Analysis reveals declines in antiretroviral treatment in 26 countries, indicating potential disruptions in HIV care.
Here we analysed recently released treatment data from the US President’s Emergency Plan for AIDS Relief (PEPFAR) programme following a year of disruption. Globally ( n = 55 countries), the programme reported approximately 1.97 million (−10.2%) fewer individuals receiving PEPFAR-supported antiretroviral treatment in fiscal year (FY) 2025 as compared with FY2024. FY2025 treatment budget execution declined by approximately 8 percentage points compared with the historical mean. Within a subset of countries selected for further analysis ( n = 26), most experienced absolute declines in PEPFAR-supported treatment and 14 deviated negatively from pre-2025 trends. For South Africa, PEPFAR reported a decline of ∼1.73 million individuals on direct PEPFAR-supported treatment and an increase of ∼1.64 million individuals on treatment benefitting solely from the programme’s broader support to health systems, yielding a net treatment loss of 94,881 (−1.8%) individuals. Outstanding questions remain regarding the drivers, persistence and broader impact of PEPFAR-supported treatment shifts, underscoring the need for timely programme data.
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Godbole et al. (2026) studied this question.
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