Overall Impact of the Stop Work Order
Key Impact Areas
As of April 2025
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PrEP Delivery Service Disruptions: While some countries have suspended PrEP services almost completely; others have reduced; and some still have good service. See below for map. |
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Product Introduction Stalled: PEFPAR’s goal had been to initiate 100,000 users across ten African countries on CAB by end of 2025. By Oct 2024 end, they had initiated 5,000 users across four countries, and in Jan 2025, procurement for 2025 was paused. |
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Research Studies Suspended: Projects studying CAB and DVR serving over 11,000 participants have been terminated, and other projects were temporarily suspended. |
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Healthcare Workers Forced to Pause Work: Initially, in Kenya, 17% of total nurses (22,000) and 12,000 ancillary staff stopped work; while in Zambia and Malawi numbers rose to 20% (17,000) and 43% (4,500) of nurses, respectively; Malawi has since used domestic funding to hire 6,000 healthcare workers, and 50% of healthcare staff have returned to work in Kenya. |
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Key Populations Struggle with Access: Many delivery sites catering to KPs have closed, and governments fear blacklisting from future US government funding if they engage in KP-supportive work. |
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System-level Impacts are Being Felt: This includes the cessation of health system strengthening projects in Kenya, shuttering of health MIS systems in Malawi, and disruption to the development of long-acting PrEP guidelines in Uganda. |
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Key Mitigation Strategies: Most countries are seeking alternative funding sources (Global Fund, government financing) and integrating service delivery (comprehensive care clinics and key population services) into public health systems. |
