Elton John, Sen. Frist: We’ve come too far to let AIDS win | Opinion

In the early days of AIDS, when the disease ripped through communities with terrifying devastation and speed, we had little more to offer than aspirin, blankets, love and prayers. That was all there was. We watched a generation disappear right before our eyes. Families shattered. Millions of orphans around the world left to raise themselves. The grief was relentless, but we vowed to help turn the tide.

Decades later, thanks to American leadership and extraordinary global cooperation, despair has given way to hope and action. We are closer than ever to ending AIDS. The latest breakthrough is long-acting HIV PrEP, an injection just once every six months that stops the virus in its tracks. In the pipeline: even better, cheaper prevention and treatment options for the millions still at risk and already infected.  

We would have given anything for these miracles back then. And yet, in 2024 alone, 630,000 people died from HIV-related causes and 1.3 million people became HIV positive. That's not just a tragedy. It's a failure of delivery.

Since its creation in 2003, the bipartisan President's Emergency Plan for AIDS Relief (PEPFAR) has saved more than 26 million lives, prevented about 8 million new infections in children, slashed economic and health care costs for the world's poorest countries and is associated with a fourfold increase in U.S. exports to Africa. It stands as one of America’s greatest global achievements. But the next phase of this work beckons a new approach.

We have the tools. We must act with urgency.

In the 2025 and 2026 budgets, Congress provided – and the president approved – the resources to drive a strategic transition of PEPFAR to country led-and-run HIV programs, without sacrificing decades of miraculous progress, and to continue to leverage global solidarity for this effort through the Global Fund.

Sadly, most of these funds – billions of dollars worth – are still stuck in Washington rather than saving lives in some of the poorest countries in the world.

This includes funding for newly negotiated agreements between the U.S. government and partner countries, where America can carefully support lower-income countries as they take control of their HIV responses.   

This also includes billions appropriated for the Global Fund, whose success is essential to PEPFAR’s effective transition.   

Compacts with countries are at the heart of the administration’s America First Global Health Strategy and are a sensible shift in approach, but only if these agreements are seen, smart and well-supported, especially for African countries in economic distress. Clear benchmarks and metrics can help us stay on track ‒ and course correct as needed if the right data is collected.

These budgets also include resources for an innovation fund that can help scale bold ideas from the American private sector to accelerate the end of AIDS.

The U.S. government and the Global Fund to Fight AIDS, Tuberculosis and Malaria are already committed to reaching 3 million people over three years with new HIV prevention drugs – a strong start. But demand already outstrips supply.

We urge the State Department and the Global Fund to consider doubling their rollout plan so resources can reach more communities without delay and to reengage community health workers, far too many of whom have been terminated. These are the on-the-ground care providers needed to once again “get shots in arms.”

The tools are in our hands: cutting-edge American medicines, available funding and proven policies, programs and partners. Now we must support countries in bringing these elements together and act with urgency.

We can end AIDS

First, we must rapidly scale the purchase and distribution of new HIV prevention, treatment and diagnostics. Reaching only narrow, select populations, while important, is not enough to bend the curve of this epidemic. PEPFAR’s own data from the end of 2025 shows declining prevention, treatment and diagnoses for most groups. We need to go big before we go home – for children and adults.   

Second, we must continue to work with trusted faith-based and community-based organizations to provide outreach, end stigma and support retention in care. In too many places, fear of judgment still speaks louder than facts. These efforts are essential to engaging those in need, increasing support and testing, and sustaining both prevention and treatment.  

Third, scale innovative delivery. The United States has already invested in the drone company Zipline, which has revolutionized medical supply chains in hard-to-reach areas. Drones can whisk lifesaving drugs over rugged terrain, ensuring no one is left behind.

With further investment and by harnessing advances in artificial intelligence and telehealth platforms, we can expand these models to reach tens of millions more people, faster and more efficiently than ever before.

In this increasingly unstable world, there are few global challenges for which the cost-benefit analysis is so unmistakably clear. We can apply American ingenuity to finish the job once and for all or risk the collective trauma of a global resurgence with a drug-resistant HIV that no one, including the United States, can afford.

If we are focused, bold and willing to give it all we’ve got, we can end AIDS. The funding exists, and much more was proposed in April by the House of Representatives. But we need the administration to spend it to end it.   

A poll done by the president’s pollster recently affirms that 80% of voters agree that the United States must “maintain its funding commitment to PEPFAR to continue to provide access to preventative and life-saving treatments to help end the HIV/AIDS global pandemic.”

Let's seize the moment. The world is watching.

Elton John is a world-renowned musician and founder of the Elton John AIDS Foundation.

FormerSen. William H. Frist, MD is a heart and lung transplant surgeon and former U.S. Senate majority leader representing Tennessee. He serves on the board of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria.