According to international organizations and members of Congress, the United States has suspended funding for its flagship AIDS relief program, according to members of Congress who warn that it has already hurt patients and has suspended globally important projects.
The full scope of budget cuts related to US-funded HIV/AIDS relief efforts is very unknown, with Congress still fighting the White House’s proposed budget clawback and withholding billions of dollars in funding.
Formally called the US President’s Emergency Plan for AIDS Relief, Pepfar is believed to have saved more than 26 million lives over the past 20 years and prevented millions of HIV infections, particularly in Africa.
Last year alone, government figures show that Pepfar provided 20 million people with a life-saving HIV drug called antiretroviral therapy. It also supported over 342,000 healthcare workers, providing HIV treatment, preventive care and support services, and strengthening health systems in more than 50 countries.
Funding for the Landmark Program, established in 2003 by the Bush administration, was primarily implemented by USAID. This was dismantled by US President Donald Trump earlier this year after the freeze on foreign aid. The US Department of State later issued an exemption to exempt relief services from freezes, including Pepfer, and transferred operations to the Department of State’s authority.
However, nonprofits are sounding an alarm saying that the HIV/AIDS project has ended without any issues. And without USAID, many planned initiatives have also stagnated. These cuts, they say, have significantly disrupted patient care across Africa, Asia and Latin America, and threatened a global battle against disease.
UNAIDS, a UN agency that works to end AIDS, cites examples of medical stockouts, HIV/AIDS clinic staffing, suspended community outreach services, and “stigma, discrimination, rising mortality rates, and mortality rates” following US funding cuts.
The suspension has caused major disruption in HIV reactions in dozens of countries, including Uganda, the Philippines and Tanzania, the UN agency said.
According to a non-profit doctor for human rights, who compiled testimonies of health care disruptions from people in Tanzania and Ugandan, people living with HIV are distributing doses of antiretroviral drugs, creating conditions for the emergence of drug-resistant HIV strains.
The borderless doctor warns that “Pepfer is facing an uncertain future,” and that cancellation of projects after the demolition of USAID has already affected humanitarian activities.
“The scope of PEPFAR’s work has already declined dramatically since January, when the State Department restricted work in key areas of HIV prevention, treatment, care and support,” the borderless doctor said repeated claims by the US government contradicted repeated claims that life-saving jobs are preserved.
“Cutting isn’t just about hitting program activities and medical stocks. It’s crippling the logistics backbone of HIV care. The transport to distribute supplies has almost disappeared,” said Zahra Zeggani-Bec’s representative of the organization in Zimbabwe.
World Vision, an international Christian organization focusing on poverty and development, told CNN that a large Pepfar programme has been concluded in Kenya.
“It (the program) focused primarily on orphans and vulnerable children and prevention activities,” said Margaret Schuler, World Vision’s Chief Executive Officer. Schuler said it was surprising that “what was considered a ‘life-saving program’ has ended” including other world vision programs related to healthcare and disease management.
PEPFAR report data has not been published for several months. In other words, there is little clarity about the ongoing activity of the program. The message on the government website says it is “receiving an update.” All release dates for the 2025 PEPFAR Data Report are listed as “TBD”.
A State Department spokesperson told CNN “data collection is ongoing and we will capture recent updates in programming.”
In its April report, UNAIDS said 28 (40%) of the country’s 70 offices have ended community-driven services through US funding cuts. Meanwhile, 21 (30%) reported that services by international NGOs had been suspended.
Charles Kenny, a senior fellow at the Centre for Global Development, a US- and UK-based think tank, said that while some of the work may have resumed given the lack of budget data, contract services and “what was actually delivered,” it is impossible to determine how much money it costs.
He wrote in an analysis of the situation of US aid operations, “Now Congress and taxpayers are not aware of what the foreign aid system is trying to achieve, let alone if that is happening.”
Secretary of State Marco Rubio has said that Pepfer is a continuing important and life-saving program, a State Department spokesperson told CNN, adding that Rubio “as with all aid programs, Pepfer should be reduced over time as it will affect the achievement of its mission.”
Last week, the State Department announced its joint commitment with the Global Fund to purchase Lenacapavir, an HIV vaccination that must only be taken twice a year from American biopharmaceutical company Gilead Sciences. PEPFAR will distribute the drug in 8-12 high-burning HIV countries in 2026, with an emphasis on reducing the number of new HIV infections in pregnant and breastfeeding mothers.
According to budget documents on the nonprofit website tracking OMB, the White House Management and Budget Office (OMB) has only released about half ($2.9 billion) of the $6 billion that Congress has allocated to Pepfar’s 2025 funding.
Congressional aides raised concern that the budget document listed billions of dollars in funding this year as part of fiscal year 2026.
Budget experts told CNN that the allocation of Pepfer in 2025 looks “strange” compared to previous year’s documents. Funds released this year will be listed as “unallocated” and are subject to expenditure plans that must be agreed upon by the OMB and the State Department. These spending plans are not published.
Sources also said placing funds in 2026 indicates that at least the OMB is willing to spend Pepfah’s money now, and could be an attempt to “slow walk” the funds.
Another Congressional aide told CNN that Congress has no clear figure due to the delay in information that the White House must report to the public. Funds for 2025 could still be released in the coming weeks and months.
The photo of the fundraising stream remains vague, coming after the Trump administration has already tried to hold back $400 million for Pepfer. The proposal was cancelled after bipartisan opposition in the Senate. But not all of these funds have been released, Susan Collins, the top budgeter for the Senate budgeter, a Republican from Maine, told CNN in a statement last week.
“OMB is blocking funding for Pepfar, one of the most successful global health programs in history,” Collins said. “As confirmed by people on the ground, Pepfahl’s funds simply aren’t reaching those in need.”
Washington Sen. Patty Murray, a ranking Democrat on the Senate Budget Committee, called OMB Director Russell Vert directly, saying that “even after promising Republicans that the program would be protected, he suffocated most of the funding provided by Congress for Pepfer.”
“The law is clear as a day. The full funding provided by Pepfar for work in and out during the day will result in the more people going unnecessarily the more these funds are hampered and delayed,” Murray told CNN in a statement.
CNN contacted OMB for comment but did not receive a response.
Separately, last week, Trump notified Congress that he was about to cancel the $4.9 billion in foreign aid already approved this year, drawing criticism from lawmakers on both parties who questioned the legality of the move. The US Government’s Accountability Office says retirements in the second half of the fiscal year are illegal.
Last Wednesday, a federal judge ruled that without Congressional approval, the administration cannot decide to withhold budgeted foreign aid funds from the federal government, which will expire later this month.
But the White House has put in multifaceted efforts to do so at both the court and Capitol Hill, and Trump is asking the Supreme Court to return to the fight on Monday.
