Browsing by Author "Hontelez JAC"

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    The impact of the PEPFAR funding freeze on HIV deaths and infections: a mathematical modelling study of seven countries in sub-Saharan Africa.
    (2025-May) Hontelez JAC; Goymann H; Berhane Y; Bhattacharjee P; Bor J; Chabata ST; Cowan F; Kimani J; Knox J; Lora WS; Lungu C; Manne-Goehler J; Mauti J; Moshabela M; Mpembeni RM; Wa Mwanza M; Ndung'u T; Omondi E; Phiri S; Siedner M; Tanser FC; de Vlas SJ; Bärnighausen TW; Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.; African Population and Health Research Center (APHRC), Nairobi, Kenya.; Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.; Partners for Health and Development in Africa, Nairobi, Kenya.; Department of Global Health and Epidemiology, School of Public Health, Boston University, Boston, MA, USA.; Centre for Sexual Health and HIV AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe.; HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa.; School of Global and Public Health, Kamuzu University of Health Sciences, Lilongwe, Malawi.; Africa Health Research Institute (AHRI), Somkhele and Durban, South Africa.; Center for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Department of Medicine, Harvard Medical School, Boston, MA, USA.; Department of Pathology, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA.; Ragon Institute of Mass General Brigham, Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA.; Partners in Hope, Lilongwe, Malawi.; University of Cape Town, Cape Town, South Africa.; South African Centre for Epidemiological Modelling and Analysis, Centre for Epidemic Response and Innovation, School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa.; Muhimbili University of Health and Allied Sciences, School of Public Health and Social Sciences, Dar es Salaam, Tanzania.; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.; Division of Infectious Diseases, Brigham and Women's Hospital, Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, USA.; Institute of Global Public Health, University of Manitoba, Winnipeg, Manitoba, Canada.; Public Health Group, Malawi Liverpool Wellcome Trust-Clinical Research Programme, Lilongwe, Malawi.; Division of Infection and Immunity, University College London, London, UK.; Institute of Mathematical Sciences, Strathmore University, Nairobi, Kenya.; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.; HIV Center for Clinical and Behavioral Studies, NewYork State Psychiatric Institute and Columbia University, New York, New York, USA.; Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Germany.
    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.