On January 20, 2025, the United States announced a freeze on all foreign assistance funding, subsequently implemented through a series of executive actions including work-stoppage orders, the issuance of limited waivers, and successive rounds of grant and contract terminations. The President's Emergency Plan for AIDS Relief (PEPFAR)—the largest bilateral HIV program in history, supporting antiretroviral therapy for more than 20 million people across more than 50 countries—was directly and severely affected.
These factsheets use data inadvertently released by PEPFAR in January, 2026, alongside officially released data from April 17, 2026. The official data only included data from 2025Q4 while the earlier dataset provided full year (Q1 - Q4) results. This release of data provides the first opportunity to genuninely assess the effect of the disruptions on service delivery across all PEPFAR-supported programming. Because PEPFAR's data systems are dependent on facility-level reporting based on active support from PEPFAR programs, aggregated analyses of the service delivery results conflate two distinct issues: 1) Genuine increases/decreases in service delivery; and 2) Apparent decreases in service delivery due to non-reporting of data from implementing partners with terminated grants or pausing operations in accordance with a stop-work order.
To account for these discrepancies, it's necessary to use PEPFAR's facility-level data and categorize facilities according to reporting consistency. (See: The impact of the United States foreign aid freeze on HIV service delivery in PEPFAR-supported countries: a facility-level analysis of 2024–2025 programme data (pre-print, non-peer-reviewed analysis)).The below country-level factsheets apply the same methodology and incorporate country-level expenditure data alongside programmatic results.