Pepfar escaped from the cancellation ax. But where do you stand?

When Kenneth Nagour thinks about the global effort to control HIV/AIDS, he says, he feels as if he was flying.

"It is like a plane that travels at the height of the sailor, and is looking for its destination," Nagor, the president of the International Association of AIDS and associate professor of global health at the University of Jumo Kenyatta in Kenya, says.

He says that destination is a world where HIV/AIDS is no longer a threat. Although there are still more than half a million AIDS deaths every year, he felt as if this goal was in full view of his map on the plane. He says a large part of credit goes to the massive American investment in fighting the virus.

"(The legislators in the United States) are the pilots. They are drivers," Nagour explains. "They were placed in sufficient resources."

Then an unexpected area of severe disorder came.

On the opening day, President Donald Trump Declare He was stopping the vast majority of external aid. That was a tremor.

"It has hit the turmoil and begins to lose height. And you do not know if we would reach our destination," Your Ngure. "Everyone was in a state of panic. Is it the end?"

But last week, he says, the equivalent of a reassuring message came from the pilot.

The American effort to treat HIV/AIDS was part of the Trump administration’s efforts to restore again Billion dollars It was previously allocated by Congress for public media and foreign aid. The total pledge of PePfarand Or the president‘s AIDS relief planand It was scheduled to be reduced: $ 400 million. However, the word came on July 15 The Senate was coming out of the cancellation list and rejecting these cuts. The program has long been supported by the two parties and the leaders wanted to avoid a revolution inspired by PePfar to the package. The rest of the cancellation package approved the House of Representatives and the Senate, and regained $ 9 billion. But Pepfar fled safely.

When Ngure heard that PePfar had survived the discounts attempts, he says, thought of himself: "There is hope, but still maintain your safety belts."

But this was just one small positive note on an increasing rough journey. Was this effort from the two parties to help Pepfar enough to install the plane and ensure its access to its destination? Many rumors. Some say that Pepfar is convicted. Others hope for the history of the two parties. What does the future hold?

History of Pippar

President George W. Bush Pippar established in 2003 – a time when HIV/AIDS virus was devastating communities in Africa and other parts of the world, and killing About 3 million People in the year.

"I have seen very dark days – hospitals on a daily basis witnessing, frankly, the death of teenager or twenties," He says Dr. Charles HolmesWho worked in Malawi as a medical student in 1999 and then again in 2002 before the birth of Pepfar. Later on the position of chief medical officials in the program during the Obama administration.

Holmes returned to Malawi in February and found himself "They mentioned to what extent we have reached." Since its foundation, Pepfar has placed more than $ 120 billion to combat the virus in more than 50 countries. The result of all this money and effort, He saysIt is clear, quoting the accepted achievements on a large scale: 26 million lives rescued, and the rates of HIV infection and the long -life apostasy, especially in Africa.

However, this was not enough to protect Pepfar from foreign aid. When Trump began cutting international aid programs a lot of Pepfar clinics and services Overnight With the stoppage of work orders.

"Customers come to the clinic, and in some cases, they found that the doors are literally closed and that their trusted doctors are not present to see them, and their drugs they expect are not present," Holmes, who is now directing the International Innovation and Health Center at Georgetown University, says.

Nagor says that all the disturbances of the past seven months have had a real and severe effect. It refers to a new study conducted by researchers at the National Institute of Health and the Ministry of Health in Mozambique, which was found, among children there who suffer from HIV therapy, and the percentage that has succeeded in maintaining the virus in the Gulf by 43 % from February 2024 to 2025.

Will Pepfar change?

Holmes is not completely optimistic. Although Congress has maintained $ 400 million financing for PePfar in the current fiscal year, he says that the organization’s future is far from safe.

"The President suggested major financing discounts for the next year," He says. "I don’t think the program is outside the forest yet."

Others repeat this uncertainty. YAP Boum II, a African Centers to Combat Disease and Prevention, says it’s it. "It is too early to really know how PePFAR will change."

Even if funding continues as in the past years, Holmes says, the main question is what this funding is directed. Until now during the Trump era, the vast majority of HIV prevention-with a limited exception from preventing the mother’s transfer to the child-has stopped many of the support that the United States used to provide millions of AIDS. Orphans. For example, I paid Pepfar for purchase and distribution Preparatory, The drug that prevents HIV infections of individuals at risk, such as husbands, where one of them is positive HIV and one negative HIV. Trump administration jump After taking office to reduce this medicine for pregnant women and breastfeeding – and it was not allowed to provide it to others.

"Without prevention and without sponsorship of orphans and weak children, PePfar will be a lot, dwindling," Holmes says.

A spokesman for the Ministry of Foreign Affairs has not answered specific questions about the resumption of a set of full prevention efforts for PePfar as well as its sponsorship of AIDS orphans and weak children. However, the Ministry of Foreign Affairs Justice the budget of Congress For the next fiscal year, it emphasizes the importance "Publishing targeted campaigns to reduce new HIV infections" The new individual individual and effective HIV prevention shots.

Undoubted future

Experts say there are several reasons that make it difficult to predict what Pepfar will look like in the future.

For beginners, the Pepfar license from Congress has ended in March and has not yet been renewed. This does not mean ending PePfar – Congress can still provide financing even without permission – but there are risks.

"Without permission, this can lead to special interests trying to include things in financing bills that reduce the program," Holmes explains.

Another challenge is that PePfar usually puts the country and regional Operations plans To determine the program strategies and clarify the activities that it will support in different parts of the world. This information has not yet been issued for 2026. Foreign Ministry spokesman has not answered questions about when these plans will be issued.

However, an e -mail statement said to NPR: "Al -Amin Rubio stated that Pepfar is an important and life -saving program that will continue. He also said that Pepfar, like all help programs, should be reduced over time because it achieves its mission."

There is another concern about how PePfar works in this world that has been greatly changed from external aid: HIV and other diseases.

"The largest killer for people who live with HIV is actually tuberculosis," Holmes says. The United States tuberculosis program has been greatly cut off," He says.

Failure to know what the rest of the global health scene will appear to make it difficult to know what the HIV/AIDS virus will be. "It is time for great uncertainty," He says.

"We started to see a glimmer"

However, some HIV/AIDS specialists are increasingly confident in the future of PePFAR – even when they expect the United States to probably convert control into other countries.

"I feel we see the return of strong commitment from the two parties," Susan Heleis, who spent seven years in Pepfar, says. During the first period of Trump, it was chosen to lead a $ 100 million initiative to use religious groups to enhance HI/AIDS. "We started to see a glimmer: Yes, it is possible to move forward in the same direction together."

Hillis was meeting with legislators, she says, people began to agree on some things, including working with countries to impose them from PePfar – gradually.

In the Ministry of Foreign Affairs Justice the budget of CongressThe administration confirmed the United States plan "Accelerate the transmission of HIV to the receiving countries and the increase in the international ownership of the efforts to combat HIV/AIDS," Including a "Outside the slope."

Hells admits that no one knows exactly how PePfar of the Future – and how existent is as an independent program.

However, despite a turbulent year yet, NGURE is not ready for umbrella. He says over the past few months, other countries are trying to ensure that the plane will reach its destination, and even bring two additional pilots. HIV/AIDS "It is not possible to return."

Copyright 2025, NPR