After the Exit: How USAID Scaledown Is Rewriting Kenya’s HIV Battle

The Pulitzer Center's support for this reporting was made possible through the Stavros Niarchos Foundation (SNF).

This reporting project examines how the scaledown of USAID support is reshaping Kenya’s decades-long fight against HIV. For years, donor funding through programs such as PEPFAR sustained treatment, prevention, and community outreach, helping transform HIV from a death sentence into a manageable condition. But as the United States reduces its financial support, cracks are beginning to show in the system that once promised stability and progress.

Through the voices of patients, health workers, and policy experts, reporting documents the real-world consequences of this funding retreat. From crowded clinics in Nairobi’s informal settlements to the quiet wards of Kilifi’s coastal hospitals, this project captures how lives are being disrupted, programs halted, and trust in the public health system tested.

The project explores not only the economic implications of donor withdrawal but also the human cost: the uncertainty, fear, and resilience of those living with HIV who now face an uncertain future. It is a story about dependency, transition, and the urgent question of whether Kenya can sustain its HIV response when global partners begin to leave.