Malawi, one of the poorest nations in the world, is bracing for a severe health crisis after the U.S. government’s decision to freeze nearly all foreign health funding, including support for the life-saving PEPFAR program.
The freeze, which took effect immediately following an executive order from President Donald Trump, could significantly undermine the fight against HIV/AIDS in Malawi, where the epidemic remains a critical public health concern.
PEPFAR (the President’s Emergency Plan for AIDS Relief), created in 2003, has been a cornerstone in the global effort to combat HIV/AIDS, providing $6.5 billion annually to support prevention, treatment, and education programs.
In Malawi, where over a million people are living with HIV, PEPFAR has been instrumental in providing antiretroviral (ARV) drugs, testing, and educational initiatives.
Since its inception, the program has saved an estimated 26 million lives worldwide.
The freeze, announced on January 20, 2025, halts nearly all U.S. foreign assistance for at least 90 days while the new administration reviews existing programs.
The only exceptions to this freeze are emergency humanitarian aid and military financing for Israel and Egypt.
While the order did not specifically name PEPFAR, sources at USAID (U.S. Agency for International Development) confirmed that it is included in the suspension of funding.
For Malawi, the timing could not be worse.
The country has made substantial progress in addressing its HIV/AIDS epidemic over the past two decades, largely due to the support provided by PEPFAR.
Without continued funding, many of the millions relying on ARV medications and treatment could face life-threatening consequences.
Jeremy Konyndyk, a former senior USAID official, warned that the halt to PEPFAR would be catastrophic for nations like Malawi.
“The immediate cessation of funding will disrupt life-saving programs and endanger the health of millions,” Konyndyk said.
“For people living with HIV in Malawi, this freeze could halt their access to vital treatment, leading to avoidable deaths and further transmission of the virus.”
In Malawi, PEPFAR funding supports both government-run health facilities and local organizations that deliver services to those most at risk.
With the freeze in place, healthcare workers are left uncertain about the continuation of their roles, and many projects that help prevent new HIV infections could be suspended.
Asia Russell, executive director of the HIV access organization Health GAP, described the decision as “catastrophic” for countries like Malawi. “This freeze does not just affect funding for the future—it halts ongoing programs that are keeping people alive,” she said. “The impact will be immediate and devastating.”
As Malawi struggles with one of the highest HIV prevalence rates in the world, the loss of U.S. funding will further strain the country’s already fragile healthcare system. The consequences could extend beyond HIV/AIDS, as Malawi relies on foreign assistance for a wide range of health services, from maternal care to nutrition programs.
Health experts and international organizations are calling for immediate action to mitigate the damage caused by the funding freeze. While there are hopes that the new administration may reverse the decision or at least carve out exceptions for critical health programs, time is running out for millions of vulnerable people in Malawi and other affected countries.
For now, Malawi’s health sector faces an uncertain future, with the potential to see significant setbacks in its efforts to combat HIV/AIDS and improve overall health outcomes. The global community is watching closely, hoping for a resolution that will ensure the continued flow of life-saving support to countries in need.
