HIV Crisis Looms as U.S. Halts PEPFAR Funding—African Experts Demand Urgent Action

A sudden freeze on U.S. global health aid has sent shockwaves through HIV programs worldwide, particularly in Africa, where millions rely on the President’s Emergency Plan for AIDS Relief (PEPFAR) for life-saving treatment.

What is PEPFAR?

PEPFAR is the largest commitment by any nation to address a single disease in history, enabled by strong bipartisan support across ten U.S. congresses and four presidential administrations, and through the American people’s generosity.

Since PEPFAR’s inception in 2003, the U.S. government has invested over $100 billion in the global HIV/AIDS response, saving over 25 million lives, preventing millions of HIV infections, and supporting several countries to achieve HIV epidemic control, all while significantly strengthening global health and economic security.

The Fallout of a 90-Day Funding Pause

On January 20, 2025, the U.S. President issued an Executive Order pausing all foreign aid funding for 90 days, directly affecting PEPFAR. Since its launch in 2004, the program has saved over 26 million lives and provided HIV treatment to more than 20 million people globally.

The African-led HIV Control Working Group (AHCWG) has condemned the decision by, warning of devastating consequences for people living with HIV (PLHIV) and fragile health systems across the continent as a result of this decision.

The abrupt halt, implemented without a contingency plan, has triggered panic among implementing agencies and millions of patients. While a limited waiver was later announced, it does not cover pre-exposure prophylaxis (PrEP), a crucial preventive treatment for high-risk groups such as adolescent girls, young women, men who have sex with men, and sex workers.

A Blow to Decades of Progress

Describing the Executive Order’s impact as “dropping a bombshell”, the AHCWG highlighted how PEPFAR’s funding supports more than just HIV treatment. The program has also helped African health systems respond to COVID-19, Ebola, and the Mpox outbreak. Experts warn that the 90-day uncertainty could erode decades of trust, disrupt medical supply chains, and worsen health inequalities.

The Bigger Lesson: Africa Must Reduce Its Dependency on Foreign Aid

While calling for an immediate reinstatement of funding, the AHCWG also stressed the urgent need for African governments to rethink their dependence on donor-driven health programs.

“This crisis exposes the fragility of Africa’s reliance on foreign funding for critical health services,” the group stated. “Now is the time for bold leadership and domestic investment in health security.”

AHCWG’s Four-Point Call to Action

To address this unfolding crisis, the AHCWG has outlined four urgent measures:

– Immediate reinstatement of all PEPFAR and U.S.-funded HIV programs, ensuring continued access to treatment and prevention services.

– Transparent communication on the future of U.S. funding, so governments and healthcare providers can plan accordingly.

– African governments to take control of their HIV response, defining the resources needed for testing, prevention, care, and treatment, and securing domestic funding to safeguard health services.

– Stronger collaboration between African governments and global stakeholders to build sustainable healthcare systems that are not vulnerable to external policy shifts.

With millions of lives at risk, the AHCWG is calling for immediate action from African leaders and the international community. Whether the U.S. government will reverse course remains uncertain, but one thing is clear—Africa must seize this moment to build a more independent and resilient healthcare system.