More than two decades ago, Nigeria faced a severe HIV crisis, with about 3.5 million people living with the virus, posing a serious threat to the country and the region.
The United States, seeing its strategic interests at risk, including Nigeria’s oil reserves and regional stability, launched the President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003 to fight the epidemic.
Since then, millions of lives have been saved worldwide through this programme, which provides life-changing HIV treatment and prevention.
While living in Nigeria, I witnessed how PEPFAR transformed the lives of many Nigerians. Women who once feared death or abandonment found hope, the ability to build families, and the chance for an everyday life.
However, today, this progress faces a serious threat.
The Trump administration’s recent decision to restrict access to PEPFAR-funded HIV prevention tools like pre-exposure prophylaxis (PrEP) risks cutting treatment for millions and denying many others the protection they need.
This cut comes at a time when new HIV prevention breakthroughs, such as the drug lenacapavir, which offers six months of protection with one injection, promise to make HIV prevention simpler and more effective.
Restricting access to these tools risks reversing years of progress in fighting HIV globally.
When treatment options are unavailable, the impact extends beyond the health realm.
Some people living with HIV may lose hope and stop seeking care, which can increase the spread of the virus.
The withdrawal of aid also causes communities to feel abandoned, making it harder to implement future healthcare efforts.
In Nigeria, cultural expectations make living with HIV even more challenging.
Many women contract the virus from their partners and face difficult choices between protecting their health and fulfilling family roles.
For example, Elizabeth, a Nigerian woman living with HIV, carefully followed her treatment but struggled with condom use in her marriage due to cultural pressures to have children.
Such stories show how HIV affects not only health but also relationships and social life.
Past U.S. policy changes, such as the Mexico City Policy, show how shifting political decisions can increase deaths and infections in countries reliant on American aid.
Nigeria’s decline in HIV cases from nearly 6% in 2001 to about 1.3% in 2019 was mainly possible because of steady support from PEPFAR and other international donors who funded over 80% of the country’s HIV fight.
Cutting these funds threatens not just health but also global security and economic ties. Disease outbreaks do not respect borders.
Failures in health systems can lead to costly international emergencies, as seen with Ebola and the H1N1 flu pandemic.
Reducing aid also weakens America’s influence abroad, allowing other global powers, such as China, to expand their presence through health diplomacy and trade.
In Nigeria, reduced access to prevention tools like PrEP risks forcing women back into impossible choices between their health and social survival.
Without continuous support, the hope for an AIDS-free generation could fade, putting millions at risk and undoing hard-won progress.
The future of HIV prevention in Nigeria and the wider world depends on sustained commitment to funding and access to treatment.
Cutting aid now will bring greater health crises and weaken global efforts to control HIV.
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