Clinton Global Initiative frames counterweight to aid cuts with new HIV prevention pact

NEW YORK — Former President Bill Clinton opened the Clinton Global Initiative's annual meeting with a blunt assessment of the era’s risks, saying it would be irresponsible to ignore a rise in political violence and growing domestic and international frictions. He cited concerns about dismantling aid programs, what he characterized as a war on science and public health, cuts to education, trade tensions and potential threats to free expression. He described CGI as a counterweight to negative trends and said the two-day conference would shift toward working groups designed to tackle the challenges he outlined.

The event’s biggest public development on Wednesday was a cross-border health initiative aimed at expanding access to HIV prevention drugs in lower- and middle-income countries. The Clinton Health Access Initiative, Dr. Reddy’s Laboratories, Unitaid and Wits RHI announced a plan to provide Gilead Sciences’ HIV prevention drug lenacapavir in 120 countries at about $40 per person per year, starting in 2027. In a separate but complementary move, the Gates Foundation announced a similar arrangement with the Indian manufacturer Hetero Labs. Clinton framed the programs as partly a response to foreign aid cuts he said could lead to millions of additional HIV infections and deaths in Africa if not addressed promptly.

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In July, GOP leaders blocked an additional $400 million cut to PEPFAR, the U.S. program that has helped curb HIV/AIDS in Africa since its creation under President George W. Bush, a point Clinton and others highlighted to illustrate what they describe as uncertain support for foreign health programs. Points of Light Chairman Neil Bush, whose family has long tied its philanthropic identity to PEPFAR’s success, emphasized the role of private philanthropy in filling gaps, while noting he has not spoken with his brother, former President George W. Bush, about the CGI announcement. He argued that America’s withdrawal from global engagement has tangible consequences and signaled a broader aim to expand volunteering in the United States over the next decade.

Activist and philanthropist Abigail Disney urged CGI attendees to push for more aggressive giving and to support cultural movements as a means of advancing change. She warned that mistrust, fear and anger remain pervasive, even among large philanthropies, and urged leadership to act boldly. Disney’s comments framed the challenge as diplomatic as well as financial: philanthropic institutions must respond to social fragmentation with strategic investments, she said, regardless of political divides.

Clinton, stepping back to a longer arc, recalled that the Clinton Global Initiative launched in 2005 with a mission to translate philanthropy into practical solutions. He urged CGI participants to keep their focus on collaboration and openness: if leaders “hold our heads high, keep our eyes and ears open and deal with others with an outstretched hand and not a clenched fist, we’ve got a chance to keep hope alive.” He framed CGI as a forum for testing and scaling solutions that can improve lives around the world, even amid fiscal and political headwinds. The event highlighted how philanthropic networks are trying to respond to emerging global health needs while addressing broader concerns about democracy, science and education.