An Evangelical mission doctor has issued a warning that millions of lives are at risk amid the potential dismantling of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).
Launched in 2003 under President George W. Bush, PEPFAR is the largest global health initiative focused solely on a single disease, HIV/AIDS, having allocated over $100 billion to more than 50 countries in the last two decades.
This funding has provided antiretroviral therapy (ARVs), life-saving treatment, and infrastructure support to regions most affected by the epidemic, particularly in Africa.
Recently, however, aid cuts and reductions in global health funding during the Trump administration, along with logistical disruptions, have jeopardized the delivery of these essential services. As a result, 20 million individuals reliant on PEPFAR-supported medications are now at risk.
The initiative depends on logistical support from the U.S. Agency for International Development, and the law establishing PEPFAR is set to expire on Tuesday.
Dr. Matthew Loftus, an Evangelical physician working at a Presbyterian mission hospital in Kenya, has expressed serious concerns about the impact of these disruptions. He said, “Many people will die,” emphasizing reports of patients struggling to access ARVs or being forced to pay for their medications.
Loftus elaborated, “In some places they're not getting the drugs or they're being asked to pay cash for the drugs. Other places are completely closed and so patients are scrambling to find medications or they're going without.”
He expressed his fears that patients who have not been consistently taking their medications might develop resistance, stating, “I think there would be permanent damage. Once you fire people and close clinics, rebuilding trust is difficult; getting people to come back is difficult.”
Historically, the PEPFAR program has garnered bipartisan support as well as backing from Evangelical organizations and leaders, including the National Association of Evangelicals, Pastor Rick Warren, and World Vision.
Evangelicals were instrumental in lobbying for PEPFAR's creation in 2003. Faith-based organizations, such as World Relief, the humanitarian arm of the National Association of Evangelicals, have played key roles in PEPFAR's efforts since its inception.
Clinics supported by PEPFAR often serve as critical health hubs that also address other medical needs in underserved regions. For instance, PEPFAR accounts for nearly all HIV funding in Nigeria, and its collapse could reverse decades of progress.
The United Nations warned in February that failing to reauthorize PEPFAR could result in a 400% increase in AIDS deaths between 2025 and 2029. Christine Stegling, deputy executive director of UNAIDS, stated at a press briefing last month, “That's 6.3 million people, 6.3 million AIDS-related deaths that will occur in the future.”
In response to the situation, several prominent country artists, led by Christian contemporary singer Amy Grant and the ONE Campaign, signed a letter sent to Congress last week urging full funding for PEPFAR. Other signatories included Brad Paisley, Darius Rucker, LeAnn Rimes, and Sheryl Crow, among others.
