A global HIV resurgence is possible now that Donald Trump has paused a life-saving HIV aid program that distributes treatment worldwide.
Since taking office, Trump has set his sights on slashing federal aid and assistance, both foreign and domestic. One of his first Executive Orders ordered a 90-day pause on funding for foreign programs, including the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which has saved tens of millions of lives worldwide. Several days later, the United States Office of Management and Budget abruptly dropped a late-night memo on Americans, revealing that, in less than a day, almost all domestic federal aid programs would be frozen while Trump reviewed them to ensure each program meets his agenda. There has been little guidance on what programs, besides Medicare and Social Security, are exempt from the freeze and how long the pause will last. Americans are simply left bracing for the worst as healthcare facilities, housing assistance, educational programs, and even children’s school lunch programs could be impacted.
Amid the focus on Trump’s freeze on domestic federal aid, many have ignored the huge implications of his decision to pause PEPFAR.
Donald Trump halts life-saving PEPFAR
President George W. Bush started PEPFAR in 2003. It’s considered one of the most successful global health programs of all time and the most significant commitment by any nation to fight a single disease. Since 2003, PEPFAR has invested over $100 billion in preventive measures and treatment for HIV worldwide, saving an estimated 25 million lives. Multiple countries achieved epidemic control because of PEPFAR’s efforts.
It’s common for new presidential administrations to review federal aid programs. However, no presidential administration has chosen to pause PEPFAR for a prolonged period for such a review—until Trump’s second term. His Executive Order demanded a halt to the program for at least 90 days. The government also quickly issued a stop-work order, sparking immediate chaos and confusion, as groups that already had grants paid out were uncertain about what they were or were not allowed to do. The New York Times reported that people were already being turned away from clinics, and groups funded by PEPFAR have been told to stop distributing available medication purchased by the aid. When it comes to HIV, there’s no time to wait around for orders, instructions, and reviews. If unable to access medicine, HIV patients who have suppressed their infections could experience flare-ups in as little as a month.
Craig Spencer MD MPH warned that stopping the program was “self-defeating stupidity,” as it provides HIV treatment to over 20 million people and, without such treatment, “HIV can rebound in less than a month.” He warned a global resurgence of HIV is possible that will impact America and the rest of the world.
David J. Kramer, the Executive Director of the Bush Institute, issued a statement urging Trump to make PEPFAR exempt from the freeze lest it “risks interrupting life-saving access to treatment, potentially placing millions of lives in danger.” Unfortunately, the government appears unlikely to relent. State Department spokesperson Tammy Bruce issued this cold statement about the PEPFAR freeze, “[The U.S.] is no longer going to blindly dole out money with no return for the American people.” Apparently, avoiding tens of millions of deaths worldwide isn’t enough “return” for America. The government’s website on PEPFAR has also been shut down, raising concerns that there are no plans to bring the program back.
As Aaron Parnas pointed out, PEPFAR accounts for less than 0.1% of the government’s entire budget. Additionally, for 22 years, this program has flourished to gaza
without opposition from any president, including Trump during his first term. Support for the program was bipartisan. Yet, Trump, one of the wealthiest people in the world, has decided to abruptly stop the program and risk millions of lives over a minuscule portion of the government’s budget.
Published: Jan 28, 2025 8:50 PM UTC