The PEPFAR program, launched in 2003 by President George W. Bush to combat the HIV/AIDS epidemic, has been severely gutted under the Trump administration. The program, which has saved millions of lives for relatively little money, is now facing an estimated death toll of 70,000 people due to cutbacks.
PEPFAR was created after game-changing antiretroviral therapy became available in the 1990s, allowing HIV patients to live normal lifespans. However, the treatment was unaffordable for most people living with HIV worldwide. The program’s success lies in its rigorous monitoring and evaluation, which has led to significant reductions in AIDS-related deaths.
Since its inception, PEPFAR has spent over $120 billion and saved an estimated 26 million lives. Despite efforts to phase down American assistance around 2030, Republican lawmakers have instead imposed drastic cuts, effectively halting the program’s progress.
Critics argue that the US is not absorbing enough of the debt burden in Africa, with estimates suggesting that African countries can fund their own HIV/AIDS treatment and prevention efforts themselves. However, abandoning PEPFAR would have far-reaching consequences, including increased military conflicts and social instability.
Researchers estimate that 70,000 people have already died due to the suspension of PEPFAR-funded services. The program’s effectiveness has been marred by controversy over abstinence promotion and leadership in Washington pushing too hard for efficiency metrics. Despite this, experts agree that PEPFAR was an extremely well-run program that deserves support.
As the situation continues to deteriorate, the world watches with concern as millions of lives hang in the balance.
Source: https://www.npr.org/2025/06/27/nx-s1-5443943/cuts-under-the-trump-administration-have-gutted-the-pepfar-program