By Bunmi Yekini
The temporary freeze of the US government’s funding to the President’s Emergency Plan for AIDS Relief (PEPFAR) is already having dire consequences for people living with HIV (PLHIV) worldwide, according to Doctors Without Borders/Médecins Sans Frontières (MSF). Despite some clarifications allowing limited HIV treatment programs to continue until April, key elements of the program remain stalled, putting millions at risk.
“More than three weeks since the US government froze PEPFAR funding, there is still widespread confusion and uncertainty as to whether this critical lifeline for millions of people has been cut off,” said Avril Benoît, chief executive officer of MSF USA.
“Despite a limited waiver covering some activities, what our teams are seeing in many of the countries where we work is that people have already lost access to lifesaving care and have no idea whether or when their treatment will continue.”
In Sub-Saharan Africa, where PEPFAR has been a cornerstone of HIV prevention and treatment for decades, the freeze is already taking a toll. In South Africa, HIV clinics funded by PEPFAR have shut down, leaving thousands without access to testing, treatment, and pre-exposure prophylaxis (PrEP).
Mozambique has seen a major HIV organization halt operations, while in Zimbabwe, disruptions to the DREAMS program have left adolescent girls and young women particularly vulnerable.
“Any interruption to HIV services and treatment is deeply distressing to people in care and an emergency when it comes to HIV treatment,” said Tom Ellman, director of the South Africa Medical Unit at MSF Southern Africa. “HIV medicines must be taken daily or people run the risk of developing resistance or deadly health complications.”
The impact is also being felt in the Democratic Republic of Congo (DRC), where community-run distribution centers, known as PODIs, have been forced to close. These centers provided free antiretroviral medication and peer support, particularly crucial in a country where stigma and poverty already hinder access to care. “Thousands of people were left without support and with a high risk of developing advanced HIV,” MSF reported.
The consequences of the funding freeze extend beyond HIV treatment. In Uganda, PEPFAR-supported infectious disease surveillance and response programs, including efforts against Ebola, have been halted. In South Sudan, where just 47% of people living with HIV are on treatment, the potential discontinuation of PEPFAR funding threatens to set back progress significantly.
“These disruptions will cost lives and upend years of progress against this virus,” warned Benoît. “Every day that passes is an emergency for millions of people for whom PEPFAR is a lifeline.”
MSF has called on the US government to fully reinstate PEPFAR funding, warning that even temporary interruptions could result in severe setbacks in the global fight against HIV/AIDS. The organization highlighted that over the past 20 years, PEPFAR has helped save more than 25 million lives and played a crucial role in strengthening health systems in partner countries.
“When MSF first started treating people with HIV/AIDS in South Africa 25 years ago, there were no ARV medicines on the shelves, every diagnosis felt like a death sentence, and communities were desperately trying to curb the virus’ spread,” said Ellman.
“PEPFAR has changed that, but only if it continues.”
Benoît emphasized the urgency of the situation, stating: “We urge the US government to immediately resume all funding of critical humanitarian and health aid, including the full range of PEPFAR operations.”
The US has yet to clarify when or if full funding will be restored. Meanwhile, millions of people across the globe remain in limbo, waiting for a program that has, for many, been the difference between life and death.