APCOM organised a online meeting with the community affacted by the US President’s Executive Order on PEPFAR in Asia and the Pacific on Friday 7 February 2025. Prior to the call APCOM developed and shared an advocacy letter with information specific to country context in 9 countries in Asia and the Pacific, including Cambodia, India, Indonesia, Laos, Nepal, Papua New Guinea, Philippines, Thailand and Vietnam. These letters are aimed at the national government and Global Fund program urging their prompt assistance during this critical period.
Thank you very much to the participants who were able to participate in the online call at such short notice.
Impacts at the community level
During the call, community representatives provided updates from their countries on the impact of the funding freeze on both the HIV program and operations of the community-led organisations.
Burma/Myanmar:
HIV community in Burma/Myanmar still does not know the extent of impact of PEPFAR fund freeze to the HIV treatment program. This freeze has also impacted other services, including community-led behavioral change communications. Efforts have been made to communicate with the Global Fund country team, and it is reported that they will attempt to cover operational costs for offices. However, smaller community-based projects must continue despite these challenges. Mitigation strategies are currently being developed, and there is a pressing need to ensure that staff salaries are covered as their role is crucial in providing services.
Cambodia:
The suspension of PEPFAR funding has primarily affected technical support and prevention programs. Organizations and agencies are currently gathering data to determine the extent of the impact. The main source of funding for Cambodia’s HIV program is USAID through PEPFAR. The community is working on finding ways to support programs that have been put on hold until more information is available. The Country Coordinating Committee for the National HIV Program has been notified of temporary closures of community-based organizations at the district and province level. There is currently no contingency plan in place to prepare for this unexpected situation.
Laos:
There are currently 26 employees of EpiC Program in three provinces who are currently unemployed. This has resulted in hundreds of clients in these provinces being unable to access essential resources such as condoms, lubricants, and HIV testing. The only remaining sources of funding for these services are through regional networks, but they are only available in Vientiane. The Global Fund grant in Laos provides support for a different set of provinces, making it difficult to supplement the current gap in PEPFAR funding.
Nepal:
The PEPFAR funding freeze has affected the employment of communities. 21 service sites supported by PEPFAR throughout the country have been completely suspended. Communities are now searching for alternative sources of funding, but the gap left by the frozen PEPFAR funds is substantial and there may only be limited options available. The National HIV program has allocated 2.2 million USD for this year, but it remains uncertain how this will affect the long-term livelihoods of key populations.
Philippines:
The impact of suspending EpiC Program in the Philippines is that the organisations solely relying on PEPFAR funding are facing uncertainty. These organizations have ceased all operations and instructed their staff not to report to work. This has resulted in a noticeable decrease in the number of employees and consultants. They have also been directed that no expenses will be incurred after the issuance of the order from 27 January 2025 onwards. Community-led organisations suspended physical and virtual operations, and stopped outreach activities and other activities in partnership with local government units.
Thailand:
The suspension of PEPFAR funding has impacted several programs, including those focused on capacity building and technical assistance. While some community-led organisations have been approved by the NHSO to receive reimbursement for services led by key populations, not all services are currently covered under the UHC scheme. As a result, communities rely on USAID and PEPFAR not only for support with care needs, but also for capacity building. Due to the freeze in funding, several projects such as mental health programming, harm reduction initiatives, and basic HIV services have come to a complete pause. The EpiC Program and their Primary Recipients were instructed not to be in communication with anyone.
Vietnam:
Vietnam is a PEPFAR-focused country. Despite a 10% reduction in PEPFAR funding this year, the National AIDS Program still received a significant amount of 35 million USD. USAID also provides funding for other programs such as disabilities and inclusivity. However, the current funding freeze has negatively affected the MSM (men who have sex with men), transgender individuals, people living with HIV (PLHIV), and mother-to-child transmission (MTC) populations. These groups are still in discussions with the government to address their needs and continue to collect data and evaluate the impact on all levels of the HIV program. While there are currently some medications available through PEPFAR, such as PrEP and HIV self-testing kits, there is uncertainty about funding for future quarters. As of now, service delivery for this quarter remains unaffected, but information for subsequent quarters is currently unavailable.
Community Recommendations:
The community unanimously agreed that there is a need for emergency funding to cover the funding gaps resulting from the US Executive Order which froze almost all US foreign aid, especially PEPFAR. There is a call for other donor governments, including the French Government, to intervene and help address the funding gaps at the country level and continue the operations during the 90-days work suspension or if ever the work will not resume.
The community is also recommending APCOM to advocate, on behalf of country-based community-led organisations, with philanthropic agencies for increased funding to supplement the funding gap especially for the operations of community-led organisations and continuity of community-led services.
