article · Nature Health
Abstract Here we analysed recently released treatment data from the US President’s Emergency Plan for AIDS Relief (PEPFAR) programme following a year of disruption. Globally ( n = 55 countries), the programme reported approximately 1.97 million (−10.2%) fewer individuals receiving PEPFAR-supported antiretroviral treatment in fiscal year (FY) 2025 as compared with FY2024. FY2025 treatment budget execution declined by approximately 8 percentage points compared with the historical mean. Within a subset of countries selected for further analysis ( n = 26), most experienced absolute declines in PEPFAR-supported treatment and 14 deviated negatively from pre-2025 trends. For South Africa, PEPFAR reported a decline of ∼1.73 million individuals on direct PEPFAR-supported treatment and an increase of ∼1.64 million individuals on treatment benefitting solely from the programme’s broader support to health systems, yielding a net treatment loss of 94,881 (−1.8%) individuals. Outstanding questions remain regarding the drivers, persistence and broader impact of PEPFAR-supported treatment shifts, underscoring the need for timely programme data.
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DOI: 10.1038/s44360-026-00159-1
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