Six Reasons for Radical Hope

If our founders didn't believe persistent action could create a healthier, more just future for vulnerable people, Partners In Health (PIH) would not exist. Fortunately, nearly four decades ago, Dr. Paul Farmer didn't allow despair to hold him back from working to improve the lives of folks in Haiti.

Since then, PIH has expanded access to care for communities around the world, from Kazakhstan to Malawi-both by providing health services globally and by advocating for health as a human right in the halls of power. Throughout that journey, PIH has consistently reinforced the belief that pessimism is a privilege and optimism is a moral choice.

Co-founder Ophelia Dahl has said, "Optimism is the only choice if we are to transcend apathy and work together for a better, more humane world."

And Dr. Joia Mukherjee, senior clinical and academic advisor, embodies that same spirit of "radical hope," viewing cynicism as a "cop-out."

This year, during one of the most challenging periods for global health and foreign aid in recent memory, we continue to revisit the hope that has catalyzed our work since 1987. The progress we've made in defending equitable global health-despite immense challenges-is a powerful reminder of what determined advocates can accomplish together.

There is a Haitian proverb that says, "dèyè mòn, gen mòn," meaning beyond mountains, there are mountains. Our continual, radical hope will help us as we climb each one. When optimism is the only choice, real systemic change can follow. Read on for six achievements that helped sustain our hope this year:

Congress's foreign aid spending package for 2026 was $5 billion higher than requested.

Over the past year, PIH's advocacy efforts-including Congressional briefings, constituent outreach, and organized Hill Days-led to hundreds of members of Congress signing bipartisan letters in support of global health funding priorities.

As a result of advocacy by both PIH and partners, on February 3, the House passed a $50 billion foreign aid spending package for this fiscal year. This package maintained relatively steady funding levels for global health-an immense success following threats of massive cuts outlined in President Trump's budget request.

Under the current administration, Congress has repeatedly made it clear that they still support funding critical global health programs. We urge them to reassert their constitutional power of the purse -Congress's authority under Article I of the Constitution, which provides critical oversight to the executive branch-by pressing the current administration to actually spend the approved funds.

The House included $5 million for Tribally operated physician training programs in its spending bill.

PIH is celebrating a major advocacy win in our campaign to address Tribal health workforce challenges through federal investments in Tribal graduate medical education, recognizing the importance of well-staffed health systems both in the U.S. and globally.

PIH trained and advocated alongside American Indian and Alaska Native residents, medical students, and physicians to build support for this priority among policymakers.

On June 9, the House Appropriations Committee released and advanced a health funding bill for Fiscal Year 2027 that includes $5 million for a new Tribal Track within the Health Resources and Services Administration's Rural Residency Planning and Development (RRPD) grant program.

RRPD has provided critical funding to support the planning and development of new residency programs, leading to the establishment of 66 new physician training programs in underserved areas. If signed into law, this Tribal Track funding will support the creation of new residency programs administered by Tribes or tribal organizations, filling a key gap in the health workforce.

There is a long road ahead before the FY27 appropriations bills are finalized, and we are already planning continued advocacy to secure this funding in the Senate.

At a critical moment for global economic justice, the Champerty Fix Act passed the Senate in New York.

The Champerty Doctrine is a specific part of New York law that states claims such as sovereign debt cannot be purchased solely for the purpose of litigation.

However, in 2004, lobbying by vulture funds-creditors who purchase the debt at cheap rates and sue for full collection, plus interest-created a loophole in the law that allowed any purchase of debt over $500,000 to be excluded from the purview of the law. PIH is working to close that loophole.

With over half of all sovereign debt bonds, or a total of approximately $870 billion, governed by New York state laws, PIH's advocacy team has been pushing for legislation to help countries burdened by unjust and unsustainable debt repayments.

In June 2026, the Champerty Fix Act passed the New York Senate, marking an important milestone in turning the tide for countries crippled by the debt crisis, and generating global attention to the problem of debt restructuring.

Sheila Davis's testimony outlined PIH priorities for global health funding in the FY27 budget.

PIH CEO Sheila Davis submitted testimony to Congress articulating PIH's priorities for the U.S. government's global health funding. As part of the annual appropriations process, during which Congress sets the federal budget, PIH and other organizations were invited to submit public witness testimony outlining their priorities.

Davis's testimony called on Congress not only to increase funding levels for bilateral and multilateral USG global health assistance, but also to conduct oversight to make sure the State Department allocates these funds appropriately. You can read the full testimony here.

Major news outlets add to constituent pressure, bringing issues resulting from foreign aid cuts to the forefront.

Throughout the past year, media coverage has been a critical tool supporting advocacy efforts.

PIH staff have provided background information, stories from our care delivery sites, and critical context for reporting by journalists at the New York Times, ProPublica, NPR, and CNN.

These articles have helped expose actions-and the reality of their consequences-that the executive branch has tried to keep hidden from public view, while also informing members of Congress who have often been deliberately left out of the loop.

Over a year ago, we saved PEPFAR from millions of dollars in cuts. Today, activists, advocates, and celebrities have joined us in continuing to defend its lifesaving programming.

The United States President's Emergency Plan for AIDS Relief, or PEPFAR, was launched in 2003 by the Bush administration to support the global effort to reduce suffering from HIV/AIDS. Since then, the program has saved 26 million lives and prevented millions of HIV infections.

In June 2025, the Trump administration tried to cut significant funding to PEPFAR as part of a larger rescissions package that gutted foreign aid. However, under pressure from constituents and organizations like PIH, Senate Republicans pushed back and demanded the removal of $400 million in proposed cuts to PEPFAR.

Unfortunately, that wasn't the last attempt to dismantle the program. In the past year, the Trump administration has withheld billions of dollars in congressionally approved funding, reducing access to lifesaving HIV treatment and prevention.

With the program's lifesaving legacy and decades of success, politicians on both sides of the aisle, advocates, and even Elton John have joined the fight to protect PEPFAR's future.

Turning Hope into Progress

Recently, a new plan was proposed that would scale back global health work done by the Centers for Disease Control and Prevention (CDC), which, before 2025, managed nearly half of PEPFAR's budget. If implemented, the proposal would effectively dismantle the program and could jeopardize the lives of more than 12 million people who rely on CDC-funded HIV treatment.

Right now, we need optimism to push our community into action.

The window for Congress to act is closing. However, constituent voices can help prevent this plan from moving forward and protect the lives of millions of people who receive care and support through PEPFAR.

You've helped us sustain this program for more than 23 years, and we hope you'll continue standing with us to protect its lifesaving legacy for decades to come.

Contact Congress

Email your Members of Congress now and urge them to ensure that lifesaving programs continue without interruption.

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