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In a recent piece for The New York Times, Emily Bass details a recent visit to Uganda where she was able to see the impact of reductions in PEPFAR support and the resilience of health care workers during times of uncertainty. Community health care workers from the AIDS Support Organization (TASO) worked for months without pay to ensure people throughout Uganda had access to life saving antiretrovirals. At the same time, some clinics continue to face significant challenges.
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Bass writes, “On Good Friday, the executive director of a slum-based clinic told me it hadn’t received any antiretrovirals for almost two months. It had tried and failed to make three weeks’ worth of drugs last by giving out fewer pills to every patient. Twenty-five percent of the H.I.V.-positive mothers in a recent birth cohort had delivered babies who were already infected with H.I.V. because the clinic hadn’t had reliable drug supplies. It had previously gone years without seeing a single baby born with H.I.V.”
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Ahead of IAS, South African HIV activists called upon China, India, Brazil, and Thailand to address HIV/AIDS programming and funding gaps that the United States previously filled. It is clear that a retreat in U.S. foreign investment creates a void that our adversaries are willing and able to fill. Topics surrounding the future of international support for HIV/AIDS will likely be the center of debate during this week's IAS meetings and events.
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UNAIDS released their 2025 Global AIDS Update, “AIDS, Crisis and the Power to Transform” on July 10. This annual report illustrates the status of the HIV/AIDS pandemic throughout the globe, outlines existing gaps along the continuum of care, and analyzes future trends. The report is coupled with the UNAIDS global factsheet, which shows that last year, approximately 87% of all people living with HIV knew their HIV status, 89% had access to treatment, and 94% were virally suppressed. However, these results vary greatly between geographies and populations, showing that the world will need to chart an aggressive, country-tailored course to end HIV/AIDS as a public health threat by 2030.
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The Clinton Health Action Initiative and Unitaid released a memo underscoring the potential impacts of foreign aid funding cuts for HIV relief for low- and middle-income countries. While disruptions exist in access to essential relief, the organizations recommend "identifying and addressing gaps, reprioritizing goals, improving real-time supply visibility, and aligning with global procurement strategies." The memo specifically responds to cuts in PEPFAR funding and budget reductions for global partners as well.
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The Center for Strategic and International Studies (CSIS) released a statement underscoring the impact of PEPFAR funding cuts on women and girls under the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) initiative. DREAMS stands to lose a significant portion of its funding, and therefore its remarkable impact on women and girls facing elevated risks of violence, exploitation, and HIV infection in Africa. CSIS noted that "the dismantling of U.S. foreign assistance and global health programming perpetuates the reality that HIV has a female face in Africa, reversing recent progress."
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During a conversation hosted by NPR, Jon Cohen, a senior correspondent for Science magazine, underscored the efficacy of drugs that have allowed people with HIV to lead completely normal lives. In high-income countries, these life-saving treatments have preserved millions of lives, but at a cost of $15,000 per person per year, they remain largely inaccessible to many in the Global South. As the future of PEPFAR hangs in the balance, so too does the health and survival of millions who rely on U.S.-funded HIV treatment.
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