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US Secretary of State, Marco Rubio

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Hope for Nigeria, others as US Secretary of State issues waiver for PEPFAR to continue HIV interventions

It is estimated that PEPFAR supports treatment for over 20 million people living with HIV, accounting for two-thirds of all people globally receiving HIV treatment

byMariam Ileyemi
January 29, 2025
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The US Secretary of State, Marco Rubio, has granted an “emergency humanitarian waiver” allowing the President’s Emergency Plan for AIDS Relief (PEPFAR) to continue providing life-saving HIV medications to low-income countries.

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This waiver will allow people to continue accessing HIV treatment funded by the US across 55 countries worldwide.

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This move follows President Donald Trump’s recent Executive Order on “Reevaluating and Realigning United States Foreign Aid,” which temporarily halted many overseas assistance programmes.

As a result of the order, PEPFAR funding was initially suspended for at least 90 days, leaving millions of lives in uncertainty.

However, in a memo issued Wednesday, Mr Rubio approved an exemption for critical humanitarian efforts, including medical aid, food, and shelter assistance.

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It is estimated that PEPFAR supports treatment for over 20 million people living with HIV, accounting for two-thirds of all people globally receiving HIV treatment.

Waiver directives, restrictions

The waiver directs implementing agencies, partners, and NGOs to resume providing treatment for vulnerable populations.
“Implementers of existing life-saving humanitarian assistance programmes should continue or resume work if they have stopped, subject to the following directions. This resumption is temporary in nature, and except by separate waiver or as required to carry out this waiver, no new contracts shall be entered into,” the memo read.

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The waiver maintains restrictions on programmes involving family planning conferences, gender or DEI (Diversity, Equity, and Inclusion) initiatives, and transgender surgeries.

Mr Rubio said this waiver does not apply to activities that involve abortions, family planning conferences, or administrative costs other than those covered.
“Additional waivers or exceptions for humanitarian assistance not covered by this waiver may be sought through the Director of Foreign Assistance at the Department of State.”

Reacting to the development, the Joint United Nations Programme on HIV and AIDS (UNAIDS) in a press statement welcomes the decision by the US Secretary of State to continue life-saving HIV treatment.

The Executive Director of UNAIDS, Winnie Byanyima, said this decision recognises PEPFAR’s critical role in the global AIDS response and brings renewed hope to those affected by the disease.
“UNAIDS welcomes this waiver from the US government which ensures that millions of people living with HIV can continue to receive life-saving HIV medication during the assessment of US foreign development assistance,” Ms Byanyima was quoted as saying.

She said this urgent decision recognises PEPFAR’s critical role in the AIDS response and restores hope to people living with HIV.

PEPFAR impacts

With an annual budget of $6.5 billion, PEPFAR delivers HIV/AIDS treatment to more than 20.6 million people. It has helped save lives and curb the spread of the virus.

The US State Department fact sheet showed that PEPFAR has saved the lives of an estimated 26 million people since its inception.

In Nigeria, about two million people are currently living with HIV, with many of them benefitting from PEPFAR.

As one of the countries with the highest HIV burden globally, Nigeria relies heavily on programmes such as PEPFAR for access to life-saving medications, and healthcare infrastructure support.

Over the years, PEPFAR has contributed over $6 billion to support Nigeria’s national HIV/AIDS response.

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