A Shot in the Arm Podcast

This is the first episode of AIDS 2060, a special multimedia mini-series of podcasts and Substack articles devoted to understanding what is needed to bring the HIV epidemic under control, how long that will take, and why the world has been unable to do so to date, notwithstanding overly ambitious public commitments that questionably are not rooted in science and hide the real threat HIV poses, even today.

We are in San Francisco, one of the first epicenters of the epidemic, and meet the City’s Community Health Center which is on the frontline of providing comprehensive care and prevention services to the hardest to reach populations, people of color, the trans community, people who inject drugs, the homeless and people with mental health issues. Ending the HIV epidemic will not be achieved, let alone by an arbitrary date like 2060, unless human rights and evidence-based programs reach and are used by these people. Does a progressive city like San Francisco have the political will to do what the science tells us works?

Host Ben Plumley is joined by Lance Toma (CEO), Dan O’Neill (Chief Medical Officer), and Dr. Tatyana Moaton (Chief Strategy & Workforce Officer).

00:00 Welcome to AIDS 2060

00:38 Why the Response Stalled

02:05 Picking 2060 as the Lens

03:01 San Francisco Frontlines

03:39 Targets and Reality Check

04:16 Meet the Health Center Team

05:35 Will AIDS 2030 Happen

07:46 Local Progress and Setbacks

10:52 Who the Clinic Serves

14:12 Trans Communities as Canary

18:15 Surveillance Data Under Attack

22:15 Leading Through Funding Chaos

26:53 Long Acting Injectables in Practice

28:47 Prep Access Gaps and Equity

30:14 Street Medicine and Viral Suppression

32:50 Worrying About Innovation Stalls

33:16 HIV Pipeline Reality Check

33:54 Long Acting Drug Revolution

35:10 New Classes And Regimen Design

36:02 Once Yearly Prevention Vision

37:09 Equity Over Innovation

37:52 Whole Person Care Infrastructure

40:31 Radical Roots And Community Power

42:58 Hard Reboot In Crisis

46:25 Coalitions Beyond HIV

49:43 Data Visibility And Erasure

53:55 Global Community Connections

55:32 2060 Hopes And Closing

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.

Investigative journalist and public health expert Emily Bass returns to A Shot In The Arm with the most consequential update on the global HIV response in months. Drawing on a brand-new report from Physicians for Human Rights and South African partners — built from 40 oral histories — Emily walks Ben Plumley through the human cost of the Trump administration’s foreign aid disruptions, the staggering waste of dismantled prevention infrastructure, and the bizarre data spin emerging from the State Department.

The episode also covers Dr. mike Reed’s headline-making resignation as PEPFAR’s Chief Scientific Officer, the dangerous quiet around supply chain contracts and bed-net procurement, and what the new “America First Global Health Strategy” is choosing to celebrate — and choosing to obscure. Ben closes with a preview of two new initiatives: AIDS 2060, a long-horizon project from A Shot In The Arm Media, and the rebrand of MTV Staying Alive Foundation to Shuga Global.

00:00 Welcome and Setup

01:18 Global Health Upheaval

03:13 PEPFAR Data Spin

04:07 South Africa Report

05:51 Prevention Platform Collapse

09:27 Clinic Breakdown Story

12:52 Why 18 Percent Matters

16:33 Community Resilience

19:22 Research Partnerships Lost

22:12 Treatment Disruptions

25:26 Trauma to Transition

31:11 Data Blackout Returns

39:07 Prep Data Mirage

42:08 Kids Treatment Declines

44:55 Age Data Removed

47:02 Congress Pushback

52:02 Supply Chain Breakdown

59:38 Last Mile Disaster Story

01:02:16 Orderly Transition Demands

01:06:23 AIDS 2060 Vision

01:10:35 Sugar Global Storytelling

01:15:20 Africa Led Future

01:20:42 Closing Thanks

Read Emily Bass’ Substack:

https://substack.com/@emilysbass

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.

What the hell has gone wrong with the global HIV and AIDS response? Does it matter? And what do we need to do to fix it?

Ben Plumley introduces AIDS 2060, a new project from A Shot In The Arm Media asking the questions the global health community has been quietly dodging for a decade. With 40.8 million people living with HIV, 1.3 million new infections every year, and the US sending the world into "septic shock" with sudden cuts to PEPFAR, the scale of the real challenge ahead is finally coming into focus.

Over the coming months, we'll travel the world to gather insights from scientific, political, and community leaders — starting with an initial AIDS 2060 episode focused on San Francisco’s evolving epidemic and long-term plans. Look out for that episode dropping soon!

00:00 Welcome and Big Question

00:30 Why HIV Still Matters

00:57 Funding Shock and False Optimism

01:42 Introducing AIDS 2060

02:05 Looking Ahead to Future Conferences

02:19 World Tour and First Episode

02:42 Subscribe and Closing Thanks

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.

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.

Ben discusses living with stage IV colorectal cancer, noting fluctuating wellbeing and chemotherapy side effects including pain, nausea, fatigue, itchy skin, brittle nails, and poor appetite. He mentions infusion logistics, new pains and temperature swings, as well as anxiety about his PET scan. He observes minor changes in tumor and thyroid SUV values and plans to review these with his oncologist. Ben recommends Colontown for peer support and acknowledges recent losses in his community.

00:00 Welcome and Gratitude

00:46 Up and Down Health

02:02 Too Much to Say

03:31 Humor and Sports Talk

06:14 Time Travel Thoughts

08:21 Facing Death and Grief

09:34 Chemo Routine Update

12:33 PET Scan Anxiety

14:23 Mystery Pains and Symptoms

18:45 Planning Life Anyway

22:27 Travel Dreams and Politics

26:04 Reading PET Results Early

29:16 Wrap Up and Colontown

29:31 Final Reflections on Loss

Visit Colontown!

https://colontown.org

Join the Conversation!

If you or someone you know is living with cancer, share your experiences and thoughts in the comments!

Check Out Ben’s Substack:

https://substack.com/@benplumley1

Subscribe & Stay Updated:

Listen on Spotify, Apple Podcasts, or your favorite podcast platform.

Watch on YouTube & subscribe for more in-depth global health.