PEPFAR’s Dr. mike Reid Resigns on Substack: Equity, Authoritarianism, & the Future of Global Health

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: https://reimaginingglobalhealth.substack.com/p/stepping-away Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health.