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PORT-AU-PRINCE — The Trump Administration’s suspension of operations at the United States Agency for International Development (USAID) and foreign aid freeze have left HIV/AIDS treatment specialists in Haiti scrambling to maintain life-saving services and continue prevention campaigns. Public health professionals warn that the decision threatens to unravel years of success in the fight against the epidemic. It also hampers the larger goal of eliminating the condition as a public health threat by 2030.
A community health worker, who works at a treatment site, told The Haitian Times that the situation is already dire. She asked that her and her organization’s names not be mentioned, given patient privacy rules and the sensitivity of the matter.
“We are in shock,” the worker said, adding that her nonprofit medical facility is 90% funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and managed through USAID.
“We were preparing a 3-month medication supply for our patients when we were told to stop distributing medicines,” she said. “HIV-positive patients depend on ARVs to survive. Without them, how will they manage?”
The new U.S. administration issued a 90-day freeze on nearly all foreign assistance two weeks ago, throwing the foreign aid sector into chaos worldwide. Since then, numerous nonprofit organizations (NGOs) and healthcare centers in Haiti that rely on this aid have struggled to remain open. Some are trying to move forward with plans to seek help elsewhere, while others remain in shock as USAID shuts down operations.
According to USASpending.gov, a site that lists where the federal government gives money abroad, USAID has committed $368 million to Haiti since October 2023. Many of these awards are for multiyear programs, with several focused on healthcare. If none of these programs receive a waiver to continue, the freeze would stop $330 million committed to ongoing projects.
Stopping or reversing Haiti’s achievement in reducing the prevalence of HIV infection to under 2% would be among the most significant casualties. Haiti’s incidence rate of 0.11% among people aged 15 to 64 in recent years stands out as a public health success story.
Much of this progress is credited to ongoing international aid, particularly through the United States President’s Emergency Plan for AIDS Relief (PEPFAR), which has supplied crucial resources for treatment and prevention. Created under George W. Bush’s administration, PEPFAR employs a comprehensive government strategy to address the global HIV/AIDS epidemic, providing substantial financial support to impoverished nations like Haiti. Since its launch in 2003, PEPFAR has allocated over $110 billion to the global response to HIV/AIDS, saving 26 million lives, preventing millions of HIV infections, and assisting 50 countries in managing and improving global health.
With the abrupt halt in U.S. funding and orders to cease daily operations, treatment centers across the globe have been forced to stop distributing antiretroviral (ARV) medication to patients. In Haiti, officials and healthcare workers from these centers fear the worst for the continuity of prevention campaigns.
Malia Jean, coordinator of the Association of Haitian Women Infected and Affected by HIV (AFHIAVIH) based in Port-au-Prince, spoke openly about the crisis.
“This is a disaster for us,” Jean said. “We must take our medication every day. Without ARVs, our health deteriorates quickly.
“If this continues,” she added, “we can expect a wave of HIV cases. The Haitian government is not equipped to fill the gap.”
A senior official at the State University Hospital (HUEH), who asked not to be identified due to not being authorized to speak to the media, expressed serious concerns and fears. The official said PEPFAR’s support allowed patients on ARVs to remain stable, be integrated into society and free from the fear of discrimination. However, without medication, the situation is uncertain.
“Drug distribution centers are closed, and many prevention programs may soon come to a halt,” the official said. “That’s a ticking public health time bomb.”
While the U.S. foreign aid freeze affects countries worldwide, policy and aid experts say the impact on Haiti is more peculiar, especially when it comes to efforts against HIV/AIDS.
For one, the funding halt will directly impact workers— including those employed by various organizations and government agencies, both nationally and internationally — exacerbating Haiti’s already severe unemployment.
Dr. Jean Ardouin Louis Charles, secretary of the Haitian Medical Association (AMH), said that PEPFAR has been a lifeline for Haiti’s HIV/AIDS response. Since 2023, the program has funded more than 80% of the country’s HIV-related healthcare programs. That’s what has helped the country’s collaborative efforts pay off by reducing the spread of the virus and suppressing its effects on those infected.
“The Trump administration did not even give these small countries time to arrange an exit,” Dr. Louis Charles said.
“The decision was abrupt, leaving no transition time. Even if Haiti could buy its own medicines, it would take time to secure stock,” he continued. “There’s no answer to what happens if there’s a shortage. It would be a serious blow.”
Many others concur with Dr. Louis Charles, saying the crisis-stricken country cannot sustain itself without the support of its major donors, even if officials manage to maintain the positive advances in controlling HIV/AIDS. With Haiti grappling with gang violence and displacement, many are living in camps, making the suspension of life-saving medicine and prevention and awareness campaigns even more dangerous.
Haiti is also facing its sixth consecutive year of negative economic growth; several other sectors will suffer enormously.
“Without ARVs, people risk becoming resistant to treatment and spreading the virus. TB (tuberculosis) often co-occurs with HIV, and untreated cases can cause further outbreaks. HIV treatment is lifelong — where will people find the money?” the AMH secretary said.
Key initiatives and strategies likely to be affected include:
Among the healthcare organizations that continue to maintain their services is Zanmi Lasante. The organization has other funding sources beyond PEPFAR, according to Dr. Allain Casseus, head of the HIV/PEPFAR project at Zanmi Lasante.
“We continue to provide care to 17,000 people infected with HIV and support vulnerable groups like orphans and at-risk adolescents,” Dr. Casseus said. “Our consortium model allows us to access medicines from European and international partners, reducing reliance on U.S. funding.”
However, since the other resources are not infinite, the organization is searching for additional funding to sustain operations. He has joined other health advocates, like Dr. Louis Charles and Jean, in calling for the U.S. government to reverse its decision.
“ARVs are a matter of life or death. This interruption is one of the greatest abuses imaginable,” Jean said.
Despite numerous phone calls, emails and text messages in attempts to seek comments on the crisis created by the U.S. funding freeze, the Haitian government and health authorities have not responded to The Haitian Times’ requests about any plans to maintain Haiti’s hard-earned gains in the fight against HIV.
The post USAID chaos: Foreign funds freeze threatens success of Haiti’s fight against HIV appeared first on The Haitian Times.
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