Paul Manyamba

Paul Manyamba has a plan to save the National Association for People Living with HIV and AIDS in Malawi. It means, at age 58 and after a lifetime spent advocating for better HIV services, embarking on an entirely new career.

Manyamba is working at becoming an entrepreneur.

His organization, NAPHAM, was founded in 1993 as a support group for people living with HIV. In the decades since, it has grown into a national institution, its members skilled at helping people get tested for HIV and allaying any concerns they have about staying on treatment.

We don’t have enough workers at the health facility. There are very few. So we train our members to be at the health facility, at least to assist in the service delivery, to assist in the counseling.

That work was vital and it depended almost entirely on support from the U.S. President’s Emergency Plan for AIDS Relief. In February, the Trump administration abruptly revoked nearly $2 million in support that had been guaranteed through 2026.

They say it is not in line with the policy of the new government in the USA. I think there were some issues they were not happy with. The issue of gender and the like.

As part of its work, NAPHAM trained counselors to look for signs of gender-based violence. An evil on its own, this violence often foreshadows HIV transmission.

The Trump administration, with its kneejerk antagonism toward anything linked to gender, repudiated even these attempts to offer protection. Then, for good measure, it tore down the rest of NAPHAM’s work.

Manyamba stopped drawing a salary. He laid off seven of NAPHAM’s 10 employees. He left the support groups to wither. He had no choice.

He also began to take stock of the resources NAPHAM still had: a small fleet of vehicles and some properties it had collected over the years. Within weeks of being abandoned by the Trump administration, he was cobbling together a business plan for a small car and home rental business.

What we want is to establish a branch to do some sort of business, not business as it is, but where we can get some funds to implement our activities.

After years of writing grant proposals, primarily to U.S. government agencies, drafting the business plan does not feel unfamiliar. He has some hesitation about what will happen if he succeeds, though, and must actually start operating a business. It is not what he is trained to do. It might also keep him away from the work of running NAPHAM.

But he can’t think of any other way to rescue the organization. In the five months since NAPHAM lost its U.S. support, there has been no intervention from another donor or from the Malawian government.

We are very much relying on donor funding. I think it’s time now that we need to work on our own, get funding, and then implement our activities.

He has given himself a year. If the business is not established by April 2026, he is not sure he – or NAPHAM – will be able to continue. Already he is worried about what will happen in the year that will be lost to building the business.

We were doing good in Malawi, where the new infections were dropping, and the issue of prevalence, and the issues of spread was going down. But now with this, where our activities are being reduced at community level, our worry is that we may have a rise of new infections in our communities. They will be going up. We may have defaulters. So many defaulters. As a result, we may lose some of the members, because they are not adhering on treatment.