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Despite decades of progress, the HIV pandemic still claims a life every minute. In 2023 alone, 1.3 million people were newly infected and 630,000 died from AIDS-related causes. Now, sweeping US funding cuts are threatening to unravel critical HIV programmes in some of the world’s most vulnerable countries.
In Eswatini, a small southern African nation with one of the highest HIV prevalence rates globally, the impact is already being felt. At the Luyengo Clinic, about 350 patients rely on daily access to life-saving HIV treatment. Dozens of infants are tested for the virus, and around 3,000 people in total depend on the clinic’s services.
Until recently, 80% of the clinic’s operations were funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR). But with that support slashed, fears are mounting about medication shortages and service disruptions that could cost lives.
Nompilo Mdluli, a young woman living with HIV in rural Eswatini, has already seen the fallout. A mobile clinic that once brought care to her doorstep—including HIV prevention tools and support groups for young people—has now shut down.
“I’m going to miss young people coming together and sharing ideas,” she says. “Especially the livelihoods training, access to PrEP referrals, and free condoms. Those really helped Eswatini a lot.”
The government is scrambling to plug the funding gap. “We’re doing everything we can to keep patients on treatment,” says Khanyakwezwe Mabuza, Principal Secretary at the Ministry of Health. “Even without a budget, we are working to avoid service disruption. But we urgently need to find new sources of funding.”
Hard-Won Progress at Risk
Eswatini has achieved remarkable strides—new infections have dropped by over 70% since 2010, and AIDS-related deaths have halved. Much of that success has been powered by US support, which has funded roughly half of the country’s HIV response.
Now, that progress hangs in the balance. Without urgent action, the gains of the past decade could be lost—putting countless lives at risk and setting back the global fight to end AIDS.
