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In the wake of massive U.S. cuts in foreign aid, as well as tariffs imposed by President Donald Trump’s administration, small Southern African Lesotho faces deep uncertainty over its fight to end the country hiv The pandemic and its economy.
Lesotho long had the world’s second-highest HIV infection rate. Over the years, with nearly $1 billion in U.S. assistance, Lesotho built a health network efficient enough to slow the spread of the pandemic. But when Trump cut off foreign aid and dismantled USAID, chaos and confusion reigned in the country known as the “Empire in the Sky.”
Clinics closed, staff were let go and some patients were discontinued. Much of Lesotho’s system to treat thousands of HIV-positive patients and prevent new infections is overwhelmed. Experts are sounding the alarm, even as some US-funded programs have been temporarily reinstated.
For many people in the Hill Country and elsewhere, a positive HIV test 20 years ago was tantamount to a death sentence. If untreated, most people with HIV develop aidsAcquired immunodeficiency syndrome. At the peak of the epidemic in 2004, more than 2 million people died from AIDS-related disease worldwide – 19,000 in Lesotho, UNAIDS estimates.
Many Basotho – as they are known in Lesotho – say the chaos that has engulfed most of this year over aid cuts has caused irreparable damage, and they are worried about what will happen next. Most people feel deep disappointment at the loss of money and support – even betrayal.
Such concerns span Lesotho society: from rural to urban, from low to middle income, from patients to officials.
Trump’s announcement in April to impose new tariffs on almost all US trading partners had further increased anxiety and uncertainty in the country. Lesotho first found itself at the top of the list with a rate of 50%. Officials and economic experts said they were stunned. Since then, Lesotho’s rates have been adjusted to 15%.
The damage had already spread across Lesotho’s economy, where textile manufacturing comprises the largest private industry with more than 30,000 workers in 2024.
Before the threat of tariffs, textile manufacturer Tzikk had steady business. Its 1,300 employees made and exported sportswear to U.S. stores including JCPenney, Walmart and Costco. But just months after Trump’s April announcement, orders dried up, leaving factory floors empty and dark and most of its workers sent home.
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This is a documentary photo story curated by AP Photo editors.