J ames Akot has three goats. He shares them with his wife, his mother, three younger siblings, and two of his cousin's children, in a household in Northern Bahr el Ghazal in South Sudan. The crops Akot's family planted were washed away in the floods last year, the fourth and worst flood in the region in four consecutive years.

Even those PEPFAR programs operating must limit distribution of preventive medication, according to apparent State Department guidance.

Trump administration appointees and allies of Elon Musk wanted to use the Treasury’s sensitive payment system to block disbursements.