The waiver does not apply to activities that involve family planning, conferences, and selected administrative costs
Life-saving HIV care and treatment services, prevention and treatment of opportunistic infections including Tuberculosis, prevention of mother-to-child transmission services, and procurement of medicines and PrEP for pregnant and breastfeeding women are among a list of services that have been waived off for assistance by US President Donald Trump.
Also added are medical services, food, shelter, and subsistence assistance. However, the waiver does not include activities that involve abortions, family planning, conferences and selected administrative costs.
In a memo directed to US President’s Emergency Plan for AIDS Relief (PEPFAR) implementing agencies and country coordinators, the memo clarified that the life-saving humanitarian assistance under this waiver, is strictly limited to delivery of essential HIV care and treatment services.
The supported activities encompass a range of crucial interventions, including HIV testing for both adults and children, the provision of antiretroviral drugs and support systems to prevent treatment interruptions, and care for advanced HIV disease, including CD4 testing.
The waiver also covers the prevention and treatment of opportunistic infections, vital HIV treatment adherence support, and HIV viral load testing, which allows for patient monitoring and ensures the safety of drug regimens.
Recognizing that TB is a leading cause of death among people living with HIV, the waiver also supports tuberculosis preventive therapy (TPT) and tuberculosis treatment.
Beyond direct service delivery, the memo outlines support for the transportation, storage, distribution, and management of the HIV care and treatment commodity supply chain, guaranteeing the timely delivery of medications and tests to patients.
This includes the procurement of HIV medicines and other necessary commodities to prevent stockouts within national HIV programs.
Critically, the assistance extends to the prevention of mother-to-child transmission of HIV, encompassing testing for pregnant and breastfeeding women, providing HIV prevention services (including pre-exposure prophylaxis, or PrEP) for those who test negative, and ensuring access to HIV treatment for women who are HIV-positive.
Logistical support for this component mirrors that of general HIV care, including transportation, storage, distribution, and management of the related commodity supply chain.
Finally, the limited waiver also covers focused data and systems maintenance, and reasonable administrative costs associated with these activities.
United States (US) Secretary of State Marco Rubio issued the waiver to continue during the 90-day review period earlier issued by President Trump.
In the statement, Rubio directed the implementers of existing life-saving humanitarian assistance programmes to continue or resume work if they had stopped. He stated that the resumption is temporary and that no new contracts shall be entered into during the period.
“For purposes of this waiver, life-saving humanitarian assistance applies to core life-saving medicine, medical services, food, shelter, and subsistence assistance, as well as supplies and reasonable administrative costs necessary to deliver such assistance.”
He further directed that the waiver does not apply to activities that involve abortions, family planning, conferences, and administrative costs other than those covered under life-saving services, gender or Diversity, Equity, and Inclusion (DEI) ideology programmes, transgender surgeries, or other non-life-saving assistance.
Secretary Rubio was responding to uproar from US President Trump’s Stop-Work Order that would suspend all foreign assistance from the USA for 90 days.
The Andelson Office of Public Policy under the American Foundation for AIDS Research had earlier stated that Trump’s order would have serious repercussions as being a major donor, PEPFAR provides life-saving HIV treatment to over 20.6 million people worldwide and has been credited with preventing 26 million AIDS-related deaths.
Rubio has since directed in the waiver that Migration and Refugee Assistance (MRA) may only be used to support life-saving activities and for repatriation of third-country nationals to their countries of origin or a safe third country.
Further, he directed that additional waivers or exceptions for humanitarian assistance not covered by the waiver may be sought through the Director of Foreign Assistance at the Department of State, and that the implementing partners and Non-Governmental Organisations (NGOs) are to work through their US government agency partners on such requests.
At the same time, the Joint United Nations Programme on HIV/AIDS (UNAIDS) welcomed the waiver by the US Secretary of State to continue life-saving HIV treatment, and convened partners to assess and mitigate impacts on HIV services.
“UNAIDS welcomes this waiver from the US government which ensures that millions of people living with HIV can continue to receive life-saving HIV medication during the assessment of US foreign development assistance,” said UNAIDS Executive Director Winnie Byanyima. “This urgent decision recognizes PEPFAR’s critical role in the AIDS response and restores hope to people living with HIV.”
The UNAIDS has also assured that it will continue with its efforts to ensure that all people living with or affected by HIV are served, and that other key components of PEPFAR’s life-saving efforts including service delivery and services for HIV prevention, care, and support for orphans and vulnerable children are continued.
