US PEPFAR funding cliff endangers care for 8.7 million HIV patients

In September, 120 funding awards administered by the U.S. Centers for Disease Control and Prevention (CDC) for the President’s Emergency Plan for AIDS Relief (PEPFAR) will expire, and no replacement mechanism has been put in place. The awards support services for more than 8.7 million HIV/AIDS patients worldwide, primarily in Africa, covering community testing, clinical care, laboratory work and PrEP medication.

The U.S. State Department is restructuring the CDC’s role, moving greater control of PEPFAR to a “menu‑a‑la‑carte” system where partner countries select and pay for specific services. Critics warn the shift could diminish program effectiveness and sideline CDC health experts. Analyses predict the funding cliff will hit Mozambique, Tanzania and South Africa hardest, threatening the continuity of long‑standing health services.