A published report indicates the Trump-Vance administration plans to not fully fund PEPFAR in the upcoming fiscal year.

The New York Times on Aug. 21 reported the Office of Management and Budget that Russell Vought directs “has apportioned” only $2.9 billion of $6 billion that Congress set aside for PEPFAR for fiscal year 2025. (PEPFAR in the coming fiscal year will use funds allocated in fiscal year 2024.)

“They are withholding FY25 funds appropriated by Congress, so that FY26 means PEPFAR shrinks away to nothing,” Health GAP Executive Director Asia Russell noted to the Washington Blade.

Then-President George W. Bush in 2003 signed legislation that created PEPFAR (U.S. President’s Emergency Plan for AIDS Relief). UNAIDS Executive Director Winnie Byanyima in March told reporters during a Geneva press conference that PEPFAR has saved 26 million lives.

The Trump-Vance administration in January froze nearly all U.S. foreign aid spending for at least 90 days. Secretary of State Marco Rubio later issued a waiver that allows PEPFAR and other “life-saving humanitarian assistance” programs to continue to operate during the freeze.

The New York Times notes bipartisan opposition in the U.S. Senate prompted the Trump-Vance administration last month withdraw a proposal to cut $400 million from PEPFAR’s budget.

The Blade has previously reported PEPFAR-funded programs in Kenya and other African countries have been forced to suspend services and even shut down because of gaps in U.S. funding.

“As part of the administration’s effort to end diversity, equity and inclusion programs, it has terminated HIV care for gay and transgender people,” notes the New York Times. “HIV prevention programs for high-risk groups — such as sex workers and injecting drug users — have been cut and only pregnant and breastfeeding women can now receive U.S.-funded prevention drugs or condoms.”

NEPHAK is a network of Kenyan HIV/AIDS service organizations.

Nelson Otwoma, the group’s director, on Aug. 26 noted to the Blade the U.S. funding gaps have forced NEPHAK to lay off health care providers and close drop-in centers that serve key populations, including transgender people, gay men, and men who have sex with men.

“The Kenya government is integrating HIV care into general health service centers,” noted Otwoma. “With criminalized and highly stigmatized communities, this is huge barrier to access to services. Besides, there are concerns around privacy, confidentiality, and consent [and] worse because (untrained) health care workers also come with negative attitude towards (key populations) and people with HIV.”

Kenya is among the countries in which consensual same-sex sexual relations remain criminalized.

Otwoma said NEPHAK has also “had to halt” its Community Led Project that the Centers for Disease Control and Prevention funded through UNAIDS. Otwoma also told the Blade that NEPHAK had to lay off staff and go into debt because the CDC-funded project “was classified as surveillance, which was not under the limited waiver” that Rubio issued.

“At the national programming level, NEPHAK members receive life-long treatment from the U.S. government through PEPFAR,” he said.

Otwoma noted PEPFAR or the Global Fund pay for HIV treatments in Kenya — and he pointed out more than 30 percent of the Global Fund’s funding comes from the U.S.

“To deny PEPFAR the support it needs sends the wrong signal to the Kenya PLHIV (people living with HIV) community under NEPHAK,” said Otwoma. “We understand the lives and health of Kenyans is responsibility of the Kenya government but an abrupt transition may not be manageable. Trump should have put in place a responsible transition plan.”

Pasquine Ogunsanya, who directs an HIV program in Uganda, told the New York Times the funds that her organization received this month from the U.S. were only enough to pay staff salaries and cover “limited administrative costs.” Ogunsanya said she recently learned she would have to cut an additional 40 percent from her group’s budget.

“I’m just thinking how can we do that, I’m having sleepless nights,” she told the New York Times. “How can we have five people providing lifesaving H.I.V. services to 10,000 clients?”

Russell has participated in several protests in D.C. where she and other HIV/AIDS activists have demanded the Trump-Vance administration fully fund PEPFAR. Russell on Aug. 26 reiterated this demand.

“Congress has to act … it has to exert its will,” said Russell. “Lives are on the line.”

Washington Blade courtesy of the National LGBTQ Media Association.