The United States President's Emergency Plan For AIDS Relief (PEPFAR) is the global health funding by the United States to address the global HIV/AIDS epidemic and help save the lives of those suffering from the disease. According to the United States government, as of 2023, PEPFAR has saved over 25 million lives, primarily in sub-Saharan Africa. Launched by U.S. President George W. Bush in 2003, as of August 2024, PEPFAR has provided cumulative funding of $120 billion for HIV/AIDS treatment, prevention, and research since its inception, making it the largest commitment by any nation focused on a single disease in history. PEPFAR is implemented by a combination of U.S. government agencies in over 50 countries and overseen by the Global AIDS Coordinator at the United States Department of State. PEPFAR supports HIV prevention, testing and antiretroviral treatment, as well as prevention of mother-to-child transmission, care for orphans and vulnerable children, tuberculosis services for people with HIV and broader health-system strengthening. The program initially focused on emergency treatment and prevention, later shifting toward partnership frameworks with recipient governments, epidemic control targets and long-term sustainability. By September 2025, PEPFAR was credited with saving more than 26 million lives and preventing 7.8 million infants from acquiring HIV at birth. In 2025, the second Trump administration put USAID on a 90-day freeze, initially halting PEPFAR activities, before granting a waiver for HIV medicines and other essential medical services. Only about half of PEPFAR programs were later estimated to have restarted in February. For the July to September 2025 reporting period, the budget cuts led to declines in HIV testing, new diagnoses, treatment enrolment and prevention services, although the overall number of people receiving antiretroviral therapy remained broadly stable.
History
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