Non-governmental organizations (NGOs) receiving US government funds for programs in sectors such as HIV prevention, LGBTQ support, and climate change have been ordered to cease operations immediately. This follows a sudden “stop-work order” issued by the US State Department’s Office of Foreign Assistance late Friday.
Letters instructing grant recipients to halt activities were sent over the past two days. The directive stems from an executive order signed by US President Donald Trump on January 20, which imposed a 90-day pause on foreign aid disbursements. However, US Secretary of State Marco Rubio’s approval of the stop-work order just four days later has unexpectedly halted all ongoing projects with immediate effect.
HIV Clinics Among Worst Affected
The abrupt cessation of funding has had devastating consequences, particularly for HIV services. Over 20 million people globally rely on the US President’s Emergency Plan for AIDS Relief (PEPFAR) for access to life-saving antiretroviral therapy (ART). Interruptions in treatment can lead to severe health risks, including illness, death, and increased transmission rates, according to South African HIV clinician Dr. Francois Venter.
South Africa, a major PEPFAR aid recipient with $332.6 million allocated in 2024, has been particularly hard-hit. HIV clinics across the country have been forced to shut down, leaving patients scrambling to secure vital medication. Some clinics have given clients until Tuesday to collect their supplies, while others have redirected them to overcrowded public health facilities.
Vulnerable Communities at Risk
Many South African NGOs funded by PEPFAR serve key populations at heightened risk of HIV infection, including men who have sex with men (MSM), sex workers, and transgender individuals. Other organizations focus on young women, who account for a significant portion of new infections, and men in rural areas with limited access to healthcare.
OUT and Engage Men’s Health, two NGOs providing HIV services to MSM, announced on Monday that they would suspend all activities due to the funding halt. “We understand the urgency of your health needs and urge clients to seek care and access ARVs or PrEP [pre-exposure prophylaxis] at their nearest public health facility,” their statement read, alongside contact details for mental health and suicide crisis services.
Fear and Uncertainty
The sudden disruption has left both healthcare providers and patients in a state of shock and confusion. The inability to access daily antiretrovirals poses serious health risks for people living with HIV, who depend on uninterrupted treatment to suppress the virus, prevent drug resistance, and reduce transmission.
The full implications of the stop-work order remain unclear, but the move has sparked fears of a broader crisis affecting not just HIV services but also other critical programs funded by US aid.