A new report has revealed that aid cuts imposed during Donald Trump’s presidency in East Africa triggered a collapse in HIV prevention services, leading to unwanted pregnancies, unsafe abortions, and babies being born with the virus. Health workers across the region described how the disruption of the U.S.-backed Pepfar programme unravelled years of public health gains in just 100 days.
Pepfar disruption
The President’s Emergency Plan for AIDS Relief (Pepfar), launched in 2003, had been widely regarded as one of the most successful U.S. foreign aid initiatives, credited with saving millions of lives by providing antiretroviral treatment, testing, and support services. However, funding restrictions introduced under Trump’s administration, linked to anti-abortion policies, forced many clinics to close or scale back services.
According to the report, facilities in Kenya, Uganda, and Tanzania were among the hardest hit. Outreach projects targeting women and adolescents, a group particularly vulnerable to HIV, were dismantled almost overnight.
Consequences on the ground
Doctors and nurses interviewed described an immediate spike in health crises. Clinics lost the capacity to provide contraception and HIV testing, resulting in unwanted pregnancies and a sharp rise in unsafe abortions. Pregnant women with HIV who would previously have received consistent treatment instead gave birth without proper medical supervision, increasing the risk of mother-to-child transmission.
One nurse in Kampala noted that “we lost nearly two decades of progress in a matter of months,” while patients reported being turned away from facilities that had once been a lifeline.
Human impact
For many families, the cuts were devastating. The report documents cases of young women who contracted HIV after prevention programmes ended, alongside children born with the virus despite advances that had previously made such transmissions rare. Experts emphasised that the damage was not limited to HIV services, as clinics providing broader maternal and child healthcare were also shuttered.
Wider implications
Public health analysts argue that the episode underscores the fragility of aid-dependent systems. While some services have since been restored, the interruption left lasting scars, both in terms of health outcomes and trust in international partnerships. Critics warn that the disruption could hamper future efforts to eliminate HIV as a public health threat by 2030.
Looking forward
The report concludes that rebuilding will take years, with renewed investment and policy consistency essential to restoring momentum. Health advocates are calling on current U.S. policymakers to strengthen, rather than politicise, aid frameworks. “Lives are at stake when ideology overrides evidence,” one doctor said.
REFH – Newshub, 2025-09-04
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