HA LEJONE, Lesotho (AP) — In the snow-topped mountains of Lesotho, mothers carrying babies on their backs walk for hours to the nearest health clinic, only to find HIV testing isn’t available. Centers catering to the most vulnerable are shutting their doors. Health workers have been laid off in droves. Desperate patients ration or share pills.

This Lesotho was unimaginable months ago, residents, health workers and experts say. The small landlocked nation in southern Africa long had the world’s second-highest rate of HIV infections. But over years, with nearly $1 billion in aid from the United States, Lesotho patched together a health network efficient enough to slow the spread of the epidemic, one of the deadliest in modern history.

Then, on Jan. 20, the first day of U.S. President Donal

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