U.S. Government Approves Limited Waiver for PEPFAR HIV Services

Washington, D.C. – The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has issued a 90-day limited waiver allowing the resumption of critical HIV treatment and prevention services, following a temporary pause in U.S. foreign assistance funding.

According to the official communique, the waiver prioritises life-saving interventions, particularly HIV care and treatment, as well as Prevention of Mother-to-Child Transmission (PMTCT) services. The directive urges implementing agencies to resume operations immediately while remaining within previously approved PEPFAR Country and Regional Operational Plans.

Key Services Approved Under the Waiver

HIV Testing & Diagnosis: Community and facility-based HIV testing to identify and refer individuals for treatment, Screening for tuberculosis (TB) in people living with HIV, and Comprehensive early infant diagnosis (EID) services for HIV-exposed infants.

HIV Care & Treatment: Provision of antiretroviral therapy (ART) to prevent treatment interruptions, HIV viral load monitoring to ensure treatment effectiveness, Nutrition support for malnourished HIV patients, and Mobile clinics and community ART distribution for easier treatment access.

Prevention of Mother-to-Child Transmission (PMTCT): Testing and treatment for pregnant and breastfeeding women living with HIV, Partner testing and distribution of condoms for HIV prevention, and Strengthened community-based follow-up for mother-baby pairs.

Supply Chain & Laboratory Support: Procurement and distribution of essential HIV medicines and test kits, Laboratory sample collection and transport for HIV viral load and diagnostic tests, and Infrastructure support for health workers and data systems to monitor patient care.

Restrictions & Non-Covered Activities

While the waiver restores key services, some activities remain suspended under the current restrictions. HIV prevention programmes for key populations, community-led monitoring, and broader public health initiatives such as gender-based violence response and HIV surveillance surveys are not included.

Additionally, the funding cannot support new program expansions beyond existing operational plans.

Urgency in Resumption of Services

The decision to implement this limited waiver follows global concerns over the impact of the funding freeze, particularly in high-burden HIV countries. Health workers’ salaries, ART supply chains, and testing services had been disrupted, raising fears of treatment interruptions and rising HIV transmission rates.

Health officials and advocacy groups have welcomed the waiver but continue to push for full funding restoration, citing the need for comprehensive HIV prevention and care services beyond the 90-day timeframe.

“This waiver is a crucial step, but we urge continued efforts to ensure all affected individuals receive uninterrupted HIV services,” reads the communique.

What’s Next?

The U.S. government and PEPFAR teams will oversee the rapid implementation of the waiver, ensuring that health systems resume services effectively. Further guidance on long-term funding plans is expected in the coming months as stakeholders assess the programme’s sustainability and impact.