Relief for Nigeria, other African nations as U.S. eases HIV funding freeze

Nigerians and other Africans could heave a sigh of relief as the United States government has granted a temporary waiver for “life-saving humanitarian assistance” from a funding freeze that had threatened to disrupt critical HIV/AIDS programmes across the continent.

The waiver, issued Tuesday by the U.S. State Department, allows certain essential health services to continue despite the broader suspension of foreign aid initiated by President Donald Trump.

Just hours after assuming office, President Trump signed an executive order halting nearly all U.S. foreign aid for 90 days pending a review of its alignment with his “America First” policy.

The abrupt decision sent shockwaves through the global health community, as it initially applied to the President’s Emergency Plan for AIDS Relief (PEPFAR), a key initiative responsible for providing life-saving antiretroviral (ARV) medications to millions worldwide.

Following global outcry, U.S. Secretary of State Marcus Rubio issued a memo saying that life-saving humanitarian assistance — defined as core medical services, food, shelter, and other critical support — would be exempt from the freeze. However, he emphasized that the waiver is “temporary in nature,” leaving future funding in question.

Nigeria’s reliance on PEPFAR

Nigeria has one of the highest HIV burdens in the world, with approximately two million people living with the virus. Since its inception in 2003 under President George W. Bush, PEPFAR has played a pivotal role in Nigeria’s HIV/AIDS response, contributing over $6 billion in funding to support treatment, testing, and education efforts.

The temporary funding freeze sparked immediate fears of ARV shortages, increased transmission rates, and heightened mortality among HIV-positive individuals. The impact would have been particularly devastating in Nigeria, where PEPFAR funds a significant portion of HIV-related healthcare infrastructure and salaries for thousands of health workers.

Nigerians responded to the development on Tuesday and Wednesday with a mix of alarm and scrutiny. While many feared the potential impact of the funding freeze on critical healthcare services, others argued that it was not entirely misplaced.

They said the decision puts the Nigerian government under pressure to take greater responsibility for funding essential health programmes, rather than allowing officials to divert public funds for their extravagant spending.

“You want American taxes to fund your healthcare while your taxes fund VP mansions and private jets,” one user posted on X, referring to vice president Kashim Shettima’s N21 billion mansion and the over $100 million bought by President Bola Tinubu, both procured at a time of extreme economic hardship.

Beyond Nigeria, the funding freeze sent shockwaves across the continent. South Africa, home to the world’s largest HIV treatment program with 5.5 million people on ARVs, was caught off guard. Health Minister Aaron Motsoaledi expressed frustration, stating that the U.S. government had provided no formal notification of the funding halt.

“The world is baffled by these decisions,” he said, emphasizing the reliance of African nations on global partnerships to combat HIV/AIDS, tuberculosis, and malaria.

Despite the exemption, many health organizations in African nations remained uncertain about whether all HIV/AIDS-related services, including prevention and testing, will continue uninterrupted.

Global reaction

The World Health Organization (WHO) and UNAIDS have urged the U.S. to extend exemptions further to prevent a catastrophic rollback in the fight against HIV/AIDS.

The WHO cautioned that prolonged funding disruptions could reverse decades of progress, potentially leading to a resurgence of the AIDS epidemic similar to that of the 1980s and 1990s.

“The World Health Organization (WHO) expresses deep concern about the implications of the immediate funding pause for HIV programmes in low- and middle-income countries,” WHO said in a statement.

“These programmes provide access to life-saving HIV therapy to more than 30 million people worldwide. Globally, 39.9 million people were living with HIV at the end of 2023.”

UNAIDS Executive Director, Winnie Byanyima welcomed the waiver, saying that it “ensures that millions of people living with HIV can continue to receive life-saving HIV medication during the assessment of US foreign development assistance.”

“This urgent decision recognizes PEPFAR’s critical role in the AIDS response and restores hope to people living with HIV,” she added.

The Trump administration has defended its decision, arguing that U.S. taxpayers’ money must be spent with measurable returns.

“Our test is simple: Does it make America safer, stronger, and more prosperous? Some aid programs fail this test,” said State Department spokesperson Tammy Bruce.

Critics argue that defunding HIV/AIDS programs contradicts long-term U.S. strategic interests by undermining global health security.