AVAC: PEPFAR in transition

Experts are raising concerns about the transition of PEPFAR, the U.S. program for global HIV/AIDS relief, as it nears a potential phase-out in South Africa. Critics argue that the lack of a clear implementation strategy threatens essential health services and infrastructure.
Why it matters
The potential disruption of HIV/AIDS programs could have severe public health consequences for vulnerable populations in Africa.
Two commentaries this week recognize the breaking point to which PEPFAR is nearing. The Health Security Policy Academy argues that despite the temporary extensions, which have kept and continue to keep parts of PEPFAR operating, the US Department of State has not yet built a viable implementation system to keep HIV treatment, supply chains, laboratories and community programs working. At the same time, Emily Bass, Yvette Raphael, Nono Eland and colleagues at Physicians for Human Rights argue in Think Global Health that the planned phase-out of all US PEPFAR support for South Africa by early 2027 is not a routine transition to country ownership, and caution that this accelerated withdrawal risks severed disruption to HIV prevention, surveillance, research and community programs that have long depended on US partnership.
The article focuses on criticisms of government policy and the potential negative impact on social welfare programs.
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