Addis Abeba –The Joint United Nations Program on HIV/AIDS (UNAIDS) warns that the “pause of U.S. foreign assistance” to Ethiopia’s national HIV response will be “particularly severe” for over 270,000 beneficiaries across the Oromia and Gambella regions, as well as Addis Abeba.
In an update issued on 05 February, 2025, UNAIDS emphasized that the “pause of U.S. assistance to community programs and drop-in centers serving women, young girls, and priority populations at higher risk of HIV infection means tens of thousands of individuals will no longer be able to access critical services.” These services include HIV testing, antiretroviral treatment, pre-exposure prophylaxis for HIV prevention, and screenings for tuberculosis, sexually transmitted infections, and support to address gender-based violence.
The agency further highlighted that “the closure of many drop-in centers and the termination of outreach workers’ and peer educators’ contracts will effectively shut off support to vulnerable groups.”
A breakdown of service disruptions in Addis Abeba, Oromia, and Gambella due to the “pause” in U.S. assistance reveals that one of the most affected groups comprises 235,560 people who “will no longer receive” condoms to prevent new HIV infections and sexually transmitted infections.
An additional affected group, totaling 18,075 people, will no longer receive support for health and care services. A further 2,385 beneficiaries will be unable to continue accessing antiretroviral treatment, tuberculosis treatment, and sexually transmitted infection treatment.
A series of new directives from U.S. President Donald Trump’s administration in recent weeks has left humanitarian organizations, including the United States Agency for International Development (USAID) and its partners such as UNAIDS, uncertain about the future.
At the center of this disruption is a 90-day suspension of foreign aid disbursements, issued by President Trump on 20 January 2025. This was soon followed by a stop-work order from the U.S. State Department for “existing grants and contracts, along with an immediate freeze on new foreign aid expenditures.”
On 28 January 2025, Secretary of State Marco Rubio issued an emergency humanitarian waiver allowing the continuation of “life-saving humanitarian assistance programs” during the 90-day foreign aid review period.
However, the UNAIDS stressed that Ethiopia’s Health Information System has been “severely” affected by the stop-work order and the subsequent “termination of 10,000 data clerks,” who play a critical role in entering antiretroviral data into the health information management system. The agency stated that this disruption is “compromising data management, particularly in tracking lost-to-follow-up cases.”
UNAIDS also warned that the funding suspension “threatens to stall” efforts to build local healthcare capacity.
“It impacts the training and support of health workers, slowing progress in Ethiopia’s fight against HIV,” the update explained. “This reduction in capacity limits the ability of healthcare professionals to respond effectively to the growing HIV epidemic.”
The update from UNAIDS was issued shortly after the Ministry of Health (MoH) instructed regional and municipal health bureaus to suspend all activities and payments related to employees hired under U.S. government budget support. This directive followed the termination of funding from the Centers for Disease Control and Prevention (CDC) and USAID.
In a notice dated 31 January, 2025, the MoH stated that it had received an official directive mandating that “any work or payment” conducted through U.S. budget support “should cease” as of 24 January, 2025.
Reports indicate that the directive affects nearly 5,000 employees whose contracts were established between health bureaus and U.S. funding agencies with support from the ministry.
In its update, UNAIDS indicated that the funding freeze has caused “critical delays” in the supply of essential HIV services, including testing kits and other resources.
Noting that 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, UNAIDS emphasized that “the interruption in funding is limiting 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.”
According to UNAIDS, antiretroviral treatment is currently provided to 503,000 people in Ethiopia via 1,400 health facilities across the country. However, the agency stated that, with ongoing challenges to the country’s health system and socio-economic development, Ethiopia remains reliant on external donors for its HIV response.
As of 2023, PEPFAR has invested nearly $3 billion in Ethiopia’s HIV/AIDS response, according to the U.S. Embassy in Ethiopia. Launched by former President George W. Bush in 2003, the program allowed approximately 2.7 million adults to access essential HIV testing and counseling services, while more than 349,000 orphans, vulnerable children, and their caregivers received critical care and support annually.
The U.S. Embassy further stated that PEPFAR has facilitated the provision of lifesaving antiretroviral therapy to over 450,000 men, women, and children, representing 98% of the treatment available nationwide across more than 1,000 healthcare facilities. AS
Tigray’s Gilded Trap: Unmasking illegal mining’s toxic legacy
Japan grants $15 million to UN for humanitarian, development aid in Ethiopia