A global study says 1,700-plus HIV service sites shut after PEPFAR funding cuts in 2025. Prevention programmes and services for vulnerable communities suffered the biggest setbacks…reports Africa Daily News Desk
Funding cuts to the US President’s Emergency Plan for AIDS Relief (PEPFAR) in 2025 have significantly weakened HIV services worldwide, forcing the closure of at least 1,714 service sites and disrupting prevention, treatment and care programmes, according to a new study.
The PEPFAR Pulse Study, conducted by amfAR’s Public Policy Office in collaboration with the Johns Hopkins Bloomberg School of Public Health, Funders Concerned About AIDS and Data Etc., surveyed 166 PEPFAR-funded organisations across 46 countries to assess the impact of the funding reductions.
The study found that the affected HIV service sites included public health facilities, mobile clinics, drop-in centres and specialised HIV treatment facilities. Many of these were forced to shut completely following terminated or delayed PEPFAR payments, while almost none of the organisations surveyed were able to secure alternative funding sources to replace the lost support.
Researchers said the funding cuts had a particularly severe impact on services for key populations disproportionately affected by HIV, including gay men and other men who have sex with men, sex workers, people who use drugs, transgender and gender-diverse people, and people in prison.
Among organisations implementing PEPFAR programmes, 73 per cent reported discontinuing at least one service aimed at key populations, while 67 per cent said they had stopped outreach activities targeting these groups.
The report also highlighted significant reductions in HIV prevention efforts. Spending on prevention fell by 51 per cent between the 2024 and 2025 fiscal years, while 43 per cent of implementing partners permanently ended at least one prevention activity, including condom distribution and the provision of pre-exposure prophylaxis (PrEP).
Although HIV treatment, testing and prevention of mother-to-child transmission were not directly included in the US government’s funding cuts, the study found that these services were still widely affected.
According to the findings, 64 per cent of implementing partners delivering these services reported interruptions because funding reductions affected staffing, medical commodities and partner organisations. Nearly one in four organisations, or 22 per cent, said they had stopped providing prevention of mother-to-child transmission services altogether.
The study also identified wider disruptions across HIV service systems, noting that organisations continuing to receive funding introduced new policies to align with revised PEPFAR priorities.
Researchers concluded that the cumulative impact of the funding reductions has left the global HIV service delivery network significantly weakened, with organisations serving the most vulnerable populations facing the greatest challenges.
PEPFAR, launched by the United States in 2003, has been one of the world’s largest HIV/AIDS initiatives, providing funding for prevention, treatment and care programmes. According to the report, the programme has helped save more than 26 million lives since its inception.
The study warns that the 2025 funding reductions have jeopardised many of the gains achieved over the past two decades and could undermine efforts to control the HIV epidemic, particularly among communities most at risk.
