Trump's elimination of funding for HIV prevention worldwide: its repercussions and consequences
In a move that has raised concerns among global health experts, the Trump administration's proposed cuts to foreign aid have put at risk critical HIV prevention and treatment services worldwide, particularly in sub-Saharan Africa.
The largest global HIV/AIDS initiative funded by the US government, PEPFAR (President's Emergency Plan for AIDS Relief), has been the most specific program affected by these cuts. Initially, the administration proposed a $400 million cut to PEPFAR, which would have been about a 30% reduction in its funding. This proposal, if implemented, could have had dire consequences for HIV prevention, treatment, and care services worldwide.
The cuts have disrupted USAID-supported HIV programs as well. On January 24, 2025, USAID grant holders were ordered to stop work abruptly, resulting in layoffs of thousands of HIV testing counselors and clinic staff. This caused immediate declines in HIV testing, diagnosis, and treatment initiation in countries relying heavily on USAID, such as Mozambique and South Africa.
The cuts also disrupted HIV drug supply chains funded by USAID, leading to medications being stranded in warehouses instead of reaching patients.
However, a limited waiver in February permitted "life-saving" treatment services funded by PEPFAR to resume, but pre-exposure prophylaxis (PrEP) medicine remains curtailed for most people. This could potentially risk continued spread of HIV, particularly among high-risk populations like gay and bisexual men, sex workers, trans people, people who inject drugs, and incarcerated people, who have lost access to PEPFAR-funded HIV prevention in the past six months.
Since its launch in 2003, PEPFAR has invested over $110 billion, provided 64 million HIV tests, and saved 25 million lives in 55 countries, according to the State Department. In east and southern Africa, the United States had been funding nearly 45% of HIV/AIDS prevention programs. Countries like Malawi, Zimbabwe, and Mozambique have almost entirely relied on PEPFAR for their prevention efforts, according to UNAIDS.
Experts fear that cutting prevention efforts could undermine decades of progress in the fight against HIV/AIDS. The number of new HIV infections in 2021 was 1.3 million, according to UNAIDS. By the end of 2024, infections had fallen by 40% and AIDS-related deaths by more than half compared to 2010 levels.
It's important from an epidemiological perspective to stop infections and prevent spread among those most at risk. The Thomson Reuters Foundation, focusing on humanitarian news, climate change, resilience, women's rights, trafficking, and property rights, published this story to highlight the potential impacts of these cuts.
In summary, the two key HIV-related foreign aid programs affected by Trump’s cuts were PEPFAR and USAID-funded HIV programs. The proposed $400 million cut to PEPFAR risked prevention, treatment, and care services, while the funding freeze on USAID-funded HIV programs led to halted activities, staff layoffs, reduced testing and treatment initiation, and supply chain interruptions. These cuts could potentially slow HIV testing and treatment efforts, threatening to reverse gains made over many years in controlling the epidemic.
[1] https://www.pepfar.gov/ [2] https://www.unicef.org/ [3] https://www.state.gov/ [4] https://www.kff.org/ [5] https://www.unaids.org/en/home
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- Sadly, the Trump administration's proposed cuts to foreign aid have put at risk critical HIV prevention and treatment services worldwide, particularly in sub-Saharan Africa.
- The United Nations Children's Fund (UNICEF) has expressed concerns over these cuts, which could have severe repercussions for global health.
- The largest global HIV/AIDS initiative funded by the US government, PEPFAR, has been hit hard by these cuts, facing a proposed $400 million reduction in funding.
- This reduction, if implemented, could have dire consequences for HIV prevention, treatment, and care services worldwide.
- Experts fear that cutting prevention efforts could undermine decades of progress in the fight against HIV/AIDS, as demonstrated by the increasing HIV infections in 2021.
- In East and Southern Africa, the United States had been funding nearly 45% of HIV/AIDS prevention programs, and countries like Malawi, Zimbabwe, and Mozambique have nearly entirely relied on PEPFAR for their prevention efforts.
- The cuts have disrupted USAID-supported HIV programs as well, leading to layoffs of thousands of HIV testing counselors and clinic staff.
- This resulted in immediate declines in HIV testing, diagnosis, and treatment initiation in countries relying heavily on USAID.
- The cuts also disrupted HIV drug supply chains funded by USAID, leading to medications being stranded in warehouses instead of reaching patients.
- In 2025, a limited waiver permitted "life-saving" treatment services funded by PEPFAR to resume, but pre-exposure prophylaxis (PrEP) medicine remains curtailed for most people.
- This could potentially risk continued spread of HIV, particularly among high-risk populations like gay and bisexual men, sex workers, trans people, people who inject drugs, and incarcerated people.
- Since its launch in 2003, PEPFAR has invested over $110 billion, provided 64 million HIV tests, and saved 25 million lives in 55 countries.
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- The Thomson Reuters Foundation has published stories focusing on the potential impacts of these cuts, highlighting the importance of continued funding for these essential programs.
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