Malik Waqar
The United Nations AIDS agency (UNAIDS) has warned that more than six million people could die from HIV and AIDS in the next four years if the U.S. halts its global funding for HIV prevention and treatment programs.
Although the U.S. government issued a waiver allowing continued funding for life-saving HIV/AIDS treatment under the President’s Emergency Plan for AIDS Relief (PEPFAR), confusion and disruption persist, particularly at the community level, UNAIDS Deputy Executive Director Christine Stegling said in Geneva on Friday.
Uncertainty and disruption in HIV services
Stegling highlighted that the waiver does not fully address the impact of the broader U.S. foreign aid funding freeze. “There is a lot of confusion, especially at the community level, about how the waiver will be implemented. We are seeing significant disruptions in the delivery of treatment services,” she said.
In January, U.S. President Donald Trump placed hundreds of millions of dollars in foreign aid donations on hold for 90 days as part of a broader review of spending. While the waiver allows HIV treatment to continue for the 20 million people globally who rely on U.S. funding, the halt in financial support has severely impacted community-based services that focus on HIV prevention.
Drop-in centres and outreach programs at risk
The funding freeze has resulted in the closure of health centres and the termination of outreach workers’ contracts, depriving vulnerable populations of critical support. UNAIDS reported that in Ethiopia alone, 5,000 public health worker contracts and 10,000 data clerk positions funded by U.S. assistance have been terminated.
The biggest impact has been on community clinics and prevention services. Thousands of individuals—particularly women, young girls, and those at high risk of HIV infection—are losing access to vital services such as HIV testing, condom distribution, pre-exposure prophylaxis (PrEP), tuberculosis screenings, and support for gender-based violence.
A potential surge in AIDS-related deaths
Stegling warned that if PEPFAR funding is not re-authorized beyond 2025, the consequences could be catastrophic. “There would be a 400% increase in AIDS-related deaths—6.3 million people could die due to lack of treatment and prevention services,” she stated.
UNAIDS is urging the international community to step in and fill the funding gap, emphasizing that delays in securing financial support will have long-term consequences.
“If people stop coming forward for treatment, new infections will rise. Any cut, any pause, matters for all of us,” Stegling stressed.
PEPFAR, which has invested in HIV prevention and treatment in 55 countries since 2003, has been a cornerstone of global efforts to combat the epidemic. The U.S. currently provides 70% of global HIV funding, making its commitment crucial for sustaining progress against the disease.
Despite the waiver, UNAIDS remains deeply concerned about the long-term impact of the funding freeze on global HIV prevention efforts.
