Health
WHO Urges Continued Funding for PEPFAR as US Freezes Foreign Aid
The World Health Organization (WHO) has called for continued funding of global HIV programmes following the recent decision by US President Donald Trump to freeze foreign aid, a move that threatens treatment and testing for millions worldwide.
The funding suspension puts at risk access to HIV diagnostics, medicines, and treatment in low- and middle-income countries, according to WHO officials. The organisation warned that halting these programmes could lead to severe health consequences, particularly in regions heavily impacted by HIV/AIDS.
Dire Consequences of Funding Cuts
“A funding halt for HIV programmes can put people living with HIV at immediate increased risk of illness and death and undermine efforts to prevent transmission in communities and countries,” the WHO said in a statement.
Health officials fear that an extended pause on foreign assistance could undo decades of progress in the fight against HIV/AIDS, potentially returning the world to conditions seen in the 1980s and 1990s when millions died annually due to lack of treatment.
As of 2023, nearly 39.9 million people worldwide were living with HIV, with two-thirds residing in sub-Saharan Africa. Despite a significant reduction in AIDS-related deaths—from 2.1 million in 2004 to 630,000 in 2023—the disease remains a leading global health crisis.
Impact on PEPFAR and Global HIV Efforts
The most affected programme by the funding freeze is the President’s Emergency Plan for AIDS Relief (PEPFAR), which has been instrumental in saving more than 26 million lives since its launch in 2003 under then-President George W. Bush.
In 2024, PEPFAR provided antiviral HIV treatment to 20.6 million people across 55 countries. The programme also initiated 2.5 million individuals on pre-exposure prophylaxis (PrEP), a preventive measure against HIV infection, and facilitated testing for 83.8 million people.
Beyond direct patient care, PEPFAR supports 342,000 health workers worldwide whose jobs are now in jeopardy due to the funding suspension. The freeze also affects additional US-backed foreign aid initiatives that collectively provide HIV treatment to 30 million people.
US Pullback from Global Health Leadership
President Trump’s decision to freeze foreign aid for health initiatives marks another step in scaling back US global health commitments. In addition to pausing PEPFAR funding, he has initiated the process of withdrawing the US from the WHO and reinstated the Mexico City Policy, which restricts US funding to foreign organisations that provide abortion-related services or information.
Trump has cited dissatisfaction with the WHO’s handling of the COVID-19 pandemic and concerns over the disproportionate US financial contributions to the organisation as reasons for these decisions.
Calls for Exemptions and Humanitarian Waivers
WHO officials have been working with nations benefiting from PEPFAR to develop long-term strategies for reducing dependency on US aid by 2030. However, the abrupt funding halt threatens to derail these efforts, putting millions of lives at risk, according to the organisation.
The WHO is advocating for exemptions to allow the continued delivery of essential HIV treatment and care. US Secretary of State Marco Rubio has reportedly granted a humanitarian waiver to maintain critical health services impacted by the freeze. According to The Washington Post, the waiver covers “core lifesaving medicine, medical services, food, shelter, and subsistence assistance.”
However, it remains unclear whether the exemption will apply to PEPFAR, leaving the future of millions of HIV patients in uncertainty. Global health advocates continue to urge the US government to reinstate funding for these essential programmes to prevent a major health crisis.
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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026
Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.
“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.
Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.
At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.
The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.
A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.
The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.
Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.
International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.
If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.
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