Global HIV Services Disrupted as PEPFAR Funding Cuts Force Closure of More Than 1,700 Sites

Global funding cuts have led to widespread disruptions in HIV services, forcing the closure of more than 1,700 service delivery sites and reducing access to treatment for thousands of people, according to new research presented at the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, Brazil.

The findings, released during a scientific highlights press briefing, show that recent disruptions to the United States President’s Emergency Plan for AIDS Relief (PEPFAR) have had far-reaching consequences for children, key populations, and locally led organizations that rely on the program to deliver essential HIV prevention, testing, and treatment services.

The PEPFAR Pulse Study, which surveyed 166 implementing partners across 46 countries, assessed the impact of recent funding and policy changes on HIV service delivery. Researchers found that 52 percent of implementing partners had at least one funding award terminated, while 77 percent were required to scale back or restrict their activities to comply with new United States policies.

As a result, 1,714 HIV service delivery sites have closed, including 1,010 public health facilities, 325 access points, and 126 drop-in centres, significantly reducing access to care for vulnerable communities.

Organizations serving key populations, including sex workers, men who have sex with men, and other marginalized groups, were identified as the most likely to permanently discontinue services. More than one in five HIV treatment providers also reported permanently halting at least one clinical HIV care activity.

The disruptions have also led to shortages of essential commodities, including condoms, laboratory supplies, pre-exposure prophylaxis (PrEP) medicines, and antiretroviral drugs, raising concerns about increased HIV transmission and interruptions in treatment.

A second study, which analyzed newly released PEPFAR programme data, found that 77,163 fewer children received PEPFAR-supported HIV treatment globally in 2025 compared with the previous year, representing a 14.2 percent decline.

South Africa alone recorded a reduction of more than 30,000 children receiving treatment support, equivalent to a 45 percent decrease, with similar declines reported across several other PEPFAR-supported countries.

Researchers called for urgent investigations into the causes of the decline and the restoration of routine reporting systems to prevent further setbacks in HIV service delivery.

Commenting on the findings, Professor Kenneth Ngure, President-Elect of the International AIDS Society, said the funding disruptions had produced “negative, far-reaching consequences,” particularly for vulnerable populations who depend on donor-supported HIV programmes.

Dr. Beatriz Grinsztejn, President of the International AIDS Society and Co-Chair of AIDS 2026, warned that scientific advances in HIV prevention and treatment would have little impact without sustained investment.

“Science is moving fast, giving us more powerful HIV prevention and treatment tools, but these advances cannot save lives if they never reach the people who need them the most. We require robust, stable financing and steadfast political commitment,” she said.

The findings have renewed calls for countries, particularly those heavily dependent on donor funding, to strengthen domestic health financing, diversify funding sources, and build resilient health systems capable of sustaining HIV prevention and treatment services during periods of financial uncertainty.

Health experts warned that without immediate action to restore funding and protect HIV programmes, progress made over decades in reducing new infections and AIDS-related deaths could be reversed, placing millions of people at greater risk.

Source: GNA