Failure to reauthorize global AIDS program would be catastrophic

MSF urges US lawmakers to sustain lifesaving support for PEPFAR

MSF Dr. Dilorom Babakhodjaeva provides consultations for people with HIV, hepatitis C, and syphilis in Tashkent, Uzbekistan.

Uzbekistan 2022 © Umida Akhmedova/MSF

NEW YORK, SEPTEMBER 29, 2023—Allowing the United States President’s Emergency Plan for AIDS Relief (PEPFAR) to expire tomorrow instead of reauthorizing it for the next five years would have catastrophic global health consequences, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF).

Since its inception 20 years ago, PEPFAR has saved more than 25 million lives worldwide and prevented millions more people from becoming infected with HIV/AIDS. In the early 2000s, approximately 8,000 people were dying per day from AIDS-related complications and very few people with HIV were on treatment due to its price and availability in low-income countries. Today, with the help of PEPFAR, mortality figures have decreased exponentially, and 75 percent of people living with HIV globally are on the lifesaving medicines they need.

PEPFAR, which has historically been lauded as a model of bipartisan success, is at risk due to an unprecedented politicization of the Congressional reauthorization process fueled by false claims about the use of the program's funds for abortion. While the program has been reauthorized every five years since its creation, failing to do the same this year will open it up to annual Congressional negotiations, leaving people with HIV and treatment providers without a stable and reliable funding source.

MSF does not accept US government funding and will not be directly affected by cuts to PEPFAR.

Dr. Carrie Teicher, director of programs at MSF-USA, said today:

“US lawmakers must immediately reauthorize PEPFAR for its traditional five-year period or risk a global reemergence of HIV/AIDS as a medical humanitarian crisis.

“For 20 years, our medical teams all over the world have seen firsthand the massive role that PEPFAR has played in the collective global response to the HIV epidemic—from preventing the spread of HIV, testing people for the virus, and ensuring equitable access to lifesaving treatment for those who need it.

“But we know these gains are fragile. We saw during the COVID-19 pandemic what can happen when services for HIV/AIDS are interrupted: people lose access to care, infection rates in communities can spike, and the progress we've made starts to reverse.

“Without reauthorizing PEPFAR as lawmakers have in the past, we could fall so far backwards in this fight that this completely treatable disease could turn into a global health emergency again.

“Two decades of US leadership and support for HIV prevention, testing, and treatment has saved lives, encouraged investment from governments and global institutions, and improved the types of programs being carried out locally by PEPFAR partners.

“As the global health community, we’re closer than ever to making sure that people everywhere have access to the HIV prevention, testing, and treatment they need to stay healthy, but we can’t achieve that if US lawmakers turn their backs on PEPFAR now.”