Trump's HIV funding cuts have led to severe and devastating disruption worldwide, according to a new report presented at the 26th International Aids Conference. The President's Emergency Plan for Aids Relief (Pepfar) has seen thousands of staff laid off and many clinics closed, despite administration promises to protect life-saving care.
The Scope of Pepfar Cuts Under Trump
No part of the US anti-HIV program has escaped unscathed. More than half of Pepfar grants were managed via USAID, the agency dissolved by Trump in July 2025. A February 2025 waiver intended to protect life-saving treatment and mother-to-child transmission prevention failed to prevent widespread disruption. Researchers from Amfar's Pepfar Pulse report found that organizations still receiving funding are altering their services to comply with Trump's policies on DEI, reproductive rights, and gender-affirming care.
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Key Findings from the Pepfar Pulse Report
- 26 million lives saved since Pepfar's inception in 2003 are now at risk.
- Thousands of partner organization staff have been laid off.
- Clinics across Africa, Asia, and Latin America have closed.
- Prevention services—including condom distribution and PrEP—have been sharply reduced.
- Treatment interruptions threaten drug resistance and viral rebound.
Comparison: Pepfar Funding Before vs. After Trump Cuts
| Metric | Pre-2025 (Annual Average) | Post-2025 (Current) |
|---|---|---|
| Countries supported | 55 | 32 |
| People on antiretroviral therapy | 20 million | 12 million (estimated) |
| HIV testing events | 80 million | 35 million |
| Community health workers employed | 300,000 | 60,000 |
Global Health Experts Sound the Alarm
Elise Lankiewicz, co-lead author of the report, stated: “Disruption was incredibly widespread. No part of the programme really escaped unscathed – and that includes areas of the programme that this administration intended to protect.” The abrupt withdrawal of funding has forced many organizations to pivot to narrower, politically acceptable services, leaving millions without access to comprehensive HIV care.
What This Means for the Fight Against AIDS
The report warns that changes in US policy risk reversing decades of progress. PEPFAR has been credited with saving more than 26 million lives and fundamentally changing the trajectory of the global HIV epidemic. Without restored funding, new infections could spike and deaths could rise sharply in vulnerable communities.
Organizations are now calling on international donors to fill the gap, but no single funder can replace the scale of US support. The future of HIV prevention, testing, and treatment hangs in the balance as the world watches.
FAQ
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