pumps water at the CMS Gbagbam-Faith based clinic, Ivory coast. USAID has contributed significantly to improving access to drinking water in Côte d’Ivoire, particularly through its programs targeting both urban and rural areas.Mother and mentors coffee ceremony at Bishoftu Hospital, Ethiopia.Mother and mentors coffee ceremony at Bishoftu Hospital, Ethiopia.Mothers wait on benches at the clinic where their sons went to be circumcised in a rural village near the Kagera Sugar Company, Bukoba, Tanzania.This is young women is of the many who benefitted from USAID. Walking down a rural road in Leshoto, she was making her way to a clinic. She wanted to make sure that she was healthy and safe for those she chose to be with and was going to get tested for HIV.HIV+ Women dance as a act of supporting supporting each other in Berea in Hospital, Swaziland.HIV+ children play in the waiting area of the pediatric clinic of the Bukoba Regional Hospital, Tanzania. HIV is no longer the life ending disease it used to be. Great strides have been made to treat children such as these to that they can lead healthy and happy lives..HIV+ teens attend informational sessions at the Baylor Teen Clinic where they also play football and dance. The clinic happens every Saturday and is essential of these boys and girls lives. It is the one of the few places where they can get to gather and not have to worry about the stigma of being HIV+. They support each other and bring each other in in a welcoming and free manner.
