Within moments of reassuming the office of US President, Donald Trump began to sign a slew of executive orders that have plunged health care in the USA, global health programmes worldwide, and health research into uncertainty and chaos. The orders touch many facets of health and science, and HIV has been hit particularly hard, with stop-work orders stalling activities of the President’s Emergency Plan for AIDS Relief (PEPFAR) and diktats issued to the Centers for Disease Control and Prevention (CDC) and National Institutes of Heatlh (NIH) to curtail research into key populations.