The International AIDS Society (IAS) has warned that the immediate halting of funding to the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), including a stop-work order for existing grants and contracts, places millions of lives in jeopardy.
On Day 1 of taking office as US President, Donald Trump signed an executive order that banned any new government spending on foreign aid projects. This was followed by an unexpected “stop-work order” issued on 24 January, which means that funding to PEPFAR, even for existing grants and contracts, is frozen.
“This is a matter of life or death,” IAS President Beatriz Grinsztejn said. “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.
“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 said PEPFAR is the largest commitment by any country, ever, to address a single disease. Since it established PEPFAR in 2003, the US government has invested over USD 110 billion in the global HIV response. They say the program has saved 26 million lives and prevented millions of HIV acquisitions in more than 50 countries.
As PEPFAR itself states: “PEPFAR’s lifesaving work is enabled through the U.S. government’s unwavering commitment to the program and the American people’s compassion and generosity, as PEPFAR ensures every U.S. taxpayer dollar is optimally focused for impact.”
The IAS urgently calls on policy makers and stakeholders to restore the funding lifeline to this pivotal program. Their message is blunt: “Lives depend on it, right now.”
The organisation has also raised concern about the US government’s reinstatement of the ‘global gag rule’ that prohibits foreign organizations that receive US health aid from providing, referring for or advocating for abortion services, regardless of whether non-US funds are used for these services.
The rule was in place during Donald Trump’s first presidency but was rescinded when Joe Biden took office. The IAS says it’s reinstatement will have dire consequences for the HIV response, particularly in low- and middle-income countries.
“The cost of reimposing this rule will be paid in hardship, human lives and a reversal of some of the most important gains in the HIV response,” Grinsztejn said.
“We know from experience that it will cause severe disruptions to health services, including HIV and reproductive and sexual health, particularly in areas of the world most affected by HIV. We have seen the negative impact of the global gag rule before, as evidenced by restrictions in women’s access to essential healthcare worldwide.”
They estimate that the policy over time has led to an estimated 90,000 new HIV acquisitions and almost 30,000 maternal and child deaths each year it has been in place, due to disruptions in HIV services. Most of these deaths were among children.
