PEPFAR Funding Cuts Force Closure of 1,700 HIV Treatment Sites Globally

Widespread Service Disruptions and Clinic Closures

The President’s Emergency Plan for AIDS Relief (PEPFAR), a program credited with saving at least 26 million lives since its 2003 inception, faced significant upheaval in 2025. According to a report from the nonprofit amfAR, The Foundation for AIDS Research, the dismantling of the U.S. Agency for International Development and subsequent grant cuts destabilized health networks across 46 countries.

The survey, which collected responses from 166 PEPFAR-funded organizations, revealed that most groups experienced terminated awards or payment delays. These disruptions forced the closure of at least 1,700 service sites and the loss of more than 16,000 full-time staff. Data from the study indicates that just six organizations were responsible for 85 percent of those site closures, highlighting how funding shocks can cause entire service systems to collapse.

Impact on Vulnerable Populations and Treatment Access

Policy changes implemented by the administration have specifically restricted services for key populations. The amfAR survey found that three-quarters of responding organizations stopped providing services to sex workers, men who have sex with men, transgender people, and people who inject drugs. Furthermore, more than 60 percent of organizations discontinued at least one service, and 44 percent stopped serving specific high-risk groups entirely.

Pediatric care has also suffered. A separate study conducted by a multinational group of scientists found that PEPFAR supported treatment for 77,000 fewer children in 2025 than in the previous year, representing a 14 percent decline. Jennifer Sherwood, amfAR’s director of research and public policy, noted that even sites remaining operational are struggling with diminished capacity. Even if a site doesn’t close, what you’re seeing is longer wait times, and fewer staff, and nonfunctioning data systems, Sherwood said.

For more on this story, see PEPFAR Pediatric HIV Treatment Drops as Trump Administration Cuts Funding.

Government Response and Data Discrepancies

The State Department has challenged the findings presented by amfAR and the independent research groups. While acknowledging that they have not verified the amfAR report, a spokesperson stated that the administration’s methodology is flawed. The agency maintains that the program remains effective under the current administration’s oversight.

“The Trump Administration has strengthened PEPFAR through clear strategic direction, promoting greater recipient-country ownership, and sharpening the program’s focus on measurable health outcomes.”

State Department spokesperson

In April, the State Department released data covering one quarter of 2025—July through September—suggesting that treatment numbers remained stable compared to the same period in 2024. However, researchers from amfAR and the International AIDS Society argue that when looking at all four quarters of 2025, the data shows substantial, systemic degradation. Other research published in the journal Nature Health reached similar conclusions, identifying a 10 percent decline in the number of people receiving PEPFAR-supported antiretroviral treatment during the 2025 fiscal year.

Future Stability and Program Oversight

The long-term effects of these funding shifts remain a primary concern for global health officials. Dr. Beatriz Grinsztejn, president of the International AIDS Society, highlighted the difficulty of gauging future HIV rates as data collection programs are shuttered. We unfortunately are going through a very complex and difficult moment, where all these good achievements are challenged by the new policies, she said.

As international stakeholders prepare to meet in Rio de Janeiro to discuss these findings, the core question remains whether the current infrastructure can recover. Ramona Godbole, an author of the study identifying the 10 percent treatment decline, noted, That does raise really important questions about program stability. With prevention spending falling 51 percent between fiscal years 2024 and 2025, the ability of PEPFAR to maintain its historic role in controlling the global epidemic remains under intense scrutiny.