Evidence map›Paper›PMID 40626258›Full record

ArticleEClinicalMedicine2025

The impact of the PEPFAR funding freeze on HIV deaths and infections: a mathematical modelling study of seven countries in sub-Saharan Africa.

Jan A C Hontelez, Hannah Goymann, Yemane Berhane, Parinita Bhattacharjee, Jacob Bor, Sungai T Chabata, Frances Cowan, Joshua Kimani, Justin Knox, Wezzie S Lora and 13 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  13. Overcoming barriers, driving progress: Clinical science at IAS 2025.Journal of the International AIDS Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Jan A C HontelezDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Hannah GoymannHeidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Germany.
Yemane BerhaneDepartment of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Parinita BhattacharjeeInstitute of Global Public Health, University of Manitoba, Winnipeg, Manitoba, Canada.
Jacob BorDepartment of Global Health and Epidemiology, School of Public Health, Boston University, Boston, MA, USA.
Sungai T ChabataCentre for Sexual Health and HIV AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe.
Frances CowanCentre for Sexual Health and HIV AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe.
Joshua KimaniInstitute of Global Public Health, University of Manitoba, Winnipeg, Manitoba, Canada.
Justin KnoxDepartment of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.
Wezzie S LoraPublic Health Group, Malawi Liverpool Wellcome Trust-Clinical Research Programme, Lilongwe, Malawi.
Cynthia LunguCenter for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.
Jennifer Manne-GoehlerDivision of Infectious Diseases, Brigham and Women's Hospital, Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Joy MautiHeidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Germany.
Mosa MoshabelaUniversity of Cape Town, Cape Town, South Africa.
Rose M MpembeniMuhimbili University of Health and Allied Sciences, School of Public Health and Social Sciences, Dar es Salaam, Tanzania.
Mwanza Wa MwanzaCenter for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.
Thumbi Ndung'uAfrica Health Research Institute (AHRI), Somkhele and Durban, South Africa.
Evans OmondiAfrican Population and Health Research Center (APHRC), Nairobi, Kenya.
Sam PhiriPartners in Hope, Lilongwe, Malawi.
Mark SiednerAfrica Health Research Institute (AHRI), Somkhele and Durban, South Africa.
Frank C TanserAfrica Health Research Institute (AHRI), Somkhele and Durban, South Africa.
Sake J de VlasDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Till W BärnighausenHeidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: On January 24, 2025, the United States government issued an executive order to freeze all foreign aid programs, including The President's Emergency Plan for AIDS Relief (PEPFAR), for 90 days. A limited waiver option became available, but its implementation remains incomplete. We estimated the impact of these policy changes on HIV deaths and new infections in seven sub-Saharan African (SSA) countries-Ethiopia, Kenya, Malawi, South Africa, Tanzania, Zambia, and Zimbabwe -, which together account for about half of all people living with HIV in SSA. Methods: We used STDSIM, an established individual-based simulation model, and previously published quantifications for the seven countries. We predicted changes in HIV deaths and new infections over the period 2025-2030 for four scenarios: (1) Findings: A 90-day funding freeze would result in 60 thousand [95% UI: 49-71 thousand] excess HIV deaths for the Interpretation: The sudden cessation of PEPFAR funding likely results in tens of thousands of HIV deaths and new infections. These losses of life and health should compel the United States government to rapidly and fully re-instate one of the most successful health programs in history. Funding: None.

Indexed as

AfricaAntiretroviral therapyARTExecutive orderFunding freezeHIVHIV deathsHIV incidenceHIV infectionsHIV treatmentImpactIndividual based modelMathematical modelingModelPEPFARPresident's emergency plan for AIDS reliefSTDSIMsub-Saharan AfricaTreatment interruption

Identifiers

PMID40626258
PMCPMC12230335

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.