Following a 23% drop in global HIV aid and U.S. funding freezes in January 2025, critical HIV services and medicine supplies have collapsed worldwide. A survey across 40 countries reveals that 55% of providers ran out of key medicines, with rapid diagnostic tests and PrEP critically scarce. In Uganda and Zimbabwe, service delivery fell by up to two-thirds, leaving criminalized and vulnerable populations without essential community-based care as humanitarian waivers failed to preserve supply lines.
Shortages reported in IPPF survey
- ▪At the time of the International Planned Parenthood Federation survey, 40% of responding members reported being entirely out of stock of a product, and 60% reported low stock levels for at least one product.
- ▪An International Planned Parenthood Federation survey of 40 countries found that 55% of responding HIV care providers ran out of stock of key medicines within the past year.
- ▪Twelve member associations in the International Planned Parenthood Federation survey reported low stock or no availability of oral and injectable pre-exposure prophylaxis (PrEP).
- ▪The International Planned Parenthood Federation survey identified HIV rapid diagnostic tests as the most critically affected product, with 17 member associations reporting low stock and five reporting no availability.
Reductions in HIV aid funding
- ▪The United States froze foreign aid in January 2025, halting work under the President's Emergency Plan for AIDS Relief (PEPFAR) and the US Agency for International Development (USAID).
- ▪Global aid spending on HIV responses fell by approximately 23% in 2025 compared with 2024, threatening to stall years of progress against the epidemic.
The humanitarian waiver
- ▪The U.S. humanitarian waiver failed to protect lifesaving HIV treatment and keep care going for USAID-funded organizations because the physical apparatus to deliver funding, distribute drugs, and restore staff, commodities, and delivery systems was dismantled.
- ▪The U.S. humanitarian waiver stated that lifesaving services could continue working and implied that they would continue to receive funding.
Service declines in Uganda and Zimbabwe
- ▪Between January 2023 and March 2026, HIV prevention services at the studied organizations fell by 37% to 63%, PrEP by 43% to 72%, treatment by 22% to 32%, and testing by 59% to 64%.
- ▪A study by the London School of Economics and Duke University found that HIV service delivery fell by half to two-thirds at four nongovernmental organizations in Uganda and Zimbabwe after the 2025 U.S. aid cuts.
Impact on criminalized populations
- ▪The U.S. aid cuts disproportionately impacted criminalized populations in Uganda and Zimbabwe, including men who have sex with men, female sex workers, drug users, prisoners, and transgender people.
- ▪Because key populations face stigma and legal barriers in Uganda and Zimbabwe, community-based care from nongovernmental organizations is often their only option for HIV services.
Debatable claims
- ▪Global HIV programs rely too heavily on U.S. government funding
- ▪The 2025 U.S. aid cuts pose a severe risk of a global HIV resurgence
- ▪The United States should restore its frozen foreign aid for global HIV programs
- ▪The U.S. humanitarian waiver was ineffective at protecting global HIV treatment
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