In the wake of new temporary changes to the US foreign aid under the Trump administration, the Rwanda Networks of People Living with HIV/AIDS (RRP+ Rwanda) has said that it is concerned over the uncertainty surrounding the future for HIV programs funding.
Shortly after taking office, President Donald Trump announced a temporary freeze on nearly all foreign assistance as part of his "America First” policy, halting billions of dollars in global funding.
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However, the administration later said the freeze would not apply to the US President&039;s Emergency Plan for AIDS Relief (PEPFAR), the world’s leading HIV initiative, which supports more than 20 million people living with HIV.
The waiver extended to PEPFAR will ensure the continuation of "life-saving humanitarian assistance," including HIV treatment and the necessary medical supplies.
Despite this, questions remain about the future of other HIV programs funded by the US, for example those focused on prevention and awareness campaigns.
In an interview with The New Times, Deo Mutambuka, Executive Secretary of RRP+ Rwanda, voiced concern that US funding cuts could destabilise community outreach efforts, awareness campaigns, as well as prevention programs.
"As you know, community outreaches can be destabilised. Even some prevention programs or activities may be somehow damaged. But we are yet to really know which activities will continue and those that will stop,” he noted.
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PEPFAR-supported programs in Rwanda include community outreach, prevention programs, strengthening civil society organisations, and providing mitigation efforts for those affected by HIV.
When asked if he was worried, Mutambuka replied.
"You cannot say that we are not worried,” He said, adding that they are concerned about the next steps but will talk to the government to give them perspective.
He pointed out that cuts to prevention programs could lead to a rise in new HIV infections, emphasising the importance of ongoing support for the fight against HIV.
Mutambuka highlighted the important role PEPFAR has played in reducing stigma and discrimination related to HIV, noting that before its involvement, stigma was at a very high rate.
He also lauded PEPFAR’s investments in empowering communities as well as its role in Rwanda’s achievement of the "95-95-95” targets set by the Joint United Nations Programme on HIV/AIDS (UNAIDS).
The UNAIDS 95-95-95 targets aim to ensure that by 2030, 95 per cent of all people living with HIV know their HIV status, 95 per cent of all people diagnosed with HIV receive sustained antiretroviral therapy, and 95 per cent of all people receiving antiretroviral therapy have viral suppression.
The World Health Organisation (WHO) also showcased concern about the implications of the funding pause for HIV programmes in low and middle-income countries, noting that such programmes provide access to life-saving HIV therapy to more than 30 million people worldwide.
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"Such measures, if prolonged, could lead to rises in new infections and deaths, reversing decades of progress and potentially taking the world back to the 1980s and 1990s when millions died of HIV every year globally, including many in the US," said WHO in a statement before the waiver that allowed the continuation of PEPFAR was announced.
PEPFAR has been a flagship initiative of the global HIV response since its establishment over 20 years ago. It works in more than 50 countries around the world and has saved more than 26 million lives over the past two decades.
Currently, PEPFAR is providing HIV treatment for more than 20 million people living with HIV globally, including 566,000 children under 15 years of age.
WHO said that over the past year, PEPFAR and partners – including WHO – "have been working on sustainability plans with countries for greater country ownership and reduced donor support up to and beyond 2030.”
"This urgent decision recognises PEPFAR’s critical role in the AIDS response and restores hope to people living with HIV,” said UNAIDS Executive Director, Winnie Byanyima.
The Rwanda Population-based HIV Impact Assessment (RPHIA), a comprehensive country-wide survey conducted in 2019, showed that the prevalence of HIV among Rwandans aged 15-64 is 3 per cent.