IDSA & HIVMA raise alarm about access to HIV care following USAID, PEPFAR cuts

2/28/2025 — The Infectious Diseases Society of America (IDSA) and the HIV Medicine Association (HIVMA) are deeply concerned by the abrupt cancellation of 92% of U.S. Agency for International Development (USAID) foreign assistance awards and the impact the action will have on many, including the more than 20 million people to whom our country has made a commitment to provide access to HIV treatment through the President’s Emergency Plan for AIDS Relief (PEPFAR).

As a primary implementor of PEPFAR programming, USAID plays a significant role in working to control the HIV epidemic globally. Terminating the vast majority of USAID grants will only serve to accelerate the epidemic. Already, dozens of USAID programs that implement PEPFAR have been shuttered in high-HIV burden countries, including a program that provides HIV treatment to hundreds of thousands of people in Lesotho, Eswatini and Tanzania, including children and pregnant people with HIV. Halting HIV treatment can lead to the development of drug-resistant HIV that is much more difficult and sometimes impossible to treat and lead to the spread of HIV through additional countries, including the U.S.

Since its start in 2003, the PEPFAR program has been a remarkable achievement in public health, health security and health systems strengthening. Until now, this achievement has been possible because of unwavering bipartisan presidential and congressional support and a whole-of-government approach. This program, driven by data and local programming, has saved more than 26 million lives while also strengthening systems for early outbreak detection and response to help keep us safer at home.

While HIV medications now allow people with HIV to live healthy and productive lives, disrupting or stopping treatment results in serious illness and death in addition to increased transmission rates. It is hard to justify or understand why we would dismantle overnight a program that has made such a difference in the world and should make all Americans proud.

If there is a desire to reduce U.S. funding of programs, it should be done in a coordinated manner with sufficient time to transfer the responsibility for programming to local implementors in order to prevent disruptions in lifesaving care. We urge Congress to act now to save lives, avert the growth of an HIV pandemic that could lead to political instability in the affected countries and protect the health and biosecurity of the United States.