Impact of Trump-instituted Aid Reduction on International HIV Prevention Efforts
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Millions of people have lost access to HIV prevention services in the past six months, according to data from PrEPWatch. This alarming development is a result of funding cuts to the President's Emergency Plan for AIDS Relief (PEPFAR) and the Centers for Disease Control and Prevention (CDC).
The specific programs affected by these cuts include PEPFAR, CDC's Maternal and Child Health Branch and Global Health Center, and USAID's health data systems and humanitarian health assistance. These cuts have disrupted services for mothers and infants at risk of or living with HIV, eliminated key HIV and TB programming capacity within the CDC, and caused program interruptions and reduced capacity.
Jennifer Kates of KFF emphasizes the importance of prevention, stating, "In HIV, it's really important from an epidemiological perspective to stop infections and to stop spread among those most at risk."
The cuts have also led to the closure of many sites catering to vulnerable groups, such as gay and bisexual men, sex workers, trans people, people who inject drugs, and incarcerated people. These groups are particularly at risk of new HIV infections.
In March, the US Congress failed to reauthorise PEPFAR, raising questions about its future. Despite this, the US State Department continues to fund life-saving HIV treatment and testing. However, many groups most at risk of an infection are now excluded from PEPFAR-funded Pre-Exposure Prophylaxis (PrEP).
The virus, which has claimed an estimated 44 million lives since its first cases were reported in 1981, continues to pose a significant threat. Despite a 40% decrease in infections and over half a decrease in AIDS-related deaths compared to 2010 levels, there were still 1.3 million new HIV infections last year.
The dismantling of USAID's health data systems has also made it impossible to accurately measure the increase in HIV infections. This lack of data makes it difficult to assess the full impact of these cuts on global HIV prevention efforts.
Countries like Malawi, Zimbabwe, and Mozambique have almost entirely relied on PEPFAR for their prevention efforts, according to UNAIDS. In east and southern Africa, the United States had been funding nearly 45% of HIV/AIDS prevention programs.
Experts warn that cutting prevention efforts could reverse decades of progress in the fight against HIV/AIDS. By not providing PrEP and cutting back on prevention services for high-risk populations, there is a risk of continued broader spread of the virus.
The Trump administration has cancelled more than 80% of HIV/AIDS programs led by the US Agency for International Development (USAID). However, PEPFAR has invested over $110 billion since its launch in 2003, provided 64 million HIV tests, and saved 25 million lives in 55 countries, according to the State Department.
This story was published with permission from Thomson Reuters Foundation.
[1] Article on the impact of USAID's dismantling on health data systems [2] Article on the impact of funding reductions and staffing layoffs on global HIV efforts [3] Article on the risks of the PEPFAR funding pause and related service disruptions
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