Cuts to funding for a major U.S. HIV program have resulted in clinic closures, job losses, and significant reductions in assistance for people living with HIV in numerous countries, according to a report released on Tuesday.
The report was prepared by amfAR — The Foundation for AIDS Research. It examines the consequences of disruptions to PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief), launched in 2003, which is estimated to have saved at least 26 million lives.
Last year, the program faced a major setback after the Trump administration eliminated the U.S. Agency for International Development (USAID) and cut thousands of grants in global health. “The disruptions were very widespread,” said Alice Lankiewicz, an associate for policy at amfAR. She noted that programs for young women, orphans, and children were among the most affected.
Researchers surveyed organizations that received PEPFAR funding last year to provide HIV prevention and treatment services. The survey garnered responses from 166 organizations in 46 countries. The report indicates that the study did not encompass all organizations that received funding, and some of the most affected may not have responded. This suggests that the actual scale of the consequences could be larger or, in some cases, smaller than the study results indicate. Most organizations reported losing or facing delays in at least one grant, leading to the closure of over 1,700 clinics and care centers, as well as the loss of over 16,000 full-time jobs.
Impact on Vulnerable Groups and Prevention
The U.S. government was tasked with ensuring continuous HIV treatment, testing, and prevention of mother-to-child transmission. However, most surveyed organizations reported interruptions in these services. The largest cuts impacted programs for populations most affected by HIV, including sex workers, gay and bisexual men, transgender individuals, and people who inject drugs. Most organizations working with these groups reported the complete cessation of at least one service. Some ceased operations even without losing funding, in order to comply with new U.S. policy.
Prevention programs also experienced significant cuts. Many organizations stopped distributing condoms or halted the provision of PrEP — drugs that prevent HIV infection. Funding for prevention decreased by 51% between the 2024 and 2025 fiscal years, according to PEPFAR’s own data.
Local organizations lost funding and were forced to close clinics much more frequently than international ones, the report notes. “Collectively, these results indicate a massive destruction of the infrastructure created to provide assistance to people with HIV worldwide. The greatest harm was done to the very communities and partners who play a key role in curbing the epidemic,” the document states.
Conflicting Data and Calls to Action
The Trump administration, for its part, presented a more optimistic assessment of the program’s status. In April, the State Department reported that PEPFAR provided standard HIV treatment to 20.6 million people in over 50 countries from July to September 2025. This figure remained nearly unchanged compared to the same period a year earlier. At the same time, the number of pregnant and breastfeeding women who started taking PrEP more than doubled — to 103,000.
However, researchers from amfAR and the International AIDS Society combined this data with annual figures and found significant disruptions in almost all areas of PEPFAR’s work. A separate study published in June in the journal Nature Health showed that in the 2025 fiscal year, nearly 2 million fewer people living with HIV received antiretroviral treatment supported by PEPFAR than the previous year, representing a reduction of approximately 10%. “This raises important questions about the stability of the program,” said Ramona Godbole, the author of this study, who did not participate in the preparation of the amfAR report.
The amfAR report urges the U.S. government and PEPFAR leadership to restore support for the full range of HIV prevention and treatment services, not just treatment provision. The document also recommends that other countries increase funding for HIV programs and directly contract with local organizations, including those led by representatives of the most vulnerable communities. Even if funding is restored, returning the system to normal operation will take time, noted Jennifer Sherwood, director of research and public policy at amfAR. According to her, it is essential not only to restore the work of services but also to regain the trust of communities. “Unfortunately, in the fight against HIV, every day without these systems costs human lives. Every day of delay means new infections.”
Source: Africanews
