A report by amfAR (The Foundation for AIDS Research) has found that U.S. cuts to PEPFAR (the President's Emergency Plan for AIDS Relief, a programme credited with saving at least 26 million lives since 2003) have caused more than 1,700 clinics to close and eliminated over 16,000 jobs across 46 countries, after the Trump administration dismantled the U.S. Agency for International Development and cancelled thousands of global health grants. The damage fell disproportionately on services for marginalised groups — including sex workers, gay and bisexual men, and transgender people — with prevention spending dropping 51% between fiscal years 2024 and 2025, and a separate study in the journal Nature Health finding nearly two million fewer people receiving PEPFAR-supported antiretroviral treatment this year compared to last. Researchers warn that even if funding is restored, rebuilding collapsed health infrastructure and community trust will take considerable time, with amfAR cautioning that every day without these systems in place risks new HIV infections.