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State Department Proposes Major Cut to PEPFAR Despite Congressional Reprieve

Draft plans call for winding down the emergency HIV initiative with a 42 percent budget cut to refocus on bilateral outbreak detection

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A woman and child walk through a corridor at the Wits Reproductive Health and HIV Institute in Johannesburg.
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Overview

  • Congress restored a $400 million cut to PEPFAR’s funding last week after bipartisan support from Senators Susan Collins and Lisa Murkowski prevented its near elimination
  • State Department draft documents outline a plan to reduce PEPFAR’s $4.7 billion budget by 42 percent and phase out the program within two years
  • Under the proposal, PEPFAR would be replaced by bilateral partnerships aimed at detecting disease outbreaks that could threaten the United States and opening markets for American drugs
  • Experts warn that deep cuts could undermine a program credited with saving over 26 million lives, enabling 7.8 million HIV-free births and providing nearly 70 percent of global HIV/AIDS financing
  • The FDA’s recent approval of the twice-yearly injectable lenacapavir and Gilead’s plan to supply 2 million low-cost doses offer a new prevention tool that could lessen reliance on large-scale emergency aid