Frontline AIDS welcomes the news that PEPFAR will be spared from US cuts to aid

US lawmakers have stopped plans to cut around US $400 million from PEPFAR, the US government funded effort to prevent and treat HIV, while greenlighting a wider rescission package, which will allow the Trump administration to cut around $9 billion from foreign aid and public broadcasting. The package was meant to allow lawmakers to retroactively approve the unlawful actions of the Department of Government Efficiency (DOGE), which included major cuts to foreign aid spending already approved by Congress, with profound impacts on access to HIV services.

PEPFAR, the largest global health programme in the world initially devoted to a single disease was first authorised in 2003 and has saved an estimated 25 million lives, supported antiretroviral treatment for nearly 20.5 million people and enabled HIV-free outcomes for 5.5 million babies born to mothers living with HIV. UNAIDS warned that discontinuing PEPFAR’s HIV programmes would lead to an additional 4.2 million AIDS-related deaths between 2025 and 2029, and an extra 6.6 million additional new HIV infections.

Despite the good news that PEPFAR funding has been spared, many questions remain around which countries and what types of programmes will be able to access PEPFAR funds going forward, and how these will be dispersed, given that USAID has been closed and the structures previously used to allocate and distribute foreign aid funding have been dramatically reduced. In addition, the PEPFAR funds safeguarded from rescission will now need to be spent before October 2025, and countries may struggle to reopen services, re-hire staff and reconnect with communities within this timeline.

John Plastow, Executive Director at Frontline AIDS says:

For people living with or at risk of HIV across more than 50 countries, PEPFAR has meant the difference between life and death, and its continued financing is a lifeline following months of uncertainty and upheaval. US lawmakers’ courage in protecting this vital funding will save lives.

“While we welcome the news, many questions remain around how the funding will reach people in need, given the current constraints facing PEPFAR,” said Plastow. “Frontline AIDS stands ready to support our partners to ensure these funds reach the people and communities that have lost access to lifesaving HIV treatment and prevention because of the recent cuts, and to work with them to build more sustainable, nationally-led HIV responses that are less vulnerable to changing donor priorities.”

In January 2025 the US government froze all foreign aid spending. While some PEPFAR-funded services, such as the distribution of antiretrovirals and services to prevent the mother to child transmission, were granted a waiver from the freeze, this was followed by the termination of around 80% of US-funded programmes and the closure of USAID. Notices rescinding this termination were then granted for a limited set of services funded by some PEPFAR programmes, but these excluded many HIV prevention programmes, as well as most services targeted at key populations and at adolescent girls and young women, who account for the majority of new HIV infections. Additionally, implementation has been challenging due to a lack of clarity from the US government, and organisational, administrative, and logistic barriers to restarting programs. Around half of Frontline AIDS partners (27 out of 54 global partners) have been impacted by US funding cuts, with some of our partners losing over 95% of their funding.