By Bunmi Yekini
The African-led HIV Control Working Group (AHCWG) has condemned a 90-day pause on foreign aid ordered by U.S. President Joe Biden, warning that the suspension of the President’s Emergency Plan for AIDS Relief (PEPFAR) could endanger millions of lives across Africa.
The Executive Order, which halts all U.S. foreign aid funding pending review, was applied immediately to PEPFAR, a landmark global health initiative that has saved more than 26 million lives since its launch in 2004 and provides treatment for over 20 million people living with HIV worldwide.
“Halting funding to such a successful public health programme without notice risks the lives of millions of people,” the AHCWG said in a statement. “The decision overlooks the interconnectedness of our global community, where solidarity is essential to reduce the global disease burden.”
The group described the move as “dropping a bombshell,” saying it had “destroyed decades of trust and security among people living with HIV (PLHIV)” and left fragile health systems, which also supported responses to COVID-19, Ebola, and Mpox, on the brink.
While a limited waiver has been issued to allow some PEPFAR-funded services to continue, the AHCWG said it had done “little to quell the anxiety” among stakeholders and criticised its exclusion of pre-exposure prophylaxis (PrEP) for high-risk populations such as adolescent girls, young women, men who have sex with men, and sex workers.
“The 90-day limbo for the future of HIV care and treatment programs is intolerable, with long-lasting consequences,” the group added.
AHCWG, a coalition of African HIV and policy experts, urged the United States to “immediately and fully reinstate all PEPFAR and other U.S. government-funded programmes that provide life-saving HIV services globally.”
The group also called for clear communication on the future of HIV funding after the policy review and urged African governments to use the crisis as a wake-up call to build more sustainable, self-reliant health systems.
“This also demonstrates the inherent risks of African countries’ over-reliance on donor support for HIV programs,” AHCWG said. “Now is the time for African leaders to look inward for domestic solutions and funding.”
It called for “strategic collaboration between global stakeholders and African governments committed to building the necessary capacity for Africa’s health care independence.”
PEPFAR, launched under former U.S. President George W. Bush, has long been regarded as one of the most effective U.S. foreign aid programs, credited with turning the tide of the HIV/AIDS epidemic in sub-Saharan Africa. The new funding freeze, advocates warn, could unravel those gains in just weeks.