PEPFAR, introduced in 2003, has saved over 26 million lives by providing antiretroviral medication (ARVs) to people living with HIV, particularly in sub-Saharan Africa. However, the Trump administrationâs 90-day pause on foreign aid has led to clinic closures and job losses for thousands of health workers, restricting access to testing and treatment.
âPeople around me had written me off when I was diagnosed, but I bounced back stronger,â Makumene said. âNow, we are like orphans, with no one to turn to.â
Clinics Close, Health Systems Struggle
Across Africa, the effects of the funding halt have been severe. In Kenya, 40,000 health workers face layoffs, while in Lesotho, 1,500 have already been dismissed. South Africa, home to the worldâs largest HIV-positive population, relies on PEPFAR for 15,000 specialist health workers. Their absence threatens to dismantle critical healthcare infrastructure, leaving patients without support.
âPeople are finding doors closed. They are desperate,â said Simon Bwanya of the Zimbabwe National Network of People Living with HIV.
A U.S. federal judge has ordered the administration to lift the funding freeze, rejecting claims that waivers were in place to keep aid flowing. However, implementation remains uncertain. Health activists also criticized the waivers for limiting access to PrEP, a preventive HIV medication, for high-risk groups like gay men and sex workers.
A Looming Health Crisis
Experts warn that the aid freeze could reverse decades of progress in the fight against HIV. Globally, AIDS-related deaths have dropped by 69% since 2004, largely due to programs like PEPFAR. Without continued support, HIV patients may be forced to stop treatment, leading to drug-resistant strains and an increase in infections.
âThe fight against HIV is not over yet,â said Dr. Kebby Musokotwane, director general of Zambiaâs National AIDS Council. âWe have come too far to let this progress unravel.â
