Children living with HIV ‘not getting treatment needed’ as aid cuts hit services
Children Living with HIV ‘Not Receiving Essential Care’ Amid US Aid Reductions
Global HIV Programs Face Deepening Challenges as Funding Cuts Reshape Services
Children living with HIV not getting - More than a year after the Trump administration imposed a sudden halt on foreign aid, the consequences for HIV programs in Africa and Asia persist, according to a recent report by the Clinton Health Access Initiative (CHAI). The data reveals a stark decline in critical health services, particularly for children, as the US-funded initiatives continue to face disruptions. With funding cuts deepening, the ability of affected regions to provide timely care and prevention has been severely compromised.
The report highlights a 42 percent decrease in the number of individuals initiating PrEP, a vital HIV prevention treatment, across 10 countries during the first half of 2026 compared to the prior year. Simultaneously, HIV testing rates dropped by 12 percent in eight countries, and the enrollment of children onto treatment fell by 15 percent. These figures signal a growing crisis, as children living with HIV are being diagnosed later and slipping through the cracks of the healthcare system.
Dr. Doris Macharia, president of the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), emphasized the urgency of the situation, stating that the data aligns with her organization’s findings. "Testing is the gateway to the paediatric HIV cascade. Once testing declines, every subsequent step—diagnosis, treatment, and retention—follows," she explained. "For children, the loss of early detection means a higher risk of disease progression and complications that could have been avoided."
The aid freeze, which began in early 2025, has left many programs struggling to maintain operations. Carolyn Amole, CHAI’s vice-president for HIV, hepatitis, and tuberculosis, noted that despite the disruptions, there has been no measurable recovery. "Key indicators remain stagnant. We’re not seeing a rebound," she said. "The foundation of our HIV response has been eroded, and the effects are still being felt across the board."
The Trump administration continues to defend its restructuring of US foreign aid, particularly the President’s Emergency Plan for AIDS Relief (PEPFAR), which has historically been a cornerstone of global HIV efforts. Officials argue that countries should assume greater responsibility for funding their own programs, shifting the focus from traditional aid models to bilateral agreements with national governments. This approach, they claim, fosters more sustainable and accountable partnerships.
However, health experts warn that this narrative overlooks the immediate fallout. While adult antiretroviral treatment numbers rose slightly—by 0.6 percent in eight countries—the overall picture is one of decline. HIV testing, diagnosis, and prevention services have all deteriorated sharply, with the number of people receiving support through the program falling from 21.9 million in late 2024 to 17.2 million by the same period in 2025. This drop has created a domino effect, weakening the entire cascade of care.
Clincs are reporting significant disruptions, including shortages of testing supplies and the loss of community health workers who play a crucial role in tracking mothers and children through treatment. "The continuity of care has been broken. We are losing children at every stage," Macharia said. She pointed to the reduction in mentor mothers—women living with HIV who support pregnant women and new parents—as a critical factor in the crisis. "Without these networks, the link between care and prevention is faltering."
The situation has worsened despite the introduction of a groundbreaking HIV prevention tool: lenacapavir, a long-acting injectable drug that offers six months of protection. South Africa recently became the ninth African nation to adopt this innovation, marking a potential turning point in the fight against the epidemic. Yet, advocates fear that weakened health systems may hinder its widespread implementation. "At the moment we have a tool capable of transforming the epidemic’s trajectory, the delivery infrastructure we relied on has been weakened," Amole said.
Asia Russell, executive director of Health GAP (Global Access Project), criticized the administration’s stance on the aid cuts. "These figures expose a preventable disaster," she told The Independent. "In 2026, with access to treatment, people living with HIV can live normal lifespans. But the administration’s policies are creating a gap in care that could cost thousands of lives." She highlighted that the drop in testing rates has led to delayed diagnoses, which in turn delays treatment and increases the risk of transmission.
CHAI’s findings underscore the ripple effects of funding reductions. For instance, the decline in PrEP initiation not only affects individual health outcomes but also impacts the broader community by reducing the population’s ability to prevent new infections. Additionally, the loss of community health workers has disrupted critical outreach efforts, particularly in rural areas where access to healthcare is already limited. "These workers are the backbone of our programs," Macharia said. "Without them, we lose the trust and connection that keep families engaged in care."
As the aid freeze continues, the question remains: how long will the global HIV response remain vulnerable? With PEPFAR’s funding levels unchanged and the Trump administration maintaining its position, the outlook for children and adults alike is uncertain. While the number of people on treatment remains steady at around 20.6 million, the quality and accessibility of services are under threat. "We’re holding the line, but it’s a fragile one," Amole admitted. "Every delay in treatment or prevention adds to the burden on already strained systems."
Experts stress that the long-term consequences of these cuts could be dire. The loss of early infant diagnosis programs, for example, means that children may not receive timely interventions to manage their HIV status. This has the potential to increase mortality rates and reduce the quality of life for those affected. Meanwhile, the shift toward bilateral agreements raises concerns about equitable access, as some countries may struggle to secure funding for their HIV programs without sustained support from the US.
In the face of these challenges, the need for a coordinated global response has never been clearer. While the Trump administration highlights its achievements, the latest data paints a different picture—one where the promise of HIV eradication is being undermined by a lack of investment. As Macharia put it: "We’re not just losing numbers; we’re losing hope. Without immediate action, the damage will be irreversible." The world watches closely to see whether the aid freeze will continue to weaken the fight against HIV or whether new strategies can restore momentum.