The impact of the PEPFAR funding freeze on HIV deaths and infections: a mathematical modelling study of seven countries in sub-Saharan Africa

SummaryBackground On January 24, 2025, the United States government issued an executive order to freeze all foreign aid programs, including The President's Emergency Plan for AIDS Relief (PEPFAR), for 90 days. A limited waiver option became available, but its implementation remains incomplete. We estimated the impact of these policy changes on HIV deaths and new infections in seven sub-Saharan African (SSA) countries—Ethiopia, Kenya, Malawi, South Africa, Tanzania, Zambia, and Zimbabwe –, which together account for about half of all people living with HIV in SSA. Methods We used STDSIM, an established individual-based simulation model, and previously published quantifications for the seven countries. We…