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With the shift in US policy, and the termination of PEPFAR/USAID programs, especially for children, what concerns you most, and how do you see it impacting your community?
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The potential termination or significant reduction of PEPFAR (President’s Emergency Plan for AIDS Relief) and USAID programs—especially those focused on children—raises serious concerns on multiple levels:<div>Health Access and Continuity: Many children and families in vulnerable communities rely on these programs for HIV testing, antiretroviral therapy (ART), and prevention services. Losing this support could disrupt treatment adherence and lead to increased child mortality and HIV transmission rates.Education and Support Services: PEPFAR and USAID often support education, nutrition, and psychosocial programs for orphans and vulnerable children. Without these, schools might see higher dropout rates, and children may experience worsening poverty and instability.Local Healthcare Systems: These programs also help train local health workers and build infrastructure. Ending them could reverse years of progress, weakening the capacity of local systems to manage HIV/AIDS independently.Stigma and Social Impact: The absence of sustained global advocacy and funding could increase stigma, marginalization, and misinformation, making it harder for communities to openly address HIV.In my view, the biggest concern is the interruption of care for children living with or affected by HIV. Their health outcomes are time-sensitive and cumulative—meaning setbacks now can lead to lifelong consequences.</div>
Country: Kenya
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What concerns me most is how totally different people in the management of HIV will be able to quickly adopt to the trends and dynamics of these group; handling them and ensure they are virally suppressed and those not suppressed are adequately being followed to achieve suppression. Lack of laid down procedure and accountability
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What you are articulating is absolutely true, I agree with you.
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My greatest worry is that the structure that was there in terms of management won’t be there again and the dedication and targeted approach that the USAID staff had for the children and adolescent. This has a negative impact to the normal programming of the clinics and may affect follow up and management at large, practically since March PCR taken are not yet back, the exposed child is growing and eligible for another PCR test but the first is not yet out, it will make it impossible to proceed with the second test, through this management becomes so hard and the health care with the caregiver remain uninformed of the HIV status of the baby. This will bring about late actions to be taken, late diagnosis and more children will be exposed, also increasing AHD among children and adolescent. So yes it has brought more harm than good
Country: Kenya
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My main concerns anchor arround 1. funding stability_our domestic budget may not be able to cover the shortfalls 2. The risk of getting a shift in the health system, from a vertical HIV program to broader program. This will affect the marginalised like women, adolescents and children including those in hard to reach places. 3. More strain on the health care system, HCPs and limited skill in service delivery_Some HCPs who were trained and funded under donor funds and have lost their jobs may not have had the ample time to pass on the skill to others. The ones still in the system may feel demotivated due to uncertainty. Withdraw of human resources strains more the already staggering human resource. 4. Reaching the last mile distribution_This will be affected as some hard to reach places were relying on donor funded resources to ride and buffer on some supplies and essential commodities. 5. Deprioritising HIV_I think that policy and governments may swallow the priority of HIV as they juggle other health priorities and emerging infectious disesases especially if ther is no sustained advocacy.
Country: Zambia
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What you’re saying is very true and practical, but for the longest time the african governments have always depended on donor funding infact most separated the HIV departments from the government facilities. There is ownership, accountability and taking responsibility was left for donors supporting the system. Government need to act fast and accept the fact that there will be no longer funding and if there is then it will never be the same again.
Country: Kenya
