The reduction of United States funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) is causing significant disruptions to HIV prevention and treatment services worldwide. According to new research presented ahead of the 26th International AIDS Conference, these cuts threaten to reverse decades of progress against the HIV epidemic, particularly in low- and middle-income countries.
Funding cuts disrupt global HIV programmes.
Researchers found that no part of the PEPFAR programme has been spared from the funding reductions introduced during the Trump administration. Although exemptions were announced to preserve life-saving treatment and programmes preventing mother-to-child transmission, the report concludes that the broader funding cuts have produced widespread consequences across the global HIV response. As a result, thousands of health workers have lost their jobs, while many clinics and community centres have been forced to close.
Thousands of services have been affected.
The study surveyed 166 organisations in 46 countries that expected to receive PEPFAR funding in 2025. More than half reported losing at least one grant, leading to the closure of over 1,700 clinics and service sites and the loss of more than 16,000 full-time positions. Furthermore, prevention programmes experienced some of the greatest setbacks. Nearly two-thirds of organisations working to prevent mother-to-child HIV transmission reported disruptions, and one-fifth suspended these services entirely. Many providers also faced shortages of medicines, condoms and laboratory supplies.
Policy changes reshape health services.
Beyond the financial impact, organisations that continue receiving U.S. support reported modifying their programmes to comply with new federal policies. For example, many reduced or eliminated services designed for populations at greater risk of HIV, including LGBTQ+ communities, sex workers and people who use injectable drugs. In addition, several organisations ended support programmes for survivors of gender-based violence in response to new policy requirements.
Experts warn that progress is at risk.
Since its creation in 2003, PEPFAR has been credited with saving more than 26 million lives and transforming the global response to HIV/AIDS. However, researchers caution that the current disruptions could undermine years of public health achievements. They also note that this study provides some of the first real-world evidence of the consequences of the funding reductions, reinforcing concerns that continued interruptions may slow global efforts to control the HIV epidemic.
Reference
Lay, K. (2026, July 21). Trump’s HIV funding cuts having ‘severe and devastating’ impact around the world. The Guardian. https://www.theguardian.com/global-development/2026/jul/21/trumps-hiv-funding-cuts-having-severe-and-devastating-impact-around-the-world