From progress to uncertainty: The global impact of US funds withdrawal from PEPFAR and other HIV-related projects on people living with HIV/AIDS in Nigeria and other low- and middle-income countries

The President’s Emergency Plan for AIDS Relief (PEPFAR) has been instrumental in the global fight against HIV/AIDS, particularly in low- and middle-income countries (LMICs). However, the recent suspension of PEPFAR funding threatens to undo decades of progress, leaving millions of people living with HIV (PLHIV) vulnerable to treatment disruptions, drug stock-outs, and increased mortality. This opinion paper explores the immediate and long-term consequences of the funding freeze, highlighting its devastating impact on antiretroviral therapy (ART) access, prevention programs, and healthcare systems in Nigeria and other LMICs. Beyond the risks of increased transmission and drug resistance, the withdrawal exacerbates economic and social disparities, placing additional strain on fragile health infrastructures. We propose alternative funding mechanisms, including regional collaborations, public-private partnerships, and sustainable financing strategies to mitigate this crisis. Urgent action is required to prevent a resurgence of the HIV/AIDS epidemic and sustain the progress made toward global health equality.