When Maddie and Emilie made plans for a June 2025 trip to Kenya with their church mission program, they expected that they would volunteer at a school in Mathare, a sprawling settlement in Nairobi where they had worked with kids and distributed food and medicine to people living with HIV during a previous 2023 trip.
But in the weeks before their departure, the two American teens and their mom, Alie, heard from news reports about a deeply concerning development: PEPFAR—the U.S. government program that has shaped the global HIV/AIDS response for more than two decades and has saved an estimated 26 million lives across 50 countries—was under threat, with potentially catastrophic consequences for communities like Mathare.
Maddie and Emilie quickly switched gears, finding out what they could about the role of international support in the fight against humanity’s worst infectious diseases. In the process, they learned that funding cuts could devastate entire communities and regions and make everyone around the globe less safe.
By the time they arrived in Kenya, they had decided to devote their visit to making a documentary film—so they could share stories from Mathare and explain to people back home how transformative community-based health interventions can be. Now they are showing their film to youth groups, schoolchildren, and policymakers and sharing it on YouTube.
We sat down with the sisters and their mom, Alie, to learn about the project.
Q: What did you set out to do on your first visit to Kenya?
Maddie: Our goal was to set up a medical clinic along with members of our team. I was assigned to a medical clinic to hand out medications, while Emilie and our mom participated in home visits, providing food and supporting families in managing their HIV medications.
Q: What did you learn during the home visits?
Emilie: It was powerful to hear the stories of kids my age who were incredible at lacrosse and soccer. Many were also taking on the responsibility of caring for their moms who had HIV. We also visited a day care, and there were so many children in this tiny room—it was clear how difficult it was for many of the moms. I felt a lot of compassion and empathy after hearing their stories and seeing how they were living and dealing with it.
Q: What are the living conditions like for families living in Mathare?
Alie: There’s no access to running water, sanitation, toilets, or cooking instruments. We were shocked by the number of young women and children leading households. When we spoke to the women, we began to understand the many barriers facing them. It was a lot to take in.
Watch the trailer from Emilie and Maddie’s film
Q: What were you hoping to accomplish when you arrived for your second visit?
Alie: We were watching news stories about AIDS medications being cut and wanted to understand if it was affecting the people we met two years earlier. We asked our program director if we could do a project and interview the people in Mathare. Our hope was to share our journey in a way that helped everybody at our church connect with the mission of our trip.
Q: When did you first hear about PEPFAR, and what did you learn about it once you were in Kenya?
Maddie: I hadn’t heard of PEPFAR before our first trip to Kenya, and it was only in the lead-up to our second trip, when I saw it in the news, that I began to understand its significance. Once on the ground, I understood how essential it is to the livelihood of so many—especially women and children. I learned that its impact is immeasurable, as it has truly transformed the landscape of health and opportunity for so many.
Q: Was there something from your trip that helped you connect community-based health interventions to something bigger?
Maddie: Alice, who cooked food for [us during] our trips, showed me what the impact of PEPFAR truly looks like. Alice tested positive for HIV as a young child after being assaulted by a family member. But with her medication, she was able to stabilize her health, start a business and find work. These medications sustained her but also supported her family and community. Seeing her journey made me realize that the impact goes far beyond health itself. When the weight of illness is lifted, people can redirect their energy into new possibilities: building businesses, helping others, spending more time with family, and contributing to the economy. It’s about unlocking human potential once the most basic needs are no longer in question.
Q: What surprised you the most about the people and programs you encountered in Kenya?
Maddie: What surprised me most was how unaware many people were that the medication they relied on could suddenly be taken away. There were no backup plans. This uncertainty was compounded by the stigma surrounding treatment, which made the situation even more fragile and isolating for those affected.
Q: How did it feel to realize that a program like PEPFAR was quietly behind so much of the work you did and saw?
Maddie: It truly surprised me. I had never stopped to question where the funding for this work came from or how it all operated behind the scenes. Realizing that PEPFAR was the driving force and seeing how intricately and efficiently the program functions was utterly astounding. It showed me how global health programs like PEPFAR can have such an enormous and life-changing effect.
Q: What would you like people to know about global health programs in general?
Maddie: People should know just how many lives programs like PEPFAR have transformed, and that the impact goes beyond individual health. Not only does it save and improve lives, it also strengthens global partnerships, supports economic development, and builds long-term stability. All of this is possible only through continued investment in global health programs like PEPFAR.
PEPFAR—the U.S. President’s Emergency Plan for AIDS Relief—was created by President George W. Bush and a bipartisan Congress in 2003. It is widely considered to be one of the most successful global health programs in history. As of September 2025, its future funding remains uncertain.
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