Health care providers in South Africa and Mozambique say the Trump administration’s cancellation and redirection of U.S. PEPFAR funding has already cost lives – and left some of the continent’s most vulnerable HIV patients without care.
PEPFAR, the President’s Emergency Plan for AIDS Relief, has for two decades funded antiretroviral treatment, testing, and prevention work across sub-Saharan Africa. Workers on the ground say the cuts didn’t happen in a vacuum. People dependent on those programs had nowhere else to turn.
The providers didn’t frame it as a budget dispute. They called it a public health collapse, one playing out in clinics and rural outreach programs that ran on U.S. dollars and had no backup plan when the money stopped or got rerouted.
South Africa and Mozambique are among the countries with the highest HIV burdens in the world. Mozambique in particular has relied on PEPFAR support for a significant share of its national AIDS response. When funding dried up or shifted, the gap wasn’t absorbed – it showed up in missed treatment, lapsed drug supplies, and, workers say, deaths that didn’t have to happen.
The Trump administration has defended broader foreign aid cuts as a reordering of priorities, arguing that U.S. taxpayer money should be directed differently. Critics, including the health workers NPR spoke with, say that framing ignores what PEPFAR was actually doing on the ground – keeping people alive.
Whether Congress will act to restore or protect PEPFAR funding remains an open question. No vote has been scheduled.
Reporting by NPR, published June 7, 2026. Read the original report.
