34 JULY-AUGUST 2025 | THE FOREIGN SERVICE JOURNAL are changing the prevention landscape. Continued investment in HIV prevention ensures the rapid deployment of these game-changing technologies, halting new HIV infections and accelerating progress toward the end of AIDS. As noted recently in Senate testimony by Secretary of State Marco Rubio, the majority of the PEPFAR program is now back up and running. These programs and services, however, relate to components of PEPFAR that are covered under the “Emergency Humanitarian Waiver” that was issued by Secretary Rubio on Jan. 28, 2025. The waiver does not cover the majority of PEPFAR’s HIV prevention programs, including pre-exposure prophylaxis, as well as support for community organizations, PEPFAR’s flagship program DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) for women and girls, and programs for orphans and vulnerable children. Smart Policy U.S. leadership in the global HIV response is one of the clearest examples of what American diplomacy, values, and strategic engagement can achieve. It is not only morally right—it is smart policy. PEPFAR strengthens America’s global standing, builds resilient partnerships, and promotes a safer, healthier, and more prosperous world. The end of AIDS is possible by 2030. But it depends on continued bipartisan commitment, visionary leadership, and strategic investment. The world is watching—and the U.S. must continue to lead. n UNAIDS estimates that the permanent discontinuation of PEPFAR treatment and prevention programs would result in 4 million additional AIDS-related deaths by 2029.
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