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CIDRAP- ​​​​​​​Trump halts foreign aid, including AIDS relief, TB funding

Lance

MPH, CSP & CIT Retired, CHMM Emeritus
https://www.cidrap.umn.edu/hivaids/trump-halts-foreign-aid-including-aids-relief-tb-funding

Trump halts foreign aid, including AIDS relief, TB funding



Stephanie Soucheray, MA


January 27, 2025

HIV/AIDS

Tuberculosis

Public Health
Amid the flurry of executive orders signed on Inauguration Day by President Donald Trump was a 90-day freeze on foreign aid spending.

But late last week, the State Department, led now by former Florida Senator Marco Rubio, issued a memo clarifying that the freeze includes current foreign assistance programs as well, including the President's Emergency Plan for AIDS Relief, or PEPFAR. Also affected is USAID, which will hamper global efforts to combat tuberculosis (TB).

Each year the State Department distributes $6.5 billion US dollars through PEPFAR to fight HIV in 50 countries around the world. PEPFAR pulls together multiple public health agencies and programs, and has been credited with saving upwards of 26 million lives since its launch in 2003 by then-President George W. Bush.

With a total of $100 billion spent, PEPFAR is the largest public health commitment in history by any country to address a single disease. For more than 20 years, the program has seen strong bipartisan support across four presidential administrations, but Trump's freeze marks a new era in US public health foreign policy.

Many get HIV treatment through PEPFAR


The Foundation for AIDS Research, amFAR, said the decision to halt PEPFAR funding will be deadly.

"The immediate stop work orders to the more than 190,000 clinicians and other health care workers will massively disrupt the global HIV response," amFAR wrote. "Even short cessations of these programs cause unnecessary suffering, loss to follow-up, and risk onward transmission that cannot simply be 'turned back on' when the suspension is lifted."

Currently amFAR estimates PEPFAR pays for antiretroviral treatments for 222,000 people, and the tests of more than 224,000 people annually. PEPFAR also funds more than 7,000 cervical cancer screening each year and provides care for more than 3,500 women each year experiencing gender-based violence.

TB treatment also affected


Though PEPFAR is one of the marquee US foreign policy programs, USAID is one of the largest investors in the global fight against TB, investing $4.7 billion since 2000. USAID is also under the federal pause.

Madhukar Pai, MD, PhD, a professor at McGill University in Montreal, told CIDRAP News that the moves of the new administration could do the most harm to global programs fighting TB and HIV. He is a Canada Research Chair in Epidemiology & Global Health at McGill and the associate director of the McGill International TB Centre.

This is a crisis moment for global health and development.

"This is a crisis moment for global health and development," Pai said. "I hope everyone in global health will advocate for the US government to continue supporting these critical organizations and programs."

Pai did acknowledge, however, that Trump's second term in office could bring new opportunities for other nations to contribute more to global health.

"I wonder if this could be an opportunity for global health to be less reliant on any single nation or donor," said Pai. "I would love to see African nations step up, manufacture their own essential medicines and vaccines, and be less and less reliant on aid. I would love to see other G7 and G20 nations step up and make up for the acute funding shortfall that the US government is creating."

As of last week, all US foreign assistance is frozen for at least 90 days pending a review of all programs, but that could be extended.
 
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