HIV Service Delivery Plummets Following US Aid Cuts in Uganda and Zimbabwe
Severe and sustained declines in HIV service delivery hit vulnerable populations across four non-governmental organisations in Uganda and Zimbabwe following cuts to United States foreign aid in 2025. According to a study published in The Lancet Global Health, key interventions including pre-exposure prophylaxis, HIV testing, and antiretroviral therapy fell sharply after the implementation of stop-work orders by PEPFAR and USAID.
The research, led by Dr. Henry Cust from the London School of Economics and Political Science and Duke University, marks the first time investigators have measured the operational impact using internal data from organizations whose US-sourced funding was terminated without restoration. Despite a humanitarian waiver designed to protect life-saving medical care, service volumes remained depressed through March 2026.
Impact on Prevention and Treatment Programs
Antiretroviral therapy distribution dropped significantly. Prevention services, particularly access to pre-exposure prophylaxis medications, experienced immediate contractions following the 2025 stop-work directives.
The study evaluates four distinct non-governmental organizations operating in Uganda and Zimbabwe, tracking institutional metrics through the first quarter of 2026. While humanitarian exemptions theoretically allowed certain clinical activities to continue, service delivery had not recovered by March 2026.
Frequently Asked Questions About the Aid Reductions
Which specific organizations and countries does the study evaluate?
The research examines four non-governmental organizations operating within Uganda and Zimbabwe, tracking their internal service delivery metrics before and after the 2025 funding cuts.
What specific HIV services experienced the sharpest declines?
HIV prevention services—predominantly pre-exposure prophylaxis (PrEP)—along with routine HIV testing and antiretroviral therapy treatment all fell sharply following the stop-work orders.
Did the humanitarian waiver prevent disruptions in care?
Despite a humanitarian waiver meant to protect life-saving services, delivery volumes had not recovered by March 2026.