US Aid suspension leaves vulnerable Ethiopians without HIV services

ETHIOPIA—The Joint United Nations Program on HIV/AIDS (UNAIDS) has raised serious concerns about the suspension of U.S. foreign assistance to Ethiopia’s national HIV response.

This pause is expected to severely impact over 270,000 individuals in the Oromia and Gambella regions, as well as in Addis Ababa.

In a recent update, UNAIDS highlighted that the halt in U.S. support for community programs and drop-in centres serving women, young girls, and high-risk populations would leave tens of thousands without access to essential services.

These services encompass HIV testing, antiretroviral treatment, pre-exposure prophylaxis for HIV prevention, and screenings for tuberculosis and sexually transmitted infections. Additionally, support mechanisms addressing gender-based violence are at risk.

The agency emphasized that the closure of numerous drop-in centers and the termination of contracts for outreach workers and peer educators will effectively end support for vulnerable groups.

Specifically, in Addis Ababa, Oromia, and Gambella, approximately 235,560 individuals will no longer receive condoms, increasing the risk of new HIV and sexually transmitted infections.

Furthermore, 18,075 people will lose support for health and care services, and 2,385 beneficiaries will be unable to continue accessing treatments for HIV, tuberculosis, and other infections.

This situation arises from a series of directives from the U.S. administration. On January 20, 2025, President Donald Trump initiated a 90-day suspension of foreign aid disbursements.

Subsequently, the U.S. State Department issued a stop-work order for existing grants and contracts and immediately froze new foreign aid expenditures.

Although Secretary of State Marco Rubio later issued an emergency humanitarian waiver allowing the continuation of life-saving humanitarian assistance programs during the review period, significant disruptions persist.

UNAIDS has reported that the termination of 10,000 data clerks responsible for entering antiretroviral data has severely affected Ethiopia’s health information system.

This disruption compromises data management, particularly in tracking patients who have lost contact with healthcare providers.

The funding suspension also threatens efforts to build local healthcare capacity by hindering the training and support of health workers, thereby slowing progress in Ethiopia’s fight against HIV.

Following the cessation of funding from the Centers for Disease Control and Prevention (CDC) and USAID, Ethiopia’s Ministry of Health instructed regional and municipal health bureaus to suspend all activities and payments related to employees hired under U.S. government budget support.

This directive affects nearly 5,000 employees whose contracts were established between health bureaus and U.S. funding agencies with support from the ministry.

The funding freeze has also caused critical delays in the supply of essential HIV services, including testing kits and other resources.

The President’s Emergency Plan for AIDS Relief (PEPFAR) is responsible for 100% of the procurement of viral load and Early Infant Diagnosis (EID) reagents.

 The interruption in funding limits the availability of these crucial supplies, undermining the program’s ability to conduct timely viral load and EID testing, which are essential for effective patient monitoring and treatment.

As of 2023, PEPFAR had invested nearly US$3 billion in Ethiopia’s HIV/AIDS response, enabling approximately 2.7 million adults to access essential HIV testing and counseling services.

Additionally, more than 349,000 orphans, vulnerable children, and their caregivers received critical care and support annually.

The program has also facilitated lifesaving antiretroviral therapy for over 450,000 individuals, representing 98% of the treatment available nationwide across more than 1,000 healthcare facilities.

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