Special focus is given to ensuring continuity of care and viral load suppression for pregnant and breastfeeding women, as well as services for HIV-exposed infants
Following the US government’s recent aid freeze under an executive order by President Donald Trump, the Global Health Security and Diplomacy Department has approved a 90-day limited waiver for specific HIV care and treatment activities under the President’s Emergency Plan for AIDS Relief (PEPFAR). This waiver ensures that essential HIV-related services continue uninterrupted, particularly for vulnerable populations.
Approved activities include HIV testing across all demographics, community and facility-based HIV screening, prevention of mother-to-child transmission (PMTCT), and support for the supply chain of HIV testing and laboratory commodities. Additionally, care for individuals with advanced HIV, provision of HIV viral load testing, and paediatric and adolescent-specific case finding and treatment remain authorized.
The waiver also prioritizes services to prevent treatment interruptions for both adults and children, the optimization of antiretroviral therapy (ART) regimens for children living with HIV (CLHIV) and differentiated service delivery models for family-based care. Special focus is given to ensuring continuity of care and viral load suppression for pregnant and breastfeeding women, as well as services for HIV-exposed infants.
Furthermore, advanced HIV disease diagnostics, opportunistic infection (OI) prevention and treatment, and laboratory support for these activities will continue. Tuberculosis (TB) screening and treatment referrals for people living with HIV (PLHIV), as well as TB preventive therapy and laboratory support, are also included in the waiver.
Women living with HIV (WLHIV) will benefit from cervical cancer screening and treatment services, including the immediate management of precancerous lesions and referrals for suspected invasive cases. However, pre-exposure prophylaxis (PrEP) will only be available to pregnant and breastfeeding women during the waiver period. Data-related support staff required for operational and analytical functions related to these approved activities will also continue their roles both in-country and at headquarters.
Activities not covered under the Waiver
Several activities remain unapproved under the waiver, including the maintenance and expansion of data systems unrelated to the covered services, HIV population-based surveys, violence against children (VACs) surveys, and community-led monitoring information systems. Additionally, implementation science projects, planning and targeting for FY 2026, and staff roles tied to non-waivered activities will not receive funding during this period. This temporary waiver ensures the continuity of life-saving HIV services while adhering to the aid restrictions in place.
