The World Health Organization (WHO) expresses deep concern about the implications of the immediate funding pause for HIV programmes in low- and middle-income countries. These programmes provide access to life-saving HIV therapy to more than 30 million people worldwide. Globally, 39.9 million people were living with HIV at the end of 2023.

A funding halt for HIV programmes can put people living with HIV at immediate increased risk of illness and death and undermine efforts to prevent transmission in communities and countries. Such measures, if prolonged, could lead to rises in new infections and deaths, reversing decades of progress and potentially taking the world back to the 1980s and 1990s when millions died of HIV every year globally, including many in the United States of America.

For the global community, this could result in significant setbacks to progress in partnerships and investments in scientific advances that have been the cornerstone of good public health programming, including innovative diagnostics, affordable medicines, and community delivery models of HIV care.

We call on the United States Government to enable additional exemptions to ensure the delivery of lifesaving HIV treatment and care.

PEPFAR’s legacy and current risks

The United States President’s Emergency Plan for AIDS Relief (PEPFAR) has been a flagship initiative of the global HIV response since its establishment over 20 years ago. The current funding pause for PEPFAR will have a direct impact on millions of lives that depend on the predictable supply of safe and effective antiretroviral treatment.

PEPFAR works in over 50 countries around the world. Over the past two decades, PEPFAR funding has saved more than 26 million lives. Currently, PEPFAR is providing HIV treatment for more than 20 million people living with HIV globally, including 566 000 children under 15 years of age.

Over the past year, PEPFAR and partners, including WHO, have been working on sustainability plans with countries for greater country ownership and reduced donor support up to and beyond 2030. A sudden and prolonged stop to programmes does not allow for a managed transition and puts the lives of millions at risk.

WHO is committed to support PEPFAR and other partners, as well as national governments, in managing change processes effectively to minimize the impact on people living with HIV.