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The Trump administration has instructed organizations in other countries to stop disbursing HIV medications purchased with U.S. aid, even if the drugs had already been obtained and are sitting in local clinics.
The directive is part of a broader freeze on foreign aid initiated last week, according to the New York Times.
It includes the President’s Emergency Plan for AIDS Relief (PEPFAR), the global health programme started by George W. Bush that was credited with saving more than 25 million lives worldwide.
The administration had already moved to stop PEPFAR funding from reaching clinics, hospitals, and other organizations in low-income countries.
Appointments were being canceled, and patients were being turned away from clinics, according to individuals with knowledge of the situation, who feared retribution if they spoke publicly.
The New York Times reports that many people with HIV were facing abrupt interruptions to their treatment, but most federal officials were also under strict orders not to communicate with external partners, leading to confusion and anxiety, according to several sources familiar with the matter.
U.S. officials had also been instructed to stop providing technical assistance to national ministries of health.
“The partners we collaborate with are in shock, and they do not know what to do because their lifesaving mission and commitment has been breached,” said Asia Russell, executive director of the advocacy group Health Gap.
Late on Sunday night, according to an email viewed by The New York Times, employees of the Centers for Disease Control and Prevention (CDC) were instructed, effective immediately, to stop communicating with personnel at the World Health Organization (WHO).
They were later directed not even to be in the same meeting room—real or virtual—as WHO employees or to participate in email conversations in which WHO staff members were also engaged.
Some said they had been too afraid to contact colleagues they consider friends, even if just to say goodbye, and did not wish to be identified for fear of retribution.
On Monday afternoon, officials worldwide were alerted that PEPFAR’s data systems would shut down at 6 p.m. Eastern time, roughly three hours after the email was received, immediately closing off access to all data sets, reports, and analytical tools.
“Users should prioritize copying key documents and data,” said the email viewed by The New York Times.
The message prompted speculation that the program would not resume, as its future was already in question.
Some Republican senators have campaigned against PEPFAR’s reauthorization for five years, alleging that the program promoted abortions. In March, the programme was renewed for one year.
Without treatment, virus levels in people with HIV will quickly spike, damaging the immune systems of the infected and increasing the odds of spreading the virus to others.
About one in three untreated pregnant women may pass the virus on to their babies, and interrupted treatment may also lead to the emergence of resistant strains that can spread globally.
One study estimated that if PEPFAR were to end, as many as 600,000 lives would be lost over the next decade in South Africa alone.
South Africa relies on PEPFAR for only 20 percent of its HIV budget, and some poorer countries are almost entirely dependent on the program.
“This is another domino in the devastating impact of the harmful freeze to programs, leaving lives hanging in the balance,” said Jirair Ratevosian, who served as chief of staff for PEPFAR during the Biden administration.
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