The Donald Trump administration has halted almost all global health funding from the US, including the President's Emergency Plan for AIDS Relief (PEPFAR), which provides HIV/AIDS medications to millions of people. According to the World Health Organisation, PEPFAR has been a flagship initiative of the global HIV response since its establishment over 20 years ago. The organisation has already issued a statement expressing deep concern about the implications of the immediate funding pause for HIV programmes in low- and middle-income countries.
“A funding halt for HIV programmes can put people living with HIV at immediate increased risk of illness and death and undermine efforts to prevent transmission in communities and countries. Such measures, if prolonged, could lead to rises in new infections and deaths, reversing decades of progress and potentially taking the world back to the 1980s and 1990s when millions died of HIV every year globally, including many in the United States of America,” says the WHO statement.
What is PEPFAR?
Launched in 2003 by president George W Bush, PEPFAR represents the largest commitment by any nation to address a single disease in history. So far, $110 billion has been allocated under this programme for HIV/AIDS treatment, prevention, and research efforts across more than 50 countries, primarily in sub-Saharan Africa.
WHO expresses deep concern about the implications of the immediate funding pause for #HIV programmes in low- and middle-income countries.
— World Health Organization (WHO) (@WHO) January 28, 2025
These programmes provide access to life-saving HIV therapy to more than 30 million people worldwide.
A funding halt for HIV programmes can… pic.twitter.com/uY7KzKq5Ql
PEPFAR has been enabled by strong bipartisan support across 10 US congresses and four presidential administrations since its inception. But now Trump administration is changing that status quo. So far, this has been projected as a programme that exemplified "what is possible through compassionate, cost-effective, accountable, and transparent American foreign assistance”.
Since PEPFAR’s inception, the US government has invested over $100 billion in the global HIV/AIDS response. According to WHO, this the programme provide access to life-saving HIV therapy to more than 30 million people worldwide. Globally, 39.9 million people were living with HIV at the end of 2023.
Managed and overseen by the US Department of State's Bureau of Global Health Security and Diplomacy, the PEPFAR has been closely working with partner countries toward achieving HIV/AIDS epidemic control while promoting the long-term sustainability of their responses.
Notably, on December 1, 2022, PEPFAR announced a five-year strategy: 'Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030'. This Strategy, which centred on collaboration and partnership to confront the challenge of HIV/AIDS in the wake of other emerging health threats, is now in question as Trump administration has put the programme’s future in limbo.
“Over the past year, PEPFAR and partners, including WHO, have been working on sustainability plans with countries for greater country ownership and reduced donor support up to and beyond 2030. A sudden and prolonged stop to programmes does not allow for a managed transition and puts the lives of millions at risk,” says the WHO.
Risk for world; risk for America
Notably, while speaking about the halt on foreign aid programmes, US Secretary of State Marco Rubio has said, “Every dollar we spend, every program we fund, and every policy we pursue must be justified with the answer to three simple questions: Does it make America safer? Does it make America stronger? Does it make America more prosperous?”
After President Donald Trump’s executive order to halt and reevaluate all foreign development assistance prompted an outcry among aid groups around the world, US Secretary of State Marco Rubio has now approved some waivers for emergency food aid and some salaries. However, there is no update so far on programmes like PEPFAR.
But the administration has already declared that it is working according to President Trump's mindset: “The United States is no longer going to blindly dole out money with no return for the American people.”
However, organisations like WHO condemn this mentality and point out that these actions will finally impact the US itself.
“A funding halt for HIV programmes can put people living with HIV at immediate increased risk of illness and death and undermine efforts to prevent transmission in communities and countries. Such measures, if prolonged, could lead to rises in new infections and deaths, reversing decades of progress and potentially taking the world back to the 1980s and 1990s when millions died of HIV every year globally, including many in the United States of America,” reads the WHO statement.
