Protesters decrying delays to funding in the battle against HIV/Aids charged into a congressional hearing where the Trump administration’s budget czar, Russell Vought, was testifying in Washington on Wednesday.
The demonstrators disrupted the proceedings on Capitol Hill and twice brought the hearing to a halt.
The Trump administration has slashed global aid, including the US President’s Emergency Plan for Aids Relief (Pepfar), which was created by George W Bush when he was president, and enjoys bipartisan support in Congress. Lawmakers funded Pepfar for $4.6bn this year. But activists say the majority of payments are still not going out to organizations in the field.
“There are trickles of funds getting out, but it’s in stop-and-start constantly,” said Asia Russell, executive director of Health GAP, one of the organizations behind the protest on Wednesday. “They’re only permitting the funding to go out in a drip-feed fashion.” Organizations on the ground worry they will not be able to pay their employees or continue their efforts testing and treating people living with HIV, she said.
In the first year of the Trump administration, an estimated 780,000 people died because of the cuts to funding, with millions more expected in coming years. For the fiscal year 2027, which begins in October, the president’s budget would end all HIV work and slash global health spending by nearly half (46%).
Vought, director of the US Office of Management and Budget (OMB), highlighted the dismantling of USAID among his accomplishments in the hearing before the US House budget committee. The cuts were made for ideological reasons, he said: “Many of our concerns on the foreign aid … it was because they were going through NGOs that don’t share this administration’s perspective on a host of issues,” he said.
The US Government Accountability Office (GAO) determined in September that funds were impounded, which is against the Impoundment Control Act.
In the hearing, Vought pushed back, saying he had “fully complied” with the law – while also taking swipes at the ICA. “As you probably know we are not fans of the Impoundment Control Act. We think it’s unconstitutional. The president ran against it,” Vought said.
Russell of Health GAP said that by not spending money appropriated and overseen by elected officials, “he [Vought] is defying the will of Congress”, which is “measured in preventable deaths and human suffering”.
“This is wildly out of step with the way appropriations operates, which is: Congress is in charge,” Russell said. “The administration is breaking all of those rules. They are sabotaging the program now.”
Soon after Vought began speaking, Aids activists and former USAID employees interrupted the hearing, chanting “Pepfar saves lives – spend the money”. They held signs reading “Protect Pepfar from Vought” and “Vought cuts kill people with Aids”.
The protesters were removed, but their chants could be heard from the corridor outside and the proceedings needed to be paused again. Six people were arrested.
It was the first time Vought has appeared for questions from House lawmakers in the 15 months he has served as OMB director; he appeared before a Senate committee in 2025.
The Trump administration cut nearly all USAID funding last year, despite the money being fully appropriated by Congress. The administration then requested a $400m rescission for Pepfar, which was rejected by Congress; even so, Vought was accused of slow-walking payments.
In August, Marco Rubio, US secretary of state, handed over leadership of USAID to Vought to “oversee the closeout” of the embattled agency.
Trump’s political appointees who took over USAID believed the agency only funded abortions – which has never been permitted – and asked for simplistic presentations like the Barney children’s show, according to an excerpt from a new book from the whistleblower Nicholas Enrich, former acting assistant administrator for global health at USAID.
An estimated 262,915 adults and 518,428 children died in the first year of cuts to aid, according to Impact Counter. By 2030, the cuts will likely lead to 14 million deaths, 4.5 million of them among children, according to a study in the Lancet.
The work of global health organizations has largely been “put on ice”, Russell said. But with epidemics like HIV, “standing still is moving backwards”, she said. “The tools are in the cupboard gathering dust, but HIV is active in the community, and you’re inviting resurgence. You’re inviting preventable HIV acquisitions, and unfortunately even disease progression and death.”
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