Sweeping foreign aid cuts by U.S. President Donald Trump have triggered a public health crisis across sub-Saharan Africa, where millions are now at risk of HIV infection due to the sudden loss of access to life-saving prevention medication, according to health officials and advocacy groups.

PrEP Access Severely Disrupted

The cuts have particularly impacted the availability of Pre-Exposure Prophylaxis (PrEP), a daily pill that reduces the risk of contracting HIV through sex by up to 99%. The President’s Emergency Plan for AIDS Relief (PEPFAR), which previously funded over 90% of new PrEP initiations in Africa, has seen its operations halted or scaled back after Trump ordered a 90-day pause on foreign aid and suspended USAID grants.

In Nigeria, 25-year-old Emmanuel Cherem tested positive for HIV just two months after losing access to PrEP. “These things were available, and then, without prior notice, they were cut off,” he told Reuters.

A Reversal of Progress

The number of Africans using PrEP had surged from fewer than 700 in 2016 to over 6 million by late 2024, contributing to a 56% drop in AIDS-related deaths since 2010. But UNAIDS now warns that the funding cuts could lead to 2,000 new infections per day, reversing years of progress.

Vulnerable Communities Hit Hardest

The cuts have disproportionately affected gay men, sex workers, and injecting drug users, who are now excluded from prevention programs that continue to serve only pregnant and lactating women. In countries like Malawi, Zimbabwe, and Mozambique, where PEPFAR funds nearly all HIV prevention efforts, clinics are closing and supplies of condoms and lubricants are dwindling.

Global Health Leaders Sound the Alarm

UNAIDS Executive Director Winnie Byanyima called the cuts “devastating,” warning that the goal of ending AIDS as a public health threat by 2030 is now “more off-track than ever”.

Dr. Linda-Gail Bekker, an HIV expert at the University of Cape Town, likened the situation to a smoldering bushfire: “If you take your eye off it and the wind is blowing, a bushfire will come back”.

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