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90,000,000 Lives for $20

2025-06-10 · letter vlog · John · 6:56 · watch on YouTube

Topic: Global development (also: US politics & society) · mode: Advocacy & fundraising · tags: timely hook, heavy topic, civic or action cta, community lore

John warns that US-led cuts to global health funding, now before Congress (PEPFAR cuts and a halved, re-matched Global Fund contribution), will reverse decades of progress against child mortality, TB and HIV, and asks viewers to call their representatives: about $20 a year per American for PEPFAR and the Global Fund, which saved 91 million lives, is the bargain of a lifetime.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Graphs of falling child mortality, TB and HIV deaths since 2000, a forecast reversal, and PEPFAR's record and bipartisan support

  • ★★★ John says graphs of child mortality, TB and HIV deaths since 2000 all bring good news, but this progress will stop and reverse because of the US-led global pullback in health funding. — 00:00:00 · child mortality, tuberculosis, global health, United States
  • ★★★ John cites a recent estimate that within five years annual TB deaths will rise from 1.3 million to 2 million, and child mortality will worsen. — 00:00:00 · tuberculosis, child mortality
  • ★★ John says premature mortality has fallen dramatically in 25 years, but HIV/AIDS deaths rose before falling because antiretroviral therapy was not widely available in impoverished communities until the mid-2000s. — 00:00:29
  • ★★★ John says PEPFAR, a US-led program against HIV globally, has been hugely effective, saving tens of millions of lives, and has long had bipartisan support. — 00:00:29
  • ★★ John says several Republican senators recently called cutting PEPFAR a red line, yet PEPFAR is in real danger. — 00:00:29 · Republican Party

00:00:58 — Graphs versus stories of needless death; young doctors seeing AIDS deaths again; TB testing in a coma

  • ★★ John says graphs are a terrible way to convey the meaning of needless suffering and death, but he knows no other way to tell millions of stories at once. — 00:00:58
  • ★★ John says a reporter told him young doctors who only knew AIDS as a manageable chronic illness are now seeing people die of it, which John calls truly horrific. — 00:00:58
  • ★★ John says tuberculosis testing is 'in a coma', as one article put it, with millions going undiagnosed and therefore untreated. — 00:00:58 · tuberculosis

00:01:27 — Congress weighing codified PEPFAR and health-aid cuts; the Trump budget's threat to the Global Fund

  • ★★★ John says the US Congress is deciding whether to codify $400 million in cuts to PEPFAR and $500 million in cuts to other US health aid. — 00:01:27 · United States Congress, United States
  • ★★★ John says that if these cuts are codified in US law, it is no exaggeration to say millions of people will die. — 00:01:27 · United States Congress
  • ★★ John says the cuts would save about $3 per American, less than one ten-thousandth of the federal budget, yet that $3 does so much good. — 00:01:27 · United States
  • ★★ John says the Global Fund, which provides treatment and diagnostics against the world's deadliest infectious diseases, is also under threat. — 00:01:56
  • ★ John says he is genuinely terrified to imagine a world without the Global Fund. — 00:01:56
  • ★★★ John says the Trump administration's latest budget proposal would cut US funding for the Global Fund by 50% and change how that funding works. — 00:01:56 · Donald Trump
  • ★★ John says the US now gives $1 to the Global Fund for every $2 raised by other partners, and the proposal would change that to $1 for every $4. — 00:02:26 · United States
  • ★★★ John says the new match would gut the Global Fund, because the UK and EU are also cutting global health spending and will use it as an excuse to cut further. — 00:02:26 · United Kingdom, global health
  • ★★★ John says this catastrophe will be the greatest setback in human health in a generation. — 00:02:26 · global health
  • ★★ John says he really believes we might be able to stop it. (hedged) — 00:02:26

00:02:55 — A Republican congressman's 'my constituents don't care'; why calling representatives works; $20 a year per American for 91 million lives

  • ★★ John says a Republican member of Congress told him in a recent meeting that he didn't disagree, but his constituents don't care about this. — 00:02:55 · Republican Party, United States Congress
  • ★★★ John thinks the congressman is wrong: many of his constituents care, he just isn't hearing from them. — 00:02:55
  • ★★★ John says he long thought contacting elected representatives was a waste of time, but knows it isn't: even in this political climate he has seen programs reinstated. — 00:02:55
  • ★★ John says he has seen TB Fighters win bipartisan support for anti-tuberculosis efforts. — 00:03:24 · tuberculosis
  • ★★ John says promises must now be kept: if someone like Susan Collins says she will always stand up for PEPFAR and the Global Fund, now is the time. — 00:03:24
  • ★★★ John says representatives most need to hear that viewers care about PEPFAR and the Global Fund, and that the $400 million cut would mean hundreds of thousands of babies needlessly born with HIV. — 00:03:24
  • ★ John announces he is going to curse for the first time in 18 years on Vlogbrothers. (playful) — 00:03:24 · Vlogbrothers
  • ★★★ John says they want about $2 billion in US federal spending for the Global Fund, about $6 per American a year; with PEPFAR's full budget, about $20 a year per American. — 00:03:53 · United States
  • ★★★ John says the Global Fund helped save 65 million lives in the last 20 years and PEPFAR has saved 26 million: 91 million human beings. — 00:04:22
  • ★★★ John says he doesn't know how to value 91 million lives, but $20 a year is a great deal. — 00:04:22
  • ★★ John says the US is not the only challenge: about 43% of the Global Fund's money comes from the UK and the EU, which are also pulling back on global health spending. — 00:04:22 · United Kingdom, global health, United States
  • ★★ John asks viewers in the UK and EU to contact their representatives too. — 00:04:22 · United Kingdom

00:04:52 — TB Fighters call-a-thons, how to call, the puff, and why red-state callers matter most

  • ★★★ John says chaotic, massive US spending cuts are the main reason hundreds of thousands have had TB treatment interrupted and millions living with HIV have been imperiled. — 00:04:52 · United States, tuberculosis
  • ★★ John says TB Fighters in the community are organizing call-a-thons every day this week (week of 9 June 2025), fun events to make friends and do something worthwhile. — 00:04:52
  • ★★★ John asks viewers to call their representatives now, using PIH scripts linked below or their own words, to say the world needs PEPFAR and the Global Fund. — 00:04:52 · Partners In Health
  • ★★ John says calling feels small and insignificant, but when tens of thousands of people do something insignificant together it becomes very significant. — 00:05:21
  • ★ John says the puff is out of control, but so are his stress levels. (playful) — 00:05:21 · the Puff
  • ★★★ John says living in a red state makes him unusually powerful now: people in Indiana, South Carolina, Texas or Maine, or represented by Tom Cole or Mario Diaz-Balart, matter enormously. — 00:05:21 · Indiana
  • ★★ John asks viewers to call and also make their parents, and even a weird aunt who disagrees about everything but would spend $20 a year to save children, call. (playful) — 00:05:21

00:05:50 — A friend in Sierra Leone asks 'what about everyone else?'; philanthropy cannot fill the gap; final ask and sign-off

  • ★★★ John says a friend in Sierra Leone with HIV had his medication rationed by funding cuts; John promised he and Sarah would cover private medication, and the friend asked: what about everyone else? — 00:05:50 · Sierra Leone, Sarah Urist Green
  • ★★★ John says private philanthropy simply cannot step up and fill these gaps. — 00:06:12
  • ★★★ John says that unless we want to return to millions dying of HIV yearly and hundreds of thousands of babies born with it, we must stand up for 'everyone else'. — 00:06:12
  • ★★★ John asks viewers with a say in their governance to tell their elected representatives that $20 a year per American to save millions of lives is the bargain of a lifetime. — 00:06:41 · United States

In the description and comments

Threads in this video

Where the stories that moved here went next

Mentioned

Central: child mortality · Global Fund to Fight AIDS, Tuberculosis and Malaria · global health · HIV/AIDS · President's Emergency Plan for AIDS Relief · tuberculosis · United States Congress

Also: People: Donald Trump · Mario Diaz-Balart · Sarah Urist Green · Susan Collins · Tom Cole

Projects: TBFighters

Organizations: European Union · Republican Party

Terms: the Puff

Concepts: antiretroviral therapy · Development aid · malaria · profanity

Places: Indiana · Maine · Sierra Leone · South Carolina · Texas · United Kingdom · United States

Only in the description or credits: Lesotho · Mike Johnson · Partners In Health · United States House of Representatives · White House

Also centred on Global Fund to Fight AIDS, Tuberculosis and Malaria: This Is Not Normal

Also centred on President's Emergency Plan for AIDS Relief: This Is Not Normal

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