PEPFAR’s Dr. mike Reid Resigns on Substack: Equity, Authoritarianism, & the Future of Global Health
Episode Description
Ben Plumley is joined by Ambassador Eric Goosby, and by Dr. mike Reid to react to Reid’s recently announced resignation from PEPFAR on Substack. Reid describes his growing moral dissonance with an administration he characterizes as authoritarian, citing concerns that lifesaving HIV services could be conditioned on geopolitical or commercial interests, a deprioritization of equity, reduced emphasis on evidence-based programming, and rapid changes made without deliberation or stakeholder engagement. The conversation contrasts partnership-based global health diplomacy with short-term coercive quid pro quo dynamics, the push toward country ownership and government-to-government funding, as well as ensuring marginalized populations are still able to access comprehensive HIV services. Is there a need for PEPFAR to course-correct, and if so, how? Perhaps the future will depend on what kind of new administration comes into office in 2029…
00:00 Special Episode Introduction
00:33 Resignation Goes Public
02:53 Why Reid Resigned Now
07:50 Authoritarianism And Ethics
10:39 Quid Pro Quo In MOUs
12:28 Partnership Versus Coercion
15:30 Making Global Health Matter
18:13 Domestic Policy Dissonance
20:22 PEPFAR Not Fit For Purpose
23:56 Country Ownership Fast Track
26:21 Public Health Versus Politics
28:23 Who Gets Left Behind
31:32 Science And Sustainable Transition
33:36 Can PEPFAR Recover
35:54 Shared Blame and Dependency
38:14 MOU Enforcement and Penalties
40:56 Minerals Deals and Ethics
43:37 Lessons From Past Bilaterals
44:47 Building Sustainable Systems
47:45 Doing More With Less
50:50 Efficiency Integration and Tech
52:41 New Tools and Market Shaping
54:08 Personal Next Steps
56:41 Moral Ambition and Hope
01:00:51 Final Thanks and Signoff
Read mike’s resignation on Substack:
substack.com/p/stepping-away" target="_blank" rel="noopener noreferrer">https://reimaginingglobalhealth.substack.com/p/stepping-away
Check Out Ben’s Substack:
https://substack.com/@benplumley1
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