­Trump Administration’s Order Requiring Immediate Suspension of All HIV Services Provided by PEPFAR Will Place Lives at Risk

More than 20 million people living with HIV globally—including 550,000 children under 15— depend on daily services provided with support of the PEPFAR program

Washington, D.C., January 24, 2025 — The Trump Administration, through the U.S. Department of State, sent a cable to all U.S. Embassies today ordering the immediate suspension of all foreign assistance consistent with President Trump’s Executive Order issued on January 20 requiring a pause on further obligations and disbursements of foreign assistance funds for 90 days. The cable specifically orders:

Effective immediately, Assistant Secretaries and Senior Bureau Officials shall ensure that, to the maximum extent permitted by law, no new obligations shall be made for foreign assistance until such time as the Secretary shall determine, following a review. For existing foreign assistance awards, contracting officers and grant officers shall immediately issue stop-work orders, consistent with the terms of the relevant award, until such time as the Secretary shall determine, following a review. Decisions whether to continue, modify, or terminate programs will be made following this review.

The only programmatic exemptions provided were for “emergency food assistance” and military financing for Israel and Egypt. If implemented for the President’s Emergency Plan for AIDS Relief (PEPFAR), it would halt life-saving treatment even if lifted relatively quickly.

Globally, the PEPFAR program operates in 54 countries, primarily in Africa, providing critical life-saving daily services for people living with HIV. According to PEPFAR’s Human Resources for Health data, there are more than 190,000 full time equivalent clinical and ancillary care providers providing core health care services every day, including: 1,422 doctors; 7,142 clinical officers; 13,577 nurses, auxiliary nurses and nursing assistants; 1,000 midwives; 5,044 phlebotomists and laboratory technicians, 1,881 pharmacists, and more than 108,000 community health workers. On average, these health care workers make just over $3,000 per year, making even short funding suspensions extremely difficult.

A stop work order immediately removes these individuals from providing daily services. Hundreds of thousands of people will immediately be unable to access effective and life-saving HIV
treatment and other services. Globally, on a daily basis, PEPFAR is responsible for supporting:

• More than 222,000 people on treatment in the program collecting ARVs to stay healthy;
• More than 224,000 HIV tests, newly diagnosing 4,374 people with HIV – 10% of whom are pregnant women attending antenatal clinic visits;
• Services for 17,695 orphans and vulnerable children impacted by HIV;
• 7,163 cervical cancer screenings, newly diagnosing 363 women with cervical cancer or pre-cancerous lesions, and treating 324 women with positive cervical cancer results;
• Care and support for 3,618 women experiencing gender-based violence, including 779 women who experienced sexual violence.

Additionally, PEPFAR provides critical technical and infrastructure support for pharmaceutical supply chains, laboratory systems, data systems, and other technical support.

While country governments invest substantially in their own HIV response as well, the immediate stop work orders to the more than 190,000 clinicians and other health care workers will massively disrupt the global HIV response. Even short cessations of these programs cause unnecessary suffering, loss to follow-up, and risk onward transmission that cannot simply be “turned back on” when the suspension is lifted.

The first Trump Administration shepherded a strong PEPFAR that oversaw significant progress and success. We call on the Administration to ensure seamless continuation of services by immediately providing a waiver to the stop work order and the 90-day suspension of services for the PEPFAR program.

About amfAR
amfAR, The Foundation for AIDS Research, is one of the world’s leading nonprofit organizations dedicated to the support of AIDS research, HIV prevention, treatment education, and advocacy. Since 1985, amfAR raised nearly $900 million in support of its programs and has awarded more than 3,800 grants to research teams worldwide. Learn more at www.amfAR.org

Media Contact:
Robert Kessler, Program Communications Manager
(212) 806-1602
robert.kessler@amfar.org

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