Immediate Risks and Disruptions

• The freeze has exacerbated chronic supply chain challenges, leading to more prominent condom stock-outs.
• Staff Terminations: Some US Government implementing partners have issued termination letters to staff due to cash flow challenges caused by the funding freeze.
• Service Disruptions: HIV prevention programs, especially those targeting key populations, have been disrupted. 

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Immediate Risks and Disruptions

• The freeze has exacerbated chronic supply chain challenges, leading to more prominent condom stock-outs.
• Staff Terminations: Some US Government implementing partners have issued termination letters to staff due to cash flow challenges caused by the funding freeze.
• Service Disruptions: HIV prevention programs, especially those targeting key populations, have been disrupted.
• Compromised Surveillance: Data collection continues but with compromised quality control and collation.

Politically Relevant Updates

• Government Response: A formal statement has not been issued. There is no country-level task team to discuss the impact of the US funding freeze.
• Regional AIDS Coordinating Committees (RACOC): These multisectoral committees - comprising community service organizations (CSOs), government ministries, local authorities, and regional leaders from all 14 regions of the country - held a seminar to discuss the decentralized HIV response. Suggested resolutions included enhancing HIV prevention and operationalizing the sustainability roadmap through social contracting and other modalities.
• Given the latest decisions made by the US Government, the Ministry of Health and Social Services has called an urgent meeting of the Sustainability Planning Steering Committee and stakeholders for Friday 07 March 2025, to discuss the operationalization of the Namibia Sustainability Roadmap for HIV, TB, Malaria and Viral Hepatitis. 

Civil Society Impact and Response

• Cash Flow Issues for Community Partners: Despite the US Government’s waiver allowing some lifesaving services to be continued during the freeze, funds for these activities have not been transferred to implementing partners, leading to staff terminations due to cash flow issues.
• Hybrid Meeting: A meeting between CSOs, the Ministry of Health and Social Services (MoHSS), and UNAIDS discussed the implications of the recent freeze of US funding. Participants called for increased networking and collaboration among community leaders and agreed on actionable steps to mitigate adverse effects.
• Namibian Sex Workers Alliance (NAMSWA): The Namibian Sex Workers Alliance convened the African Sex Workers' Alliance (ASWA) to discuss the impact of the reinstatement of the US’ Protecting Life in Global Health Assistance Policy and the implications of the funding freeze.

As of February 2025, the HIV programmes in Ukraine are facing several challenges and risks:

• Potential Stockouts of Antiretroviral Therapy (ART): There are 118,444 Ukrainian people living with HIV (PLHIV) in government-controlled areas receiving ART, with 93,893 (79%) on a TLD (tenofovir disoproxil, lamivudine and dolutegravir)-based regimen. The current TLD stock covers 5.2 months, varying by region. The 28 February Procurement and Supply Management (PSM) working group meeting, hosted by Public Health Centre, highlighted risks to TLD stocks; stockouts pose a direct threat to the continuity of HIV treatment program. The delivery of TLD drugs in the amount of 168,397 packs (15,155,730 tablets), purchased with PEPFAR project funds under COP 23, is on its way from India to Poland. However, there is a potential issue regarding the route from Poland to Ukraine.

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As of February 2025, the HIV programmes in Ukraine are facing several challenges and risks:

• Potential Stockouts of Antiretroviral Therapy (ART): There are 118,444 Ukrainian people living with HIV (PLHIV) in government-controlled areas receiving ART, with 93,893 (79%) on a TLD (tenofovir disoproxil, lamivudine and dolutegravir)-based regimen. The current TLD stock covers 5.2 months, varying by region. The 28 February Procurement and Supply Management (PSM) working group meeting, hosted by Public Health Centre, highlighted risks to TLD stocks; stockouts pose a direct threat to the continuity of HIV treatment program. The delivery of TLD drugs in the amount of 168,397 packs (15,155,730 tablets), purchased with PEPFAR project funds under COP 23, is on its way from India to Poland. However, there is a potential issue regarding the route from Poland to Ukraine.

• Logistics Issues for Delivery of ART: A PEPFAR-funded batch of TLD was manufactured and handed over to the freight forwarder, Logenics, before the U.S. government suspended aid programs. The shipment is en route to Poland, but Logenics has not received confirmation from Chemonics regarding coverage of logistics costs from Poland to Ukraine. Civil society organization 100% Life is negotiating with a donor to fund transport from the Polish border.

• Pre-exposure Prophylaxis (PrEP): The stock for TDF/FTC for PrEP is sufficient for at least six months, but this also varies by region (2–10+ months). PrEP expansion remains severely constrained. The CAB-LA PrEP pilot remains unchanged. Available stock will sustain the pilot until April 2026, but there are no plans for expansion.
• Funding Gaps: There is a funding gap of USD 1.9 million for procuring 30,000 three-month ART courses needed to sustain treatment through 2025. Ukraine’s Public Health Centre may request a state budget reallocation to close the USD 1.9 million funding gap for ART procurement, though prospects remain uncertain.

Despite ongoing challenges, Ukraine remains committed to the HIV response, supported by a strong coalition including members of Ukraine’s government, civil society, international organizations and donors. UNAIDS, including its Co-sponsors, other UN agencies and UN Member States continue working together to ensure essential services for people living with, and at risk for HIV, including women and key populations.