Until recent years, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) enjoyed bipartisan support and funding. Since it launched in 2003, the global HIV program has saved 26 million lives and enabled 7.8 million babies to be born without HIV, mostly in Africa. But under President Trump’s second term, the program has faced funding lapses and attacks from the White House. How has this chaotic environment affected PEPFAR’s ability to provide HIV services and treatment? New data from the State Department, which oversees PEPFAR, offers insight.
The number of people receiving treatment for HIV through PEPFAR in 2025 stayed about the same as the previous year, according to a State Department memo reported on by ABC News. In fact, about 20.6 million people living with HIV received antiretrovirals through PEPFAR in each year.
However, health experts estimate a decrease in the number of people being tested for HIV. What’s more, AIDS advocates tell Reuters that the State Department figures didn’t include numbers from early 2025 when the funding cuts would have had a negative impact.
“We have seen this big drop in testing, and that’s problematic, because if people aren’t tested, they can’t know if they’re positive. If we don’t know they’re positive, they cannot be put on drugs,” Charles Kenny, a senior fellow at the Center for Global Development who has been tracking the data, told Reuters. “We’re building up problems for the future.”
PEPFAR’s funding and administration has been thrown into chaos since Trump began his second term. On January 24, 2025, the Trump administration froze all foreign aid programs, including PEPFAR, for 90 days. Days later on February 1, PEPFAR received a limited waiver allowing the program to “implement urgent life-saving HIV treatment services,” including antiretroviral treatment, HIV testing, counseling, opportunistic infection treatment (for example, tuberculosis) and more. Notably, the limited waiver did not include cervical cancer screening, HIV prevention through pre-exposure prophylaxis administration (PrEP) injections or pills for anyone other than pregnant women and services for orphans and vulnerable children, according to KFF.org.
In September 2025, the Trump administration released America First Global Health Strategy which initiated the transition of PEPFAR’s financial burden away from the U.S. and toward country’s receiving aid being self-reliant for HIV care.
As the White House slashed support to PEPFAR, Congress would vote to restore funding, only for Trump to sign executive orders countering the support. What’s more, the White House has threatened to restructure the program in ways that create further confusion.
“We have been in an unprecedented period of a 16-month data blackout,” said Asia Russell, executive director of Health GAP, a global AIDS advocacy group.
Data for the first three quarters of fiscal year 2025 is unavailable due to program interruptions in funding resulting in reporting challenges. The present data, from the last quarter of 2025, is the first to show the impact of the program’s funding lapses and changes by the Trump administration.
PEPFAR treated 20.6 million people living with HIV in more than 50 countries in the fourth quarter (Q4) of fiscal year 2025, about the same number of people treated in Q4 of 2024, which is seen as a win for some state officials. Jeremy Lewin, senior official under the secretary for foreign assistance, humanitarian affairs and religious freedom, said “the numbers are very, very good,” at a conference on April 14.
While treatment rates stayed consistent, other HIV metrics fell. Testing fell from 21.9 million people in 2024 to 17.2 million. New HIV diagnoses fell from 385,000 people at the end of 2024 to 307,000 in the last quarter of 2025.
“What these data show us is the deliberate unraveling of the elements of HIV prevention and treatment service delivery that are essential to actually finish the job and defeat this pandemic,” Russell told the New York Times.
