For more than two decades, the United States Government has been a steadfast leader in the global HIV response through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, TB and Malaria and through its support to the Joint United Nations Programme on HIV/AIDS (UNAIDS). The importance of the United States contribution to the global AIDS response cannot be overstated. Since its creation in 2003, PEPFAR has saved more than 26 million lives by investing in critical HIV prevention, treatment, care and support programs.
The United States Government has recently issued an immediate pause on U.S. foreign assistance for assessment of programmatic efficiencies and consistency with United States foreign policy. This pause has impacted the programmes and services of millions of people living with and affected by HIV.
This site serves to provide routine and real-time updates to share the latest global and country information, data, guidance, and references related to the impact of the recent U.S. shifts on the global HIV response. We must collectively work together to sustain the life-saving impacts in the HIV response.
Timeline
On 20 January 2025, the U.S. Department of State announced an immediate 90-day funding pause for all foreign assistance, including for funding and services supported by The United States President’s Emergency Plan for AIDS Relief (PEPFAR). The executive order announcing a “90-day pause in United States foreign development assistance for assessment of programmatic efficiencies and consistency with United States foreign policy” was one of the first major foreign policy decisions of the new administration.
On 29 January the U.S. Secretary of State, Marco Rubio, approved an “Emergency Humanitarian Waiver”, which allows people to continue accessing lifesaving HIV treatment funded by the United States of America. This waiver approves the continuation or resumption of “life-saving humanitarian assistance” which applies to essential medicines, medical services including comprehensive HIV treatment, as well as to necessary supplies and costs to facilitate these services. More than 20 million people living with HIV, representing two-thirds of the 30.7 million people living with HIV receiving treatment globally, are directly supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR)—the world’s leading HIV initiative.
The impact of PEPFAR to date
Over the past two decades, PEPFAR has been a leader in the HIV response saving more than 26 million lives and averting almost 5 million children from acquiring HIV.
As of December 2024, the United States Government was supporting more than 20 million people with life-saving antiretroviral treatment, including about 560,000 children (ages 0-14 years).
The PEPFAR program operates in 55 countries, primarily in Africa, providing critical life-saving daily services for people living with HIV. According to PEPFAR’s Human Resources for Health data, there are more than 190,000 full time equivalent clinical and ancillary care providers providing core health care services every day, including: 1,422 doctors; 7,142 clinical officers; 13,577 nurses, auxiliary nurses and nursing assistants; 1,000 midwives; 5,044 phlebotomists and laboratory technicians, 1,881 pharmacists, and more than 108,000 community health workers.
Any sudden pause in US foreign aid for HIV will have an immediate impact on the delivery of life-saving HIV medicines and the provision of HIV prevention services to millions of people who depend on them. If PEPFAR were halted now, there would be an estimated additional 6.3 million AIDS-related deaths, 3.4 million AIDS orphans, 350,000 new HIV infections among children and an additional 8.7 million adult new infections by 2029 – making ending AIDS as a public health threat by 2030 impossible.
