The Trump administration said it would prioritize ending mother-to-child HIV transmission. Health workers say it cut services
HIV Care for Mothers and Babies Strained After US Aid Cuts
Activelifezero.com – The Trump administration said it would prioritize ending mother-to-child HIV transmission, but health workers in Tanzania say services for pregnant women, babies and children remain under pressure after abrupt US funding cuts disrupted programs that had operated for decades.
In January 2025, Dr. Theopista Masenge was helping introduce new treatments for children with high HIV viral loads at a hospital in Mbeya when the pediatric HIV program received instructions to halt its work. The order followed the suspension of operations by the US Agency for International Development, which has since been dismantled.
“It was really, very abrupt, and I recall even the hospital managers were running up and down like, ‘What are we going to do?’”
Masenge lost her job soon afterward. She said the interruption removed support structures built over nearly four decades, affecting care for HIV-exposed infants, children and expectant mothers.
“Everything has been disrupted.”
Although some limited US support has resumed more than a year later, Masenge says disruptions to care continue across Tanzania. Now president of the Paediatric Association of Tanzania, she is particularly concerned about the quality and consistency of services available to mothers and children.
“I’m not so worried in terms of supplies and medications, but I’m super worried about the quality of care for the children, for the mothers.”
Gaps in Testing and Follow-Up Care
Some patients have stopped returning to health facilities to collect medication because they believe services have worsened, Masenge said. Early infant diagnosis has also been affected, creating risks for babies who need prompt testing and follow-up after possible HIV exposure.
Preventing HIV transmission from a mother to her child relies on connected care. Pregnant women need testing, treatment and regular support. Babies exposed to HIV need timely diagnosis and monitoring, while children living with HIV require continuing treatment. Staffing shortages, reduced laboratory access, clinic closures and weakened outreach can disrupt this system even when medication remains available.
PEPFAR Partners Report Global Service Disruptions
The effects extend beyond Tanzania. A July study by the Foundation for AIDS Research, or amfAR, and Johns Hopkins University examined how funding cuts and the dismantling of USAID affected PEPFAR, the US global HIV/AIDS initiative.
Researchers surveyed 166 organizations in 46 countries that had received PEPFAR support during the prior year. The organizations represented 23% of PEPFAR partners. Nearly two-thirds of respondents, or 63%, reported disruptions to services designed to prevent HIV transmission from mothers to children.
Twenty-two percent said those prevention services had ended completely during the funding reductions. The survey also found that 1,714 health clinics previously supported by PEPFAR closed worldwide last year.
In September 2025, The Trump administration said it would protect and prioritize programs focused on stopping mother-to-child HIV transmission. But Elise Lankiewicz, a senior policy associate at amfAR, said those programs depend on wider systems that cannot easily be separated from other HIV services.
“Even if the administration’s intention was to not touch these programs, PEPFAR funding awards generally aren’t sort of specific to doing one individual task.”
“There was really no way to protect very singular parts of the system while dismantling others.”
Fewer Children in Treatment May Not Mean Fewer Infections
PEPFAR was launched in 2003 under President George W. Bush and has been credited with saving more than 26 million lives and preventing millions of HIV infections, much of its work centered in Africa.
The current administration is seeking new agreements with recipient countries and greater national co-financing. A State Department spokesperson criticized the amfAR survey’s methodology and said PEPFAR had been strengthened through country ownership and measurable health outcomes.
The spokesperson said the number of children testing positive for HIV and entering treatment has continued to decline. Health advocates, however, warn that fewer children starting treatment does not necessarily prove that transmission has fallen. When fewer babies and children are tested, screened or followed, infections may simply go undetected.
FAQ: HIV Care for Mothers and Children
What should pregnant women do if local HIV services change? They should continue attending available antenatal appointments, ask health workers about HIV testing and treatment options, and seek guidance on where medication and infant follow-up services can be obtained.
Why is early infant diagnosis important? Testing helps identify whether an HIV-exposed baby needs treatment and ongoing care as early as possible. Delays in diagnosis can make it harder to connect families with needed support.
Why do clinic closures affect mother-to-child HIV prevention? Prevention depends on more than medicine. It also requires trained staff, testing, laboratory services, records, counseling and follow-up for both mothers and children.
