Improvements in health care in Eswatini have relied for years on Pepper and the generosity of the American people. During the height of the H.I.V./AIDS pandemic, Eswatini’s population plummeted, and life expectancy dropped from 61 in 1988 to 44 by 2003.

Medicaid programs allow more children to attend school and climb out of poverty, and they allow some 4.5 million people to live in their own homes rather than in institutions.

“These proposed changes threaten access to care for millions of Americans, particularly those in underserved areas, where our member systems work every day to provide quality, compassionate care.”

The longer PEPFAR remains hobbled, the greater the number of patients who will suffer the terrifying consequences of stopped treatment—a kind of reverse Lazarus effect.

I am well aware of the dangers of “raising awareness” and making a show of one’s fasting. But I am telling people about this publicly so that they can consider whether Pepfar is something they would like to fast over.

“I want to be a companion to Sister Sheral on this journey for as long as I have breath,” Sister Maureen Sinnott writes.