AVAC analysis
A new analysis published in Nature Health finds that PEPFAR-supported HIV treatment declined in 2025 following the US Administration’s foreign aid freeze, with approximately 2 million fewer people reported as receiving PEPFAR-supported antiretroviral therapy than in 2024 (a 10% decrease). Of the 26 countries examined, treatment support fell across all, though some of the decline reflects changes in how PEPFAR classifies and reports treatment support rather than patients losing access to care. South Africa was called out in the analyses, accounting for most of the treatment declines—individuals previously counted as receiving direct PEPFAR support were reclassified as benefiting from broader health system investments, resulting in a net treatment decline of about 95,000 people (1.8%). The authors conclude a “decline of ∼1.73 million individuals on direct PEPFAR-supported treatment and an increase of ∼1.64 million individuals on treatment benefitting solely from the programme’s broader support to health systems, yielding a net treatment loss of 94,881 (−1.8%)”.
IMPLICATIONS: As the authors conclude, “while the analysis cannot determine whether and to what extent declines will translate into reduced individual- or population-level treatment outcomes, a reduction in PEPFAR-supported treatment of this scale within a single fiscal year raises concerns.” The data underscore the significant disruptions caused by funding uncertainty and restructuring across the program.
AVAC publishes a weekly Global Health Watch, a curated digest of key developments in global health. Access this week’s issue (#74, 26 June) here.
SEE ALSO:
- The Lancet Regional Health – Africa: PEPFAR interrupted: real-world consequences of US foreign aid instability for HIV service delivery in South Africa
- The Lancet HIV editorial: Human impact of cuts to global aid in South Africa
- Devex: Can South Africa survive a post-PEPFAR future? /free registration is required/
- Associated Press: South African civil groups warn of dire impact as US phases out HIV program funding
- Bhekisisa: South Africa: ‘They’re in the wind’: How US cuts pushed trans people out of care
Source : AVAC
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