Impact of US government funding freezes on the HIV response: findings from a rapid survey in 32 countries

TL;DR

A survey of 76 clinics in 32 countries found that nearly half experienced disruptions in HIV services after US funding freezes in early 2025.

Contribution

This study provides the first rapid assessment of how US funding freezes impacted HIV service delivery across multiple global regions.

Findings

47% of responding clinics reported disruptions in HIV-related services since January 2025.

28% of sites experienced medication availability disruptions, and 34% faced laboratory service disruptions.

Only 14% of sites with service disruptions reported full resolution by mid-2025.

Abstract

After the freezing of US foreign assistance in January 2025, the International Epidemiology Databases to Evaluate AIDS (IeDEA) conducted a rapid survey among clinics and programs actively participating in the research consortium to assess the status of HIV-related service delivery in mid-2025.

In June–July 2025, an online survey was distributed to 103 IeDEA-participating clinics/programs in 41 countries in sub-Saharan Africa, Latin America and the Caribbean, and Asia-Pacific. Survey domains included US funding-related disruptions in service delivery, medication availability, laboratory services, clinic operations, and attendant mitigation strategies. Responses were received from 76/103 (74%) clinics/programs in 32/41 (78%) countries. Descriptive statistics were used to characterize disruptions in HIV-related care and mitigation measures.

Almost half of responding sites reported disruptions in HIV-related services (47%) since January 2025, along with disruptions in medication availability (28%), laboratory services (34%), and non-research clinic operations (47%). Among those reporting disruptions in HIV-related services, only 14% reported that all disruptions were fully resolved at the time of the survey.

Given anticipated reductions in global HIV funding, government- and community-led monitoring of HIV prevention and treatment services and care outcomes are critical for informing national responses and averting reversal of progress in ending the epidemic.

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