Aid Cuts Leave 20 Million at Risk of HIV Drug Loss, WHO Says

More than 20 million people are at risk of losing access to HIV medicines after sudden cuts to health aid disrupted services across dozens of countries, according to the World Health Organization.

WHO said on its health-aid tracking page that 75 of 106 surveyed countries had reported disruptions in at least one essential health service area. It said the fallout has reached HIV, hepatitis, sexually transmitted infections, malaria, tuberculosis and routine immunization systems.

The sharpest warning came from WHO Director-General Tedros Adhanom Ghebreyesus, who said in a March briefing that the suspension of most funding to PEPFAR caused an immediate stop to HIV treatment, testing and prevention services in more than 50 countries. Eight countries already face substantial disruptions to antiretroviral therapy, he said, and some could run out of medicines in the coming months.

Tedros said disruptions to HIV programmes could lead to more than 10 million additional HIV cases and 3 million HIV-related deaths if they continue. He said more than 20 years of progress in reducing infections and expanding treatment were at risk.

The same briefing set out the malaria toll. Tedros said supply chains for malaria diagnostics, medicines and insecticide-treated bed nets were already under severe strain because of stockouts, delayed deliveries and lost funding. If those disruptions continue, WHO estimates there could be 15 million additional malaria cases and 107,000 deaths this year alone.

In Geneva, that is a financing emergency. In many affected countries, it looks more ordinary. Clinics are still standing. Staff are still opening doors. The missing part is the box of pills, the test cartridge, the fuel for the vaccine refrigerator, or the salary that keeps a health worker from leaving.

WHO said more than 2,600 health facilities in 12 humanitarian crises had already suspended services at least partly or were expected to do so soon. It said almost 24 million people living in those crisis settings risk losing access to essential care.

The agency pointed to Bangladesh’s Cox’s Bazar refugee camps as one example. Tedros said diagnosis and treatment of hepatitis C had been disrupted there, along with disease surveillance, primary and secondary care, laboratory services, procurement and the pay of health workers.

The cuts are being framed very differently across regions. In donor-country debates, the language has often centered on budget restraint, efficiency and a pullback from overseas commitments. WHO has described the same shift as an abrupt fracture in service continuity. On the ground, local health officials and aid workers are describing a simpler reality: patients arrive for treatment and find the chain has broken somewhere upstream.

The burden does not fall evenly. Countries with larger domestic budgets can delay procurement, stretch inventories or shift staff. Refugee-hosting states, conflict zones and rural districts have fewer options. WHO said 27 countries in Africa and Asia were already facing severe breakdowns in tuberculosis response, including staffing shortages, diagnostic disruptions and failing drug supply chains.

Immunization systems are also under pressure. Tedros said WHO’s Global Measles and Rubella Network, a system of more than 700 laboratories, faced imminent shutdown after the loss of U.S. funding. That warning landed as measles outbreaks were already rising. WHO said 57 large or disruptive measles outbreaks were recorded last year.

The financial shock is arriving at the same time as other pressures on public health systems. WHO’s country surveys already show strain from conflict, displacement, inflation and climate-linked disease risk. When health budgets are cut abruptly, prevention is usually the first line to weaken because the consequences arrive later than a hospital closure or a bombing.

That lag matters. A missed HIV treatment refill can take months to show up in mortality data. A broken malaria supply chain can become a seasonal surge only after rains arrive. A weakened lab network may not be noticed until an outbreak spreads beyond the first district.

Tedros said the United States had the right to decide what it supports, but added that any withdrawal of direct funding should be orderly and humane so countries can secure alternatives without life-threatening gaps. He also called on other donors and national governments to raise support where they can.

For now, WHO is publishing technical guidance for ministries and communities on how to manage treatment interruptions and keep essential services running. The agency says the immediate test is whether governments and donors can bridge procurement, staffing and surveillance gaps before medicine stocks run out in the coming months.