Nearly half a million children could die from AIDS-related causes by 2030 without restoration of PEPFAR programs cut by the Trump administration, a new study published in the Lancet reveals.
As President Donald Trump and Elon Musk’s DOGE team slashes foreign assistance programs, billions of dollars in programs addressing HIV prevention have been cut or put on pause for a government-wide 90-day funding review, most severely for PEPFAR, the President’s Emergency Plan for AIDS Relief.
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African doctors say their patients are arriving with tears in their eyes, asking if they’ll die from a lack of HIV medication.
The new health policy analysis estimates that one million children could become infected with HIV and nearly half a million could die from AIDS by 2030. Additionally, 2.8 million children could experience orphanhood in sub-Saharan Africa (because their parents died from preventable HIV-related illnesses) if the PEPFAR funding isn’t restored.
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“The future of PEPFAR programs hang in the balance. Losing stable, long-term support for PEPFAR programs sets global progress to end HIV/AIDS back to the dark ages of the epidemic, especially for children and adolescents,” said co-lead author Professor Lucie Cluver of the University of Oxford in the UK.
PEPFAR, launched by President George W. Bush in 2003, has been an unqualified and bipartisan success credited with saving over 26 million lives. Nearly eight million children have been born HIV-free with the program’s help. PEPFAR currently supports over 20 million people with HIV prevention and treatment services, primarily in sub-Saharan Africa.
“Losing stable, long-term support for PEPFAR programs sets global progress to end HIV/AIDS back to the dark ages of the epidemic.”
Professor Lucie Cluver of the University of Oxford in the U.K.
A study released by UNAIDS in March showed an uptick in new HIV infections has already started as local HIV prevention programs funded by PEPFAR have been thrown into chaos.
While the State Department issued waivers during the 90-day funding freeze for what it called “life-saving treatment,” both funding and communication from former contacts at the now-shuttered USAID ceased or were delayed for local partners administering the aid, ending or radically reducing services.
For those PEPFAR partners that managed to continue operating, their actions have been narrowed. On February 6, the State Department issued a memo obtained by NPR stating that distribution of PrEP would be limited “only” to “pregnant and breastfeeding women” during the 90-day foreign assistance review.
Men who have sex with men, girls, and young women between the ages of 15 and 24 not pregnant or breastfeeding, and sex workers and people who inject drugs “can not” be offered PrEP during the pause or “until further notice,” Trump administration officials wrote.
“We are already seeing the devastating impacts of the USA’s recent foreign aid freezes,” said co-author Susan Hillis, Imperial College, London. “Many of the children and adolescents who currently benefit from PEPFAR programs will slip through the cracks — increasing their chances of acquiring HIV or leading to further transmission, ultimately resulting in many preventable HIV infections and deaths.”
Trump’s 90-day foreign assistance review ends on April 24.
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