The head of the UN AIDS agency (UNAIDS) said Monday (10/2) that the number of new HIV infections could jump more than sixfold by 2029 if US support for the world's largest AIDS program is ended.
In an interview with the Associated Press, UNAIDS Executive Director Winnie Byanyima said HIV infections have been declining in recent years. Only 1.3 million new cases will be recorded in 2023, a 60% drop since the virus peaked in 1995.
She also warned that millions more people could die and more resistant strains of the disease could emerge.
Since U.S. President Donald Trump announced that the United States would freeze all foreign aid for 90 days, Byanyima said officials have estimated that by 2029 there will be 8.7 million new HIV infections, 6.3 million AIDS-related deaths and an additional 3.4 million children orphaned.
“If the U.S. government’s contribution through PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief) and through this Global Fund is stopped, our estimate is that in the next five years, we will have 6.3 million AIDS-related deaths. Ten times more,” she said.
In one area of Kenya, he said 550 workers with HIV were immediately laid off, while thousands more in Ethiopia were laid off, leaving health officials unable to track the spread of the disease.
He noted that the loss of U.S. funding for HIV programs in some countries is catastrophic, given that external funding accounts for about 90 percent of their programs.
Byanyima said that nearly $400 million of UNAIDS’ funding went to countries like Uganda, Mozambique and Tanzania.
The Trump administration’s decision on PEPFAR has also drawn strong reactions in Washington, D.C. On Thursday, hundreds of people protested outside the State Department, calling for the end of a program that is believed to serve some 20 million people around the world with HIV/AIDS treatment and prevention. The protest was organized by Housing Works, a nonprofit organization that fights AIDS and homelessness in the United States.
Matthew Kavanagh, a professor of global health at Georgetown University, was at the protest. He told Reuters, “What the administration is doing is absolutely illegal. It was Congress that actually passed the legislation that created PEPFAR. It was the United States Agency for International Development (USAID). It’s not Secretary [of State Marco] Rubio. It’s not the president. It’s certainly not Elon Musk’s decision to abolish it. It’s a clear violation of Article One of the Constitution, which says, it’s up to Congress.”
Byanyima also said the loss of American support for the fight against HIV comes at another critical time. Now, he said, there is an antiviral drug that many health experts call a “miracle preventative.” Called lenacapavir, the drug, when injected twice a year, has been shown to provide complete protection against HIV in women, and nearly as good in men.
Widespread use of the shot, along with other interventions to stop HIV, could help end the disease as a public health problem within the next five years, Byanyima said.
So far, no other countries or donors have stepped up to fill the gap left by the loss of U.S. aid, Byanyima said, but he plans to visit European capitals to talk to global leaders.
“I haven’t heard of any European countries committing to take action, but I know they’re listening and trying to see what they can do because they care about human rights and humanity,” he said.
Whether or not the U.S. is cutting PEPFAR is still a matter of debate. But the U.S. State Department said Saturday that PEPFAR is exempt from the 90-day pause in U.S. foreign aid, as quoted by Reuters. That means aid will continue to flow.
As is known, just hours after taking office on January 20, President Trump ordered a pause in foreign aid contributions, to allow for an evaluation of whether it was in line with his “America First” foreign policy.
Secretary Rubio initially issued exemptions for emergency food assistance and then the following day for life-saving medicines, medical services, food, shelter and livelihood assistance. But the lack of detail in Trump’s order and the exemptions granted have left aid groups confused about whether their work can continue.
On February 1, the U.S. State Department’s Bureau of Global Health Security and Diplomacy finally issued a Rubio memo, seen by Reuters, clarifying that PEPFAR was covered by the January 28 memo and that the program was subject to limited exemptions.
These include life-saving HIV care and treatment services, including testing and counseling, prevention and treatment of infections including tuberculosis (TB), laboratory services, and procurement and supply chain of medicines.
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