Crisis Looms as Trump Halts Lifesaving US-Funded HIV Programmes

The fight against the HIV epidemic may have suffered a devastating setback. The Trump administration has halted all US foreign funding and related projects, including critical programmes that provide lifesaving services to men who have sex with men (MSM) and transgender communities in Southern Africa.

Executive Order Halts New Foreign Aid

On his first day in office, President Trump signed an executive order to suspend new government spending on foreign aid projects worldwide. The review aims to ensure that all projects “fully align with the foreign policy of the President of the United States.”

This decision directly affects HIV and related health programmes funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR). Since its launch in 2003, PEPFAR has invested over USD 110 billion in the global HIV response, saving an estimated 26 million lives and preventing millions of HIV transmissions in more than 50 countries.

Stop-Work Order Sparks Alarm

While the suspension of new foreign aid was anticipated, public health experts were shocked when the US State Department also issued a “stop-work order” on Friday. The order requires existing HIV and related health programmes funded by PEPFAR to halt operations.

In Southern Africa, the majority of HIV programmes serving MSM and transgender individuals rely on PEPFAR funding. The review, which could take 90 days or more, may lead to the cancellation of some projects. The stop-work order has already caused confusion and uncertainty, potentially resulting in devastating consequences for people living with HIV, HIV prevention efforts, and the livelihoods of those employed by these programmes.

Given President Trump’s anti-transgender stance and his policy that the US only recognises two genders, programmes serving transgender people are particularly vulnerable to cancellation.

Grave Consequences Feared for HIV Programmes

The implications of this decision are profoundly concerning, with likely severe consequences for MSM and transgender individuals in countries where they already face significant stigma and discrimination within public health systems.

Programme implementers are anxiously awaiting further guidance from the US government on how these drastic and callous measures will affect their work.

Beatriz Grinsztejn, President of the International AIDS Society (IAS), expressed deep concern over the developments.

“This is a matter of life or death,” said Grinsztejn. “PEPFAR provides lifesaving antiretrovirals for more than 20 million people – and stopping its funding essentially stops their HIV treatment. If that happens, people are going to die and HIV will resurge.”

She continued: “It makes no sense to suddenly stop this incredible catalyst of our global progress towards ending HIV as a threat to public health and individual well-being.”

The IAS urgently called on US policy makers and stakeholders to restore the funding lifeline to this pivotal programme, asserting that “Lives depend on it, right now.”

This is a developing story, with further clarity expected in the coming days.