166 organizations in 46 countries told amfAR that Trump administration disruptions to PEPFAR forced clinic closures, staff layoffs and service cuts, with more than 1,700 sites shut and over 16,000 jobs lost.
USAID's dismantling and thousands of global health grant cuts drove the damage, and most surveyed groups reported terminated awards or delayed payments even where Washington said treatment-related services should continue.
51% of PEPFAR prevention spending disappeared from fiscal 2024 to 2025, while many groups permanently ended services for sex workers, men who have sex with men, transgender people and people who inject drugs.
The administration has pointed to stable treatment for 20.6 million people in one 2025 quarter, but amfAR and other researchers say broader PEPFAR data show major disruption, including nearly 2 million fewer people on treatment in fiscal 2025.
26 million lives have been saved by PEPFAR since 2003, and amfAR warned that restoring funding alone will not quickly rebuild clinics, staffing and community trust.
With 1,700 HIV sites now closed, what is the true human cost behind the conflicting data on global AIDS relief?
As US aid shifts to 'country ownership,' are nations prepared to independently manage the HIV crisis and prevent a resurgence?
The Cost of U.S. HIV/AIDS Funding Cuts: Millions at Risk and a Global Health Crisis Unfolds
Overview
Recent U.S. HIV/AIDS funding cuts have plunged the global health infrastructure, especially in Africa, into a dangerous situation. This has destabilized local HIV service systems, leading to the loss of many critical health workers and prevention services. For example, the Anova Health Institute had to stop its PEPFAR-funded programs and lay off about 3,000 health workers, which severely impacted the delivery of essential services like pre-exposure prophylaxis (PrEP). As a result, decades of progress in fighting HIV/AIDS are now at risk of being reversed, putting vulnerable populations in greater danger.