A new study published in The Lancet Global Health documents severe, sustained declines in HIV service delivery across four non-governmental organisations in Uganda and Zimbabwe following 2025 United States foreign aid cuts.
Impact of Stop-Work Orders on PrEP Access
- Prevention Metrics: Access to pre-exposure prophylaxis (PrEP) dropped sharply across the studied clinics after stop-work orders took effect.
- Funding Realities: Humanitarian waivers intended to protect life-saving interventions failed to restore pre-cut operational capacities by early 2026.
The Lancet Global Health Study Findings in Uganda and Zimbabwe
The research, led by Dr Henry Cust—an LSE Fellow in the Department of Health Policy and former Research Scientist at Duke’s Sanford School of Public Policy—evaluates data from organisations whose US-sourced funding was cut and never restored. According to the findings, the study provides the first direct measurement of service delivery impacts from within affected facilities following the 2025 PEPFAR and USAID stop-work orders.
HIV prevention programs, predominantly revolving around pre-exposure prophylaxis (PrEP), along with routine HIV testing and antiretroviral therapy, experienced sharp operational declines. Data gathered through March 2026 confirmed that these essential health vectors had not recovered, despite humanitarian exemptions designed to shield critical medical interventions from sweeping budget reductions.
| Parameter | Observed Status | Context |
|---|---|---|
| Study Location | Uganda and Zimbabwe | Four non-governmental organisations |
| Core Affected Services | PrEP, Testing, ART | Documented steep delivery declines |
| Key Timeline Marker | 2025 US Aid Cuts to March 2026 | Persistent service deficits without recovery |
The Ongoing Trajectory of Regional HIV Services
As the data through March 2026 demonstrates, humanitarian waivers have thus far proved insufficient to reverse the operational contraction documented in East and Southern Africa. The sustained drop in testing and treatment delivery highlights the systemic reliance of regional health networks on external donor financing, leaving local patient populations exposed to changes in global health funding.
References
- Cust, H., et al. Research on HIV service delivery declines in Uganda and Zimbabwe. The Lancet Global Health.
- London School of Economics and Political Science (LSE). Department of Health Policy institutional briefings.
