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Around 77,000 fewer children worldwide received HIV treatment supported by the United States in the fiscal year ending October 2025 compared with the previous year, according to research presented at the AIDS 2026 conference in Rio de Janeiro. The findings raise concerns about the impact of changes to U.S. foreign aid under the Trump administration, although researchers noted the data only reflects U.S.-supported care and does not account for treatment provided by national governments or other international donors.
The study analyzed data from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and found that U.S.-supported pediatric HIV treatment declined by about 14% year over year across 20 of the 21 countries reviewed. Researchers cautioned that more detailed country-level data is needed to fully assess the long-term effects.
Kenneth Ngure, a global health professor at Jomo Kenyatta University of Agriculture and Technology and co-author of the study, said the results should serve as an early warning rather than a final conclusion, stressing that children living with HIV cannot afford treatment disruptions.
The U.S. State Department disputed the study’s methodology, arguing that the decline partly reflects the success of HIV prevention efforts, as fewer children are becoming infected. Officials also noted that pediatric treatment numbers have been gradually decreasing over the past four years.
However, researchers found that treatment declines in Uganda, Haiti, Zambia, South Africa, and Kenya were significantly steeper than previous trends. South Africa recorded the largest reduction, with roughly 30,000 fewer children receiving PEPFAR-supported treatment, followed by Zimbabwe, Kenya, and Malawi.
The study also found that when broader U.S. “central support” for national and regional HIV programs is included, the decline falls to approximately 55,000 fewer children receiving assistance.
Health advocate Susan Wairimu Metta, who works with HIV-affected communities in Kenya’s Kisumu West region, said funding cuts disrupted community support services and introduced new costs for tests that were previously free. While government efforts have helped address staffing shortages, she warned that many community-based programs essential for keeping children in care have yet to be fully restored, increasing the risk that vulnerable patients will miss treatment.
