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Leaked U.S. policy reveals plan to halt PEPFAR support in developing countries
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Nigeria’s HIV fight under threat as health experts warn of looming drug crisis
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FG approves ₦4.8bn stop-gap HIV budget, but concerns mount over sustainability
Nigeria faces a looming public health emergency as the United States prepares to withdraw its long-standing support for HIV/AIDS treatment under the President’s Emergency Plan for AIDS Relief (PEPFAR), a move expected to leave millions of lives in limbo.
According to internal documents obtained by The New York Times, the U.S. government is phasing out PEPFAR’s medical and service-based support and replacing it with a narrower framework prioritising bilateral partnerships and domestic-focused global health strategies. The plan is already in motion, with global health partners reportedly instructed to begin winding down operations, especially in sub-Saharan Africa.
For Nigeria, where PEPFAR has been a cornerstone of HIV prevention and treatment for two decades, the decision could spell disaster. The programme has funded antiretroviral drugs, testing kits, and health worker training, and helped build critical infrastructure across the country, particularly in rural communities.
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A health policy expert in Abuja who spoke anonymously described the move as “a potential public health disaster,” warning that hundreds of thousands of Nigerians may be cut off from life-saving drugs unless the Federal Government swiftly ramps up local resources.
In a hurried response, the Federal Executive Council (FEC) recently approved a ₦4.8 billion allocation to sustain HIV services temporarily, though stakeholders say the sum falls drastically short of the actual financial demand. Health advocates estimate Nigeria needs at least $1 billion to fill the funding vacuum and sustain current levels of care.
Despite initial optimism after the U.S. Congress moved to exempt PEPFAR from sweeping foreign aid cuts, the leaked plans reveal a deeper policy reversal under the Trump administration, raising doubts over America’s continued global health leadership. The shift appears to favour early disease detection for threats to U.S. borders and the expansion of American pharmaceutical exports over direct humanitarian support.
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Launched in 2003 under President George W. Bush, PEPFAR has disbursed more than $100 billion globally and is credited with saving over 25 million lives.
In Nigeria alone, the initiative has been instrumental in reducing HIV prevalence and scaling access to treatment for vulnerable populations.
Now, with that safety net poised to vanish, Nigeria’s already-strained healthcare system faces the challenge of preserving two decades of progress without guaranteed international support.
Health rights organisations have urged the Nigerian government and global donors to convene a high-level emergency summit to develop alternative funding mechanisms and avert a full-blown treatment crisis.
