The expiration of PEPFAR’s authorization could mark a pivotal shift in the HIV/AIDS response
For more than two decades, the President’s Emergency Plan for AIDS Relief (PEPFAR) has been a global health success story, credited with saving more than 26 million lives and providing HIV treatment for more than 20 million people.
As of March 25, 2025, however, PEPFAR’s congressional reauthorization has expired, raising key questions about its future. Prior to 2024, bipartisan support had secured five-year reauthorizations in 2008, 2013, and 2018. Last year, Congress allowed only a one-year authorization as political strife engulfed PEPFAR.
Without reauthorization, PEPFAR sits in purgatory—even though Congress appropriated funding through the end of September via the continuing resolution that passed this month. The expiration of its authorization introduces deep uncertainty about its long-term future, meaning that officials could now terminate or significantly curtail PEPFAR at any time.
Health ministries, implementing partners, and community-based organizations across PEPFAR-supported countries must try to deliver lifesaving care without the stability that long-term U.S. commitments once provided. At the same time, structural questions remain about how the State Department will operate PEPFAR amid reported proposals to create a new U.S. Agency for International Humanitarian Assistance. The question now is not just whether PEPFAR will continue, but also how it must evolve to remain effective in a drastically reshaped foreign aid landscape.
Read the full analysis at Think Global Health.
Source : Think Global Health
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