By 2030, nearly 500,000 children may die from AIDS-related causes without stable pepfar

Faced with ongoing funding disruptions to the U.S. Foreign Aid Program, a group of international experts have called for urgent action to ensure life-saving interventions and support for children and families affected by HIV/AIDS in Sub-Saharan Africa.

New Health Policy Analysis, published in The LancetAn estimated 1 million children may be infected with HIV and may die from AIDS by 2030, while 2.8 million children may encounter orphans in the region without consistent, stable funding for the U.S. President’s Emergency AIDS Relief Program (PEPFAR) program.

The authors say their analysis presents strong evidence that at least five years of funding for at least five years to prevent unnecessary pediatric disease, death and orphans is crucial, efforts to prevent new HIV infections worldwide, and to maintain the U.S. position as a leader in global health diplomacy.

Founded by the U.S. government in 2003, Pepfar has been the cornerstone of addressing the global HIV/AIDS epidemic, providing more than $120 billion in funding to treat and prevent HIV/AIDS. It is estimated that the program saved more than 26 million lives and ensured that 7.8 million babies have no HIV. It currently supports more than 20 million people in HIV prevention and treatment services, mainly in sub-Saharan Africa [1]. However, the continued funding of the PEPFAR program remains uncertain, raising concerns about the future of HIV/AIDS prevention and treatment efforts, especially in light of the executive order of U.S. President Trump [2] All foreign aid is suspended for 90 days, pending review. Although Pepfar is subject to limited exemption to continue some plans, many of Pepfar’s services have been interrupted or suspended since January 20, 2025. [3]

“The future of the PEPFAR program is in equilibrium. Losing stable, long-term support for the PEPFAR program will end global progress to return to the dark age of the pandemic, especially for children and adolescents, Professor Lucie Cluver of Oxford, co-led Oxford University said Oxford University suddenly withdrew a strategy, especially a strategy, especially a certain strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to replace a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy, to return a strategy,

“Continuous investment in the PEPFAR program, coupled with the gradual growth of African co-financing, can create a sustainable transition for ownership of state-led HIV programs and preserve the legacy of Pepfar’s life-saving efforts,” Cluver added.

The authors used existing data to perform original modeling analysis [4] To predict the risks faced by children in sub-Saharan Africa without the Pepfar program, including increased HIV infection, AIDS-related deaths and orphans. Estimates suggest that by 2030, there may be one million pediatric HIV and 460,000 other AIDS-related deaths in children. Additionally, if Pepfar is stopped completely, it could significantly lower adult expectations and leave 2.8 million other children orphans.

“We have seen the devastating impact of the recent freeze of foreign aid in the United States,” said Susan Hillis, co-author of Imperial College London. “By eliminating HIV treatment and preventing HIV treatment and prevention, many programs that support children, such as those that prevent sexual violence and support the health and well-being of children in general, many children and adolescents who currently benefit from the PEPFAR program will benefit greatly through the cracks in the cracks in the cracks, which will increase their chances of obtaining HIV, thereby increasing the acquisition of HIV or leading to many preventable HIV HIV Ints and death groups and death groups and death groups.”

The authors also highlight how the PEPFAR program demonstrates long-term sustainability by reducing the risk of children’s lifetime access to HIV. Prior to the widespread availability of antiretrovirals in Africa, more than 20 million people died in the region from AIDS-related causes, leaving millions of orphans behind. Pepfar’s efforts have greatly contributed to reducing the number of AIDS orphans from a peak of more than 14 million children in 2010 to 10.5 million in 2023 [5].

In addition to modeling the direct impact of PEPFAR funding disruptions, the authors also evaluated the impact of Pepfar beyond HIV/AIDS, highlighting international diplomacy, economic benefits, including a fourfold increase in two-way trade between the United States and African countries, improvements in education, advances in health care, and the initiation of abuses and protection of children, as well as protection of children.

“Updated PEPFAR investment protects the health and well-being of millions of people and strengthens the U.S. position as a global leader in foreign aid and health diplomacy. Programs like Pepfar have successfully enhanced public opinion in the U.S. and enabled bilateral cooperation to promote bilateral cooperation, not only with strategies on a global scale, but also with strategies on a global scale, and promotes national efforts and promotes national efforts and promotes national support and promotes national support. Pepfar will establish gaps that may be filled by other countries, and the report shows that China and Iran are expected to play a global health leadership role, enabling them to strengthen their influence in the region.

The authors also provide insights on how to build a more sustainable PEPFAR program in 2030 and beyond, citing continued efforts to unite international and local partners to close funding gaps, increase national and community-led programs, and support improvements in domestic health care systems. By 2030, African PEPFAR-backed countries have shown commitment to ownership of HIV responses, as co-financing health systems grow from US$1.31 billion per year in 2004 to US$4 billion per year in 2021.[6]

“Our analysis not only emphasizes the direct health implications of underfunded funds, but also highlights the broader benefits of PEPFAR investment for socioeconomics and a glimpse of the future of PEPFAR programs, long-term long-term strategies in which local capabilities can build improved health and well-being to global health security, especially half of the world, and half of the activities, and over 25 years, all in all of the world, and over 25 years, all in all of the world, and over 25 years, all in all of the world, and over 25 years, all in all of the world, and over 25 years, all in all of the world, and over 25 years, all in all of the world, and over 25 years, all in all of the world, and over 25 years, all in all of the world. Joel-Pascal Ntwali, co-author of Oxford University (UK) – N’konzi.

Professor Chris Desmond (South Africa), co-author of KwaZulu-Natal University (South Africa), added: “What is urgently needed now is that the transition to the state ownership of the expanded PEPFAR program is urgently needed, which will enable this life-saving capability to continue this life-saving capability to provide stability and sustainability for the current and U.S. efforts to integrate and benefit from the U.S. efforts and to benefit from the U.S. efforts and to rely on the U.S., which is consistent, which will also reliably on the U.S. efforts and to rely on the U.S. efforts and to rely on the U.S. HIV.”

The authors point out that some important limitations of the analysis, including the rapid change in the international funding landscape, and that the future of the PEPFAR program is not yet clear. Furthermore, the analysis uses the best available data on HIV infection and mortality to develop future estimates.

In related letters, also published in The Lancet11 senior health officials from African countries wrote together: “We are confident that we can achieve HIV and AIDS as a global threat to our children and families, as our African countries work with the United States and other international donors to continue to transition to continuing to enhance and increase domestic investment and working for international investment, we are competent and competitive. Safer, stronger and more prosperous.”