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AID FREEZE: Zambia Faces Health Crisis as U.S. Halts HIV Medication Disbursement

Zambia’s health sector is confronting a major crisis following the Trump administration’s freeze on U.S. foreign aid, specifically targeting the President’s Emergency Plan for AIDS Relief (PEPFAR), which has been instrumental in Zambia’s HIV response. The decision to halt the disbursement of HIV medications purchased with U.S. aid threatens to unravel decades of progress in combating the HIV epidemic in Zambia.

Since its inception in 2004, PEPFAR has provided over $6.7 billion (K167bn) to Zambia, allowing more than 1.2 million Zambians to access life-saving antiretroviral treatment (ART). This support has significantly reduced HIV-related deaths and brought more than 86 percent of HIV-positive Zambians to undetectable viral loads, preventing further transmission of the virus.

However, the freeze on aid disrupts the supply chain of these crucial HIV medications, leaving clinics across Zambia with drugs they are now prohibited from distributing. The suspension of funding threatens the lives of millions, particularly vulnerable groups like children, adolescents, and young women, who already face significant barriers to accessing care.

Zambian journalist Dingindaba Jonah Buyoya emphasized that while citizens must always be the responsibility of their government, no country should endure such an abrupt disruption. He pointed out that thousands of Zambians working in health programs funded by U.S. aid, including healthcare workers and community mobilizers, are now left without jobs.

Zambia’s health system is already burdened by funding gaps, with approximately 80 percent of the national health budget reliant on domestic revenue. The government has not had to worry about ART funding for the past two decades, but now, the aid freeze presents a significant challenge to sustaining HIV treatment efforts.

In addition to the impact on HIV treatment, the withdrawal of U.S. support also undermines efforts in maternal and child health, malaria, and tuberculosis prevention. With 15.4 percent HIV prevalence in the Copperbelt and 15.1 percent in Lusaka, Zambia’s healthcare system risks being overwhelmed, leading to preventable deaths, surging new infections, and a collapse of essential prevention programs.

The freeze exacerbates the HIV crisis among Zambia’s youth and women, with adolescent girls and young women accounting for a disproportionate share of new HIV infections. According to UNICEF, only 60 percent of adolescents living with HIV are receiving treatment, and condom use among sexually active adolescents remains critically low.

Zambia’s government now faces a dual challenge: managing the immediate fallout of the aid freeze and seeking alternative funding mechanisms to sustain the HIV response. With 16 percent of the 2025 national budget already financed through borrowing, the government’s ability to address the funding gap remains uncertain.

The Ministry of Health is expected to make an official announcement soon regarding the next steps in response to this disruption. The road ahead looks challenging, but Zambia must find a way to protect the progress made in combating HIV/AIDS and continue providing life-saving treatment to those in need. 

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