Trump to slash funding for flagship US HIV programme by 40pc
Details from Donald Trump's 2026 budget request show nearly a two-fifths fall in funding for the United States President's Emergency Plan for Aids Relief (Pepfar).
The long-running programme is estimated to have saved more that 20 million lives in the past two decades, and is often cited as one of the world's most successful public health schemes.
A recent analysis published in the Lancet found that as many as half a million more children could die from Aids by the end of the decade because of disruptions to Pepfar.
The details on global health funding for the State Department, USAID agency, Centres for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH) also show deep cuts elsewhere.
Analysis by the San Francisco-based KFF health policy charity found the government departments were planning a 55 per cent cut in separate tuberculosis funding, a 47 per cent cut in malaria funding and a 92 per cent cut in maternal health funding.
The proposal also withdraws all £221m ($300m) given to Gavi, the vaccine alliance which provides jabs to children in poor countries.
In total, the request for money for the American government's main global health funding account is £2.8bn ($3.8bn) in 2026, down from £7.4bn ($10bn) in 2025.
Setting out the cuts, the State Department said the request for money 'eliminates funding for programmes that do not make Americans safer, such as family planning and reproductive health, neglected tropical diseases, and non-emergency nutrition'.
Mr Trump's government upended US aid spending days after taking office, saying it would suspend all aid while projects were reviewed.
It then proceeded to close hundreds of aid programmes, including Pepfar projects, resulting in lay-offs for thousands of health workers, particularly in Africa.
The budget proposals now give a clear indication that Mr Trump intends to continue with sharp cuts and will quash any hopes that the funding taps could be switched back on again.
A State Department explanation of the budget request uses the phrase 'America First' 37 times as it explains a new focus on cutting costs and protecting US national interests.
For the 2026 fiscal year, which begins on Oct 1, the budget proposals request £2.1bn ($2.9bn) for Pepfar, a 38 per cent reduction from the £3.5bn ($4.7bn) requested in 2025.
The State department said that after spending a total of £88bn ($120bn) in the past two decades, it was now focussing on finding a responsible 'off ramp' to hand over responsibility for the campaign against HIV to countries themselves.
'This [budget] request will allow the United States to accelerate the transition of HIV control programmes to recipient countries and increase international ownership of efforts to fight HIV/Aids.'
Some projects may still be paid for by other government funds, but overall the KFF analysis found the budget included 'significant reductions in global health funding including the elimination of some programs and activities'.
The details will prove a severe disappointment to aid projects who had hoped that despite Mr Trump's rhetoric, there was a chance funding could be renewed in the new fiscal year.
Public health officials argue that continuing to fund global health projects to stamp out infectious diseases is still in America's best interests as infections often cross borders.
One executive at a major South African anti-HIV organisation said: 'Nobody wins unless we all win. No one can make it out of this alone. This is how we achieve epidemic control.'
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