United States President Donald Trump’s decision to halt the country’s foreign aid funding for 90 days has triggered widespread alarm, particularly for life-saving health initiatives like the President’s Emergency Plan for AIDS Relief.
This freeze has placed millions of people globally, including Nigerian HIV patients, at risk of treatment disruption and deteriorating health outcomes.
Established in 2003 by former President George W. Bush, PEPFAR has provided antiretroviral therapy to over 20.6 million people worldwide, prevented mother-to-child HIV transmission, and saved an estimated 26 million lives. However, the programme’s future now hangs in the balance due to the funding pause, with dire consequences for countries heavily reliant on it, including Nigeria.
Nigeria bears the heaviest HIV burden in Sub-Saharan Africa, with over two million people living with the virus. In 2020, AIDS-related deaths in Nigeria were estimated at approximately 49,000 across all age groups, according to The ICIR. The country’s domestic contribution to HIV funding is less than 20 per cent of the required resources, leaving it critically dependent on international support.
Global figures from the World Health Organization underline the magnitude of the crisis. At the end of 2023, an estimated 39.9 million people were living with HIV worldwide, with 65 per cent of these cases in the WHO African Region. That same year, about 630,000 people died from HIV-related causes, and an estimated 1.3 million acquired the virus. While there is no cure, access to effective prevention, diagnosis, treatment, and care has turned HIV into a manageable chronic condition for many.
The funding freeze stems from an executive order signed by Trump on January 20, 2025, directing a review of all foreign aid programmes under his “America First” policy. Trump’s administration emphasized the need for efficiency and alignment with U.S. interests, stating that foreign assistance should no longer be provided “blindly… with no return for the American people.”
Although PEPFAR’s $6.5 billion annual budget was not specifically mentioned in the announcement, a source at USAID confirmed to NPR that the freeze applies “100 per cent to PEPFAR.” The U.S. State Department also confirmed the halt, warning of potential job losses among USAID contractors during the review.
The president of the International AIDS Society, Beatriz Grinsztejn, voiced grave concerns about the impact of the freeze. “This is a matter of life or death,” she stated. “PEPFAR provides lifesaving antiretrovirals for more than 20 million people – and stopping its funding essentially stops their HIV treatment. If that happens, people are going to die and HIV will resurge.
“It makes no sense to suddenly stop this incredible catalyst of our global progress towards ending HIV as a threat to public health and individual well-being,” Grinsztejn added.
As the funding review unfolds, advocates and health organisations worldwide are calling on the U.S. government to reconsider, warning that any disruption to PEPFAR will have catastrophic consequences for millions of vulnerable people.
