The Trump Administration’s Foreign Aid Review: Status of PEPFAR

Starting on the first day of his second term, President Trump issued several executive actions that have fundamentally changed foreign assistance. These included: an executive order which called for a 90-day review of foreign aid; a subsequent “stop-work order” that froze all payments and services for work already underway; the dissolution of USAID, including the reduction of most staff and contractors; and the cancellation of most foreign assistance awards. Although a waiver to allow life-saving humanitarian assistance was issued, it was limited to certain services only and difficult for program implementers to obtain. Since then, responsibility for remaining global health programs has been transferred to the State Department. While there have been several legal challenges to these actions, there has been limited legal remedy to date. As a result, U.S. global health programs were disrupted and, in some cases, ended. Changes to the Department of Health and Human Services, including proposed cuts and reorganization, are also likely to affect these programs. This fact sheet is part of a series on the status of U.S. global health programs.