Aid Overhaul Threatens HIV and Malaria Supply Lines in 17 African Countries and Haiti

NAIROBI/LONDON — The United States has told staff in 17 African countries and Haiti to stop implementing a long-running global health supply program by May 30, according to an internal email reported by Reuters and reviewed by U.S. News, raising warnings of new gaps in deliveries of HIV drugs, malaria treatments and bed nets.

The program, the Global Health Supply Chain Program-Procurement and Supply Management, delivered more than $5 billion of HIV and malaria products to 90 countries from 2016 to 2024, according to the Reuters report carried by U.S. News on April 3.

Five sources cited by Reuters said the speed of the change could cause shortages or breaks in the provision of life-saving products. The internal email said there could be "immediate risks to service continuity if the transition is rushed or incomplete," according to the report.

The shift comes after a year of upheaval in U.S. foreign assistance. Reuters reported that the program was halted after the administration froze international aid in January 2025, leaving supplies stranded in ports and warehouses before some activities resumed under a waiver for life-saving products.

UNAIDS says the consequences of wider HIV funding disruption could be severe. In an impact analysis posted on its website, the agency said a permanent discontinuation of HIV programs previously supported by the U.S. President's Emergency Plan for AIDS Relief could lead to 6.6 million additional HIV infections and 4.2 million additional AIDS-related deaths between 2025 and 2029.

UNAIDS said that would amount to about 2,300 additional new HIV infections and more than 600 additional AIDS-related deaths per day. It also said 300,000 additional children could die of AIDS-related causes during the same period and 3 million more children could be orphaned.

The State Department told Reuters it had not given Chemonics, the contractor that has run the supply chain program, technical direction to stop operations by May 30 or any other date. Chemonics declined to comment, Reuters reported.

Reuters said U.S. officials were discussing future use of the Global Fund to Fight AIDS, Tuberculosis and Malaria's procurement platform. Two sources told the agency that earlier discussions had focused on a November 2027 transition, and that the revised schedule was unrealistic because some medical products for hard-to-reach areas can take up to a year to order and deliver.

The Global Fund declined to comment to Reuters. The State Department said it would use available pooled purchasing mechanisms to buy supplies at the lowest prices from private manufacturers, according to the report.

Inside donor capitals, the debate has focused on contractors, efficiency and control of aid budgets. In clinics and district warehouses, the question is simpler: whether antiretrovirals, malaria medicines and test kits arrive before stocks run out.

That difference in framing has become sharper over the past year. English-language political coverage in Washington has treated the redesign as part of a broader reordering of foreign assistance. African and global health reporting has framed the same move as a continuity risk for treatment, prevention and child survival.

UNAIDS said more than 20 million people living with HIV rely on treatment directly supported by PEPFAR, representing about two-thirds of the 30.7 million people receiving treatment globally. It said the United States had saved more than 26 million lives through PEPFAR since 2003.

The agency also noted that the 2025 waiver allowed some life-saving HIV services to continue, including treatment, prevention of mother-to-child transmission, laboratory services and procurement of medicines. But it said many other activities remained paused.

The same uncertainty has implications beyond HIV. Reuters reported that earlier disruptions had already caused shortages of malaria drugs for children and gaps in HIV prevention.

That is where regional experience diverges. In Geneva and New York, the issue appears in policy memoranda and donor statements. In sub-Saharan Africa, it is measured in whether a child with fever gets treatment that week and whether a patient on antiretroviral therapy is told to return later.

The next deadlines are close. Country offices have been asked to set out how they would handle the transition and flag risks, according to the Reuters report, while the Chemonics contract is due to end on September 30 under current plans. Whether the handover slows, widens or is revised will determine whether the latest aid redesign remains a management story or becomes a medicine shortage story through the middle of 2026.