HIV drugs stopped for millions by USAID cuts — this is the drastic effect it could have on their health

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A generation after the peak of the AIDS epidemic, a new crisis looms.

The success of PEPFAR, the US-led global AIDS relief program, has made HIV a manageable condition for millions. However, the Trump administration’s foreign aid cuts and temporary waiver for PEPFAR have disrupted the system, threatening access to life-saving medications.

This disruption creates a ticking clock for those dependent on these treatments, raising fears of a resurgence of AIDS-related deaths.

For those too young to remember the devastating impact of AIDS, the effectiveness of PEPFAR has made the harrowing images of AIDS wards a distant memory. Now, health experts and patients alike worry that these scenes could become a reality again if the current course isn’t reversed.

The UN AIDS agency paints a stark picture, predicting a potential 6.3 million AIDS-related deaths in the next five years if the global response falters.

This warning comes at a time of growing complacency surrounding HIV, marked by declining condom use among some young people and the emergence of new medications. The potential for a resurgence of the epidemic underscores the urgency of the situation and the need for continued global commitment to fighting HIV/AIDS.

The agency has begun publicly tracking new HIV infections since the aid freeze.

A woman holds the hand of a sick relative lying on the floor of the overcrowded Lilongwe Central Hospital, in Lilongwe, Malawi, 1998 (file photo) (AP1998)

Here’s a look at what happens to the body when HIV drugs are stopped:

An immune system collapse

HIV is spread by bodily fluids such as blood, breast milk or semen. It gradually weakens the body’s immune system and makes it vulnerable to disease, including ones rarely seen in otherwise healthy people. The surprising emergence of such cases in the 1980s is what tipped off health experts to what became known as the AIDS epidemic.

Years of intense advocacy and shocking sights of children, young adults and others dying of pneumonia and other infections led to the response that created PEPFAR, the President’s Emergency Plan for AIDS Relief. Twenty million people around the world died before the program was founded. Now millions of people take drugs known as antivirals that keep HIV from spreading in the body.

Stopping those drugs lets the virus start multiplying in the body again, and it could become drug-resistant. HIV can rebound to detectable levels in people’s blood in just a few weeks, putting sexual partners at risk. Babies born to mothers with HIV can escape infection only if the woman was properly treated during pregnancy or the infant is treated immediately after birth.

If the drugs are not taken, a body is heading toward AIDS, the final stage of infection.

Chicago police officers, wearing rubber gloves, arrest a demonstrator outside the downtown hotel where the American Medical Association was holding its annual meeting in Chicago, June 24, 1991 (file photo) (AP1991)

The daily danger of germs

“Without HIV treatment, people with AIDS typically survive about three years,” the Centers for Disease Control and Prevention says.

For a long time, there may be no noticeable symptoms. But a person can easily spread HIV to others, and the immune system becomes vulnerable to what are called opportunistic diseases.

The National Institutes of Health says opportunistic diseases include fungal infections, pneumonia, salmonella and tuberculosis. For a country like South Africa, with the world’s highest number of HIV cases and one of the largest numbers of TB cases, the toll could be immense.

Unchecked by HIV treatment, the damage continues. The immune system is increasingly unable to fight off diseases. Every action, from eating to travel, must consider the potential exposure to germs.

Every day counts

For years, the importance of taking the drugs every day, even at the same time of day, has been emphasized to people with HIV. Now the ability to follow that essential rule has been shaken.

Already, hundreds or thousands of U.S.-funded health partners in countries such as Kenya and Ethiopia have been laid off, causing widespread gaps in HIV testing, messaging, care and support on the continent most helped by PEPFAR. At some African clinics, people with HIV have been turned away.

Restoring the effects caused by the Trump administration’s foreign aid freeze during a 90-day review period, and understanding what’s allowed under the waiver for PEPFAR, will take time that health experts say many people don’t have.

Meanwhile, the head of the U.N. AIDS agency, Winnie Byanyima, told the AP that more resistant strains of the disease could emerge.

And an additional 3.4 million children could be made orphans — another echo of the time when the world raced to confront AIDS with few tools at hand.