Nigeria is battling a serious challenge in its fight against HIV/AIDS. For several years, foreign donations from global organizations backed by the United States President’s Emergency Plan For AIDS Relief (PEPFAR) consistently supported Nigeria in its fight against HIV/AIDS through community-based advocacy, and management of People Living With HIV/AIDS (PLWHA) with Anti-Retroviral Therapy (ART).

However, the 2025 decision of the United States Government under Donald Trump to first freeze US Foreign assistance, before a subsequent restructuring, has significantly affected local NGOs’ ability to provide essential services.

While the Nigerian Government promptly responded to the cut in foreign aid by allocating a sum of 4.8billion Naira to the procurement of 150,000 HIV Treatment packs, the fight against the disease has suffered a major hit as funding continues to dry up.

According to the National Agency for the Control of AIDS, NACA, about 1.6 million Nigerians are currently placed on antiretroviral therapy, ART. While this represents a large number of individuals living with AIDS, many others, especially in underdeveloped areas, still do not have access to treatment.

Over the years, Nigeria has recorded a significant level of progress in controlling the global epidemic, but the recent sudden cut in international donor funding, the United States President’s Emergency Plan for AIDS Relief (PEPFAR), highly threatens treatment for enrolled patients.

Project Manager at Value Re-orientation for Community Enhancement, Damilola Arowolo, expressed her concern about the recent gap in funding, “When we talk about HIV programming, we’re not just talking about medications. We’re talking about active case finding to stop the chain of transmission among people, so even if medications are still there, there are no resources to test people, there are no resources to link people to care, and we have not successfully broken the chain of transmission of HIV.”

According to her, the declaration of the cut has caused panic, not just among People Living with HIV (PLHIV), but also among every program stakeholder in the HIV program space.

Interruptions in the antiretroviral therapy can lead to drug resistance, increased viral loads, and a higher risk of transmission, weakening national efforts to control the pervasiveness of HIV. Results released by the Federal Government indicate a national HIV prevalence in Nigeria of 1.3% among adults aged 15–49 years. Previous estimates had indicated a national HIV prevalence of 2.8%.

While speaking on the risk that comes with these cuts, Damilola Arowolo said, “We want to be sure that individuals have not used the recent cut as an opportunity to start extorting people, attempting to get ways to sell ARVs. Funding is very important to ensure the integrity of the medications,” she said, raising concerns about how fake drugs could be detected when there is no unilateral monitoring system, which HIV funding brings.

Disruptions in treatment pose a great risk beyond health outcomes. It raises long-term health care expenses, strains health facilities, and threatens the social and economic well-being of PLHIV, including their families.

Funding cuts also affect social and economic well-being, including support groups and advocacy programmes, funded through global funds, UNAIDS, or PEPFAR grants, which are crucial for helping PLHIV stay on treatment.

According to Abosede Alamu, the Director of Humanitarian and Health Support Organization, HASHO, another NGO in Osun State, the withdrawal threatens both life-saving medication access and broader health programmes. “The last project we had in 2025, they told us that these grants they are giving are just to empower us to sustain HIV programs in Nigeria, especially transmission of mother to child. But suddenly, the funds stopped. How then do we continue caring for people living with HIV?”

When asked about how foreign support has contributed to HIV care and services in Osun state, Abosede Alamu said foreign-funded NGOs have played a significant role in ensuring people living with HIV in Osun State continue to have access to medications. She, however, noted that only one of these NGOs is available until March 2026, citing greater challenges as HIV treatment is a matter of life and death, and not a case that can be addressed by cutting fundings.

“If these NGOs leave, we are going to face a serious problem in Osun, especially on drugs, because the drugs are important,” she said.

In curbing HIV, both the state government and the federal government need to ensure that long-term financing for HIV care is effectively put in place, encourage accountability and transparency in the health budget, and partner with public and private health organizations to create awareness and plan treatment programmes.

Speaking on the need for increased government contribution to HIV advocacy, Abosede Alamu raised the need for strong advocacy to ensure there is a certain percentage of Osun State’s budget dedicated to HIV advocacy. “We are not saying government should not abandon infrastructural development, but human beings are very important too. Let’s talk to the Governor that we need support for PLHIV.”

According to her, past support from the State Government helped significantly in buying HIV drugs and paved the way for NGOs to conduct outreach across Osun State, adding that the World Bank participated in HIV programme sponsorship under Governor Rauf Aregbesola.

She bemoaned the poor disposition of the current government in the State towards HIV programmes, adding that many structures like SACA, the State Agency for the Control of AIDS, are no longer functioning.

“The Government should be ready to take care of its people. The matter of HIV cannot be left to political will; we are looking for something quite independent, not dependent on the will or the interests of the government,” says Damilola Arowolo, Project Manager at Value Re-orientation for Community Enhancement. “Diseases like HIV do not care about who is who”, she said.

Speaking on possible steps that can be taken by the government to fill the gap left by foreign donors, Arowolo stressed that the government cannot continue to rely on international funding forever. “We must understand that we cannot continue to rely on international funding forever. Taxpayers’ money should be used properly. All funds should be directed to pass the control of HIV and other infectious disease”

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As Nigeria continues to find ways around these challenges, it is crucial to recognize that HIV care cannot entirely depend on unpredictable international donor support. There is a great call for strategic planning to ensure that Nigerians living with HIV can access drugs and receive the care they need without being interrupted.

The call for improved homegrown planning and funding for HIV/AIDS advocacy follows calls from several other sectors of the country, for country-specific public health plans that will be developed in Nigeria and financed by the Nigerian government. Experts say over-reliance on foreign support has continued to hamper the country’s development and this must not be allowed to continue.