Cuts to United States global health funding and the restructuring of the U.S.
Published in July, the amfAR research relies on a survey of 166 organizations across 46 countries that receive funding through the President’s Emergency Plan for AIDS Relief (PEPFAR). This group represents roughly 23 percent of the program’s global partners. Among survey respondents, 63 percent reported disruptions to mother-to-child HIV transmission prevention services, while 22 percent stated they had halted those specific services entirely due to budget reductions.
Funding Shifts and Clinic Closures
The disruptions arrived despite an announcement by the U.S. administration in September declaring that infectious disease control programs would be prioritized and protected from budget cuts. On the ground, however, funding streams stalled. In Tanzania, pediatrician Theopista Massengi reported that a program she supervised to care for pregnant women and vulnerable children received a work-stoppage order in January 2025. She noted that while a small portion of American funding has since returned, the disruption continues to hamper local healthcare delivery.
Data compiled by amfAR shows that 1,714 PEPFAR-supported clinics closed worldwide over the course of the previous year. Health sources point to a parallel drop in follow-up care and early infant diagnostics, which remain essential for catching infections and starting timely antiviral therapy.
Measurable Declines in Testing and Treatment
Data analyzed by amfAR reveal that HIV testing among pregnant women dropped by 2 percent at the end of 2025 compared to the same period the previous year. Infant testing fell by at least 6 percent. Across eight countries monitored by the Clinton Health Access Initiative, the number of children who started antiretroviral therapy dropped by 15 percent throughout 2025.
Conversely, the U.S. State Department maintains that President Donald Trump’s administration has recalibrated PEPFAR to focus on measurable health outcomes and to increase the self-reliance of host countries’ domestic health systems. According to the State Department, the program has supported life-saving treatment for 20.6 million people living with HIV across more than 50 countries as of September 30, 2025.
Surveillance Gaps and Clinical Risks
Public health experts caution that falling numbers of children starting treatment do not necessarily indicate a drop in new infections. Instead, the figures frequently reflect a decline in children undergoing testing and clinical tracking. Reduced data collection and fewer regular reporting cycles make evaluating the actual toll on patient populations increasingly difficult.
Specialists worry that the full health consequences of these disruptions will surface only after delays have compromised patient outcomes. Without consistent screening and follow-up care, pediatric infections run a higher risk of going undetected or receiving dangerously delayed treatment.
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