PRESIDENT Donald Trump’s decision to halt U.S. foreign aid funding for 90 days has sparked global concerns, particularly for life-saving health programmes like the President’s Emergency Plan for AIDS Relief (PEPFAR).
The funding freeze puts millions of people, including Nigerian HIV patients, at immediate risk, with fears of treatment disruption and possible deterioration of the health of people with the virus.
The PEPFAR, established in 2003 under former President George W. Bush, provides antiretroviral therapy (ART) for over 20.6 million people worldwide. Its interventions also help to prevent mother-to-child transmission of HIV and have saved an estimated 26 million lives.
Nigeria, one of the countries most reliant on the programme, faces severe crises if the pause continues.
The ICIR reports that Nigeria bears the heaviest HIV burden in Sub-Saharan Africa, with over about two million people living with HIV in the country. In 2020 alone, AIDS-related deaths in Nigeria were estimated at approximately 49,000 across all age groups.
The National Agency for the Control of AIDS (NACA), Nigeria’s contribution to HIV fight is less than 20 per cent of its required funding.
According to the World Health Organization, WHO, an estimated 39.9 million people lived with HIV at the end of 2023.
The agency noted that 65 per cent of these people were in the WHO African Region. In the same year, about 630,000 people died from HIV-related causes and an estimated 1.3 million people acquired the virus.
While there is no cure for HIV infection, access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, has made HIV infection a manageable chronic health condition and enabled people living with HIV to lead long and healthy lives.
The funding freeze stemmed from an executive order signed by Trump on January 20, 2025, directing a review of all foreign aid programmes to align with his “America First” policy.
According to a report the State Department spokesperson, Tammy Bruce, stated that “Consistent with President Trump’s executive order on reevaluating and realigning United States foreign aid, Secretary Marco Rubio has paused all U.S. foreign assistance funded by or through the State Department and U.S. Agency for International Development (USAID) for review,”
He added that Trump “is initiating a review of all foreign assistance programmes to ensure they are efficient and consistent with U.S. foreign policy under the America First agenda.”
According to NPR, while PEPFAR, funded solely by the U.S. government with a $6.5 billion annual budget, was not specifically mentioned in the announcement, a source at USAID confirmed that the stop-work order applies “100 per cent to PEPFAR.”
It, however, noted that the State Department, on Sunday, January 26, confirmed the halt in an email to NPR, stating that the United States “is no longer going to blindly dole out money with no return for the American people.
The freeze has also been projected to impact USAID staff, with many contractors at risk of losing their jobs during the review.
“This is a matter of life or death,” warned Beatriz Grinsztejn, president of the International AIDS Society (IAS). “PEPFAR provides lifesaving antiretrovirals for more than 20 million people – and stopping its funding essentially stops their HIV treatment. If that happens, people are going to die and HIV will resurge.
“It makes no sense to suddenly stop this incredible catalyst of our global progress towards ending HIV as a threat to public health and individual well-being.”
Mustapha Usman is an investigative journalist with the International Centre for Investigative Reporting. You can easily reach him via: musman@icirnigeria.com. He tweets @UsmanMustapha_M