The recent announcement by former U.S. President Donald Trump to cut funding for international HIV/AIDS programs sent shockwaves across the globe, especially in countries like Nigeria that heavily rely on donor support. Just a week later, on January 28, 2025, the U.S. administration granted a waiver that allowed essential HIV/AIDS medications and medical services to continue under the President’s Emergency Plan for AIDS Relief (PEPFAR). While this waiver provides temporary relief, it does not erase the alarming reality—Nigeria must prepare for a future with reduced foreign aid for its HIV/AIDS response.
Nigeria is one of the countries most affected by HIV/AIDS, with an estimated 10% of the global HIV burden. PEPFAR remains the largest donor supporting Nigeria’s HIV treatment, having committed approximately $7.8 billion, covering around 90% of the country’s treatment needs. This funding has been instrumental in ensuring access to lifesaving Antiretrovirals (ARVs) and medical services for millions of Nigerians living with HIV. Without it, the country risks a severe public health crisis.
Despite the waiver, the message from the U.S. government is clear: African nations, including Nigeria, can no longer rely indefinitely on foreign aid to sustain their HIV response. Over the last two decades, donor support has been the backbone of Nigeria’s HIV/AIDS fight. However, the country must now take charge of its national response and find sustainable ways to finance healthcare programs, especially those focused on HIV prevention and treatment.
Nigeria continues to lead West and Central Africa in the number of people living with HIV, and the statistics paint a worrying picture. In 2023 alone, there were 75,000 new HIV infections and 45,000 HIV-related deaths. One of the biggest challenges remains the high number of children born with HIV, as the country’s efforts to combat Mother-To-Child Transmission currently stand at only 35%, far below the 75% target. Additionally, nearly 1.7 million children have been orphaned due to HIV, underscoring the widespread social and economic impact of the epidemic.
Although Nigeria has a national HIV/AIDS response program led by the National Agency for the Control of AIDS (NACA), significant challenges persist. While antiretroviral therapy (ART) coverage has expanded to reach around 1.9 million Nigerians, problems such as limited access to healthcare facilities, deep-rooted stigma, and inadequate awareness campaigns continue to hinder progress. Without addressing these challenges, the country risks reversing the hard-earned gains made in the fight against HIV/AIDS.
The federal government and other stakeholders must take immediate and decisive action to secure the future of Nigeria’s HIV response. First, there is a need for intensified advocacy efforts to pressure lawmakers to protect HIV/AIDS funding and push back against potential donor cuts. Grassroots campaigns and civil society organizations must rally public support to ensure that decision-makers understand the consequences of reduced funding.
Beyond advocacy, Nigeria must explore alternative funding sources. Increased domestic investment in healthcare is no longer optional—it is a necessity. Public-private partnerships, increased government budget allocations, and philanthropic initiatives must be leveraged to sustain HIV programs. The country must also prioritize innovative financing models, such as health taxes or social investment funds, to create a long-term solution to healthcare funding challenges.
If Nigeria does not act swiftly, the consequences could be catastrophic. A decline in HIV/AIDS funding will not only disrupt treatment for millions but also lead to a resurgence of new infections and preventable deaths. The Trump administration’s wavering stance on HIV funding serves as a warning: Nigeria must become self-reliant in securing resources for its healthcare system. The future of millions depends on the actions taken today.
