He's one reason why aid cuts weren't as dire for the HIV population as predicted

## Summary
Global Health He's one reason why aid cuts weren't as dire for the HIV population as predicted March 20, 2026 8:10 AM ET By Gabrielle Emanuel Harerimana Ismail is a community health care worker in Kabale District, Uganda, who supports children and teens living with HIV. So much so that the forecasts warning of a major collapse in HIV/AIDS treatment efforts, after foreign aid cuts threw programs into turmoil, appear to have been averted — at least for now. As HIV/AIDS specialists pore over the latest figures to get a sense of what all the disruptions have amounted to, there is a realization: At least when it comes to the number of people on HIV treatment, the dire warnings of a tremendous dropoff didn't come to pass. "In a better place" Early last year, Charles Kenny — a senior fellow at the Center for Global Development, a Washington, D.C. think tank — tried to estimate to the best of his ability the impact of the aid cuts. Three types of action The first thing that helped boost treatment levels: The Trump Administration restarted some programs deemed lifesaving. life-saving. "The U.S. government did realize the potential impact of the stop work order," explains Mahy. "People that were in place at the [HIV/AIDS program] there in Washington were able to communicate: 'We need to get the drugs to countries and then allow the countries to distribute.' " Second, countries that had been receiving the aid stepped in to fill whatever gaps they could. "The efforts by Ministries of Health to reprioritize and sustain services was pretty heroic," says Imai-Eaton.

## Article Content
Global Health
He's one reason why aid cuts weren't as dire for the HIV population as predicted
March 20, 2026
8:10 AM ET
By
Gabrielle Emanuel
Harerimana Ismail is a community health care worker in Kabale District, Uganda, who supports children and teens living with HIV. He lost his salary as part of the U.S. aid cuts but continues doing his job.
Ben de la Cruz/NPR
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Ben de la Cruz/NPR
Harerimana Ismail hasn't had a paycheck since the beginning of last year. He's kept working nonetheless.
When the Trump Administration paused foreign aid and issued
stop work orders
in January of 2025, almost all U.S. foreign aid projects were halted. That included the termination of Ismail's work as a community health worker at the Kabale Regional Referral Hospital in southwestern Uganda, where his salary – roughly $50 a month – was paid for by a U.S. grant. He'd been a community health worker for eight years.
But he's kept going door-to-door to make sure that children who have HIV are still taking their medications, connected to medical care and feeling supported.
"There is not any stipend or salary that I'm paid," says Ismail, 32, who himself contracted HIV at birth from his mother. "It's just because I understand the pain young people living with HIV pass through — that's why I remain."
Without an income, he's surviving primarily on the vegetables he grows in his garden. He sells Irish potatoes to pay his rent and says he's lost 15 pounds this past year.
New data suggests the
work that Ismail — and others like him — have been doing to keep people on HIV treatment has had a big impact.
So much so that the forecasts warning of a major collapse in HIV/AIDS treatment efforts, after foreign aid cuts threw programs into turmoil, appear to have been averted — at least for now. Preliminary figures from the U.S. government suggest global HIV treatment levels are at roughly the same level as before the disruptions. With the U.S. supporting more than 20 million people on HIV treatment, the number dipped by only 100,000 people between the end of the 2024 reporting period and a year later.
"The most severe outcomes that we were concerned about haven't come to pass," says
Jeff Imai-Eaton
, an associate professor of epidemiology at the Harvard T.H. Chan School of Public Health.
That's good news. But there's also bad news in the world of HIV.
A brief flash of data
For decades, the U.S. has played a leading role in the worldwide fight against HIV/AIDS, pouring well over $110 billion into the effort and saving
26 million lives
. It has also provided some of
the best data
on the disease, tracking everything from how many people in various age brackets and countries are tested for HIV to how many people are on medications to suppress the virus. The goal was to make sure the programs are on target to hit their specific goals.
"It really was a gold standard for collecting data on a regular basis and sharing it transparently — and then using that data to really inform decision making," explains
Ramona Godbole
, the former deputy director of policy, planning and programs at the now-defunct U.S. Agency for International Development. In that job, she helped oversee the global health data hub.
This past year, as foreign aid has been slashed and many HIV programs upended, the U.S. government stopped reporting the data.
"It has really been a black box. There has been no new data released," Godbole says.
But a handful of weeks ago, preliminary data on the U.S.'s HIV work briefly appeared on a government website, before it was taken down. The State Department declined to comment on why the data was removed. Even though the data has not yet been officially released and the numbers could change, experts say that brief flash of numbers broadly matches what other organizations are finding.
"It complements quite well the data that we've received [from countries]," says
Mary Mahy
, director of data and evidence at The Joint United Nations Programme on HIV and AIDS or UNAIDS.
As HIV/AIDS specialists pore over the latest figures to get a sense of what all the disruptions have amounted to, there is a realization: At least when it comes to the number of people on HIV treatment, the dire warnings of a tremendous dropoff didn't come to pass.
"In a better place"
Early last year,
Charles Kenny
— a senior fellow at the Center for Global Development, a Washington, D.C. think tank — tried to estimate to the best of his ability the impact of the aid cuts. He was among a number of experts to produce
dire warnings
about the impact. That preliminary flash of government figures, he says, gives him hope that U.S. support for people on HIV treatment is stronger than he'd projected.
"If this data is right, we are in a better place than I thought we would be, even though we're still in a really bad place," says Kenny, who wrote a blog post
analyzing
the data.
In a statement to NPR, the State Department confirmed that treatment levels at the end of the 2

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## Expert Analysis

### Merits
N/A

### Areas for Consideration
- Several other HIV specialists interviewed for this story pointed to the selflessness of community health workers and other frontline medical professionals as a key reason that treatment levels have not dropped off as much as some anticipated. "Providing the absolute bare minimum" Even though treatment levels are high, a deeper dive into the world of HIV gives specialists cause for concern.
- The same goes for efforts to educate, counsel and care for the highest-risk populations — like sex workers and men who have sex with men.

### Implications
- New data suggests the work that Ismail — and others like him — have been doing to keep people on HIV treatment has had a big impact.
- The goal was to make sure the programs are on target to hit their specific goals. "It really was a gold standard for collecting data on a regular basis and sharing it transparently — and then using that data to really inform decision making," explains Ramona Godbole , the former deputy director of policy, planning and programs at the now-defunct U.S.
- Even though the data has not yet been officially released and the numbers could change, experts say that brief flash of numbers broadly matches what other organizations are finding. "It complements quite well the data that we've received [from countries]," says Mary Mahy , director of data and evidence at The Joint United Nations Programme on HIV and AIDS or UNAIDS.
- As HIV/AIDS specialists pore over the latest figures to get a sense of what all the disruptions have amounted to, there is a realization: At least when it comes to the number of people on HIV treatment, the dire warnings of a tremendous dropoff didn't come to pass. "In a better place" Early last year, Charles Kenny — a senior fellow at the Center for Global Development, a Washington, D.C. think tank — tried to estimate to the best of his ability the impact of the aid cuts.

### Expert Commentary
This article covers hiv, data, treatment topics. Areas of concern are also raised. Readability: Flesch-Kincaid grade 0.0. Word count: 1846.