The expiration of the President’s Emergency Plan for AIDS Relief (PEPFAR) one year ago has left the future of US aid for HIV/AIDS programs uncertain. The Reorganizing Government Act 2025, which is the only bill up for discussion on this date with any connection to PEPFAR, aims to extend President Donald Trump’s authority to propose a plan to reorganize the federal government until December 31, 2026.
However, it appears that US aid for HIV/AIDS programs will likely be slashed. A leaked plan by Trump aides outlines three “pillars” for foreign aid: safer, stronger, and more prosperous. The “safer” pillar would cover humanitarian assistance, disaster response, global health, and food security, with a new Agency for International Humanitarian Assistance (IHA) responsible for dispensing aid.
The blueprint emphasizes that US aid should not be philanthropic in nature but rather focused on education, moral suasion, and legal sanctions to combat HIV/AIDS. This approach has been criticized as ineffective, particularly in Africa.
If the 90-day pause on foreign aid programs is extended, it could lead to an additional 6.3 million AIDS-related deaths over the next four years. Research into HIV vaccines, long-acting pre-exposure prophylaxis, and tuberculosis studies have come to a halt due to US funding cuts.
Many experts agree that governments need to take more ownership of their HIV response. A policy proposal calls for countries to achieve 50% co-financing for HIV within five years, with funding shifting to areas where the epidemic is worsening and scaling up HIV prevention through long-acting pre-exposure prophylaxis.
The expiration of PEPFAR has raised concerns about the impact on global efforts to combat HIV/AIDS. With US aid likely to be scaled down, it remains to be seen how effectively countries can respond to this public health crisis.
Source: https://healthpolicy-watch.news/pepfar-reauthorisation-expires-with-no-clear-path-for-renewed-aid