U.S. Policy Shift Halts HIV Medications, Leaving Thousands in Crisis

For years, Engage Men’s Health has been a vital resource in South Africa, offering free HIV testing and medications to those in need. But on Monday, their doors closed indefinitely. The reason? A sudden directive from the U.S. government ordered an immediate halt to all activities funded by PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief.

This abrupt shutdown is a direct result of a sweeping stop-work order issued last Friday by the Trump administration, suspending all global health funding—including PEPFAR. The impact was immediate and devastating. Clinics across multiple countries ceased operations, medication distribution stopped, and crucial data systems were taken offline.

Dr. Atul Gawande, former assistant administrator for global health at USAID, confirmed the grim reality: “Clinics have stopped distributing medications, and PEPFAR’s central information systems were shut down.”

A Lifeline Cut Short

PEPFAR-supported clinics serve around 220,000 patients daily, providing life-saving treatments to approximately 20 million people worldwide. For many, the medications they receive are the difference between life and death. Antiretroviral drugs not only suppress the virus in HIV-positive patients but also prevent infection in HIV-negative individuals.

Patients who managed to refill their prescriptions in early December are now facing an impending crisis. According to Deborah Birx, former U.S. Global AIDS Coordinator, “Many will run out of medication by early February. We must act now to restore access.”

The Fallout: Clinics Close, Patients Left Without Options

As news of the stop-work order spread, clinics across sub-Saharan Africa scrambled to inform patients. A Johannesburg clinic serving the transgender community urged people to collect their medications before closing its doors indefinitely. Soon after, the clinic removed all references to its operations from its website and social media.

This scenario is playing out across multiple regions. Health GAP executive director Asia Russell shared distressing updates from clinic staff: “They’re telling patients, ‘Come in today if you can—our clinics are shutting down.’”

In Tanzania, USAID partners were ordered to “immediately stop, cease, and/or suspend any work being performed.” Failure to comply, they were warned, could result in disciplinary action. “Everyone is devastated,” said Russell.

Unprecedented and Dangerous

While new administrations often review or pause funding for ongoing programs, experts say this level of disruption is both “unprecedented and reckless.”

“There is no justification for cutting off life-sustaining medical care,” said Matthew Kavanagh, director of Georgetown University’s Center for Global Health Policy & Politics. “This is a dangerous move.”

In response, senior PEPFAR officials have submitted a waiver request to the U.S. State Department, seeking authorization to continue medication distribution. However, it remains unclear how quickly these waivers will be processed—or if they will be granted.

“The waiver authority of Secretary Rubio needs to be applied immediately to the entirety of the PEPFAR program,” Russell urged.

A Workforce in Limbo

The fallout extends beyond patients. On Monday, senior USAID staff were unexpectedly placed on administrative leave, while all global health contractors—who make up half of USAID’s workforce—were instructed to stop working. Many were laid off abruptly.

Family Health International (FHI 360), a key PEPFAR contractor, received an urgent directive from USAID: “Cease implementation immediately.”

With the dismantling of PEPFAR’s data systems—essential for tracking HIV treatment efforts worldwide—the situation grows increasingly dire. “The entire $6.5 billion program is now in limbo,” Russell confirmed.

Uncertain Future

For millions who depend on PEPFAR-funded programs, the next few weeks will be critical. Without urgent intervention, the consequences could be catastrophic—not just for individuals, but for the global fight against HIV/AIDS.

As clinics remain shuttered and critical medication supplies dwindle, one thing is clear: every day that passes without action puts more lives at risk.