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Global Health
PEPFAR, the campaign to end H.I.V. globally, would morph into an effort to detect disease outbreaks and sell American products, according to documents obtained by The Times.
Stephanie Nolen has covered the work of PEPFAR since it was created in 2003.
July 23, 2025, 1:04 p.m. ET
The federal program to combat H.I.V. in developing nations earned a reprieve last week when Congress voted to restore $400 million in funding. But that may be short-lived: Officials at the State Department have been mapping out a plan to shut it down in the coming years.
Planning documents for the President’s Emergency Plan for AIDS Relief, obtained by The New York Times, call for the organization to set a new course that focuses on “transitioning” countries away from U.S. assistance, some in as little as two years.
PEPFAR, as the program is called, would cease to exist as an initiative to provide medicines and services needed to treat and prevent the spread of H.I.V. in low-income countries.
It would be replaced by “bilateral relationships” with low-income countries focused on the detection of outbreaks that could threaten the United States and the creation of new markets for American drugs and technologies, according to the documents.
“With targeted investment, PEPFAR’s H.I.V. control capabilities in these countries could be transformed into a platform for rapid detection and outbreak response to protect Americans from disease threats like Ebola,” the plan says.
A State Department spokeswoman said the document had not been finalized. “The referenced document is not reflective of the State Department’s policy on PEPFAR and was never cleared by Department leadership,” she said.
