Modeled estimate. Estimated by a model from published research. Methodology last updated .
Modeled estimate of child HIV/AIDS deaths worldwide attributable to the disruption of PEPFAR funding, with the model, its assumptions and sources.
This represents the estimated number of child deaths attributed to the disruption of USAID funding of the President's Emergency Plan For AIDS Relief program.
HIV (Human Immunodeficiency Virus) attacks the body’s immune system, and if left untreated, HIV can lead to AIDS (Acquired Immunodeficiency Syndrome), where the immune system is severely compromised. This makes the body vulnerable to opportunistic infections and certain cancers. While there is currently no cure, HIV can be managed effectively with antiretroviral therapy (ART), which helps people with HIV live longer, healthier lives and reduces the risk of transmission.
PEPFAR (President's Emergency Plan For AIDS Relief) is a global funding program launched by U.S. President George W. Bush to fight the HIV/AIDS epidemic in underdeveloped regions by providing monitoring and treatment. As of 2023, PEPFAR has saved over 25 million lives, primarily in sub-Saharan Africa.
Source: Wikipedia:President's Emergency Plan for AIDS Relief
On January 27th, 2025, under the DOGE initiative, the PEPFAR program was ordered suspended for 90 days, impairing funding for 20 million people with HIV, including 222,000 people receiving daily HIV medication as well as regular HIV testing and support for thousands of medical personnel. Although a waiver was issued to fund some activities, the effect on the ground appears minimal. Over the course of 2025, the OMB ultimately released only about half of the $6 billion Congress had appropriated for PEPFAR, and the program is now being wound down under a published five-year transition plan (see Methodology).
Source: PEPFAR Impact Tracker page at PrEPWatch
Mortality statistics for many countries receiving USAID lag by a year or more, so the number presented for the current death toll is estimated using a mathematical model.
The current estimate is derived from UNAIDS' 2025 analysis of the impact of US funding cuts, which projects 4.2 million additional AIDS-related deaths between 2025 and 2029 — 300,000 of them children — if the programs PEPFAR supported are permanently discontinued. Applying the documented 2025 funding cut, in which the OMB released only about half of the $6 billion Congress appropriated for PEPFAR, gives a central estimate of 30,000 attributable child deaths per year (the adult/child split is UNAIDS' own). The model assumes deaths began at the full rate on February 27, 2025 — one month after the suspension order, allowing for the disruption lag the Impact Counter Project documented — and continue at a constant rate. Unlike the earlier Impact Counter model, which covered sub-Saharan Africa only, this estimate covers all PEPFAR-supported programs worldwide.
On average, this model attributes one child AIDS death to the funding cut every 17.5 minutes.
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This counter previously used rates sampled from the Impact Counter project, whose trackers freeze, by design, at a one-year projection horizon, and which assumed that only the 47% of HIV programs funded by PEPFAR were disrupted, within sub-Saharan Africa only. That original model has not been discarded: it remains available as a selectable alternative ("Impact Counter (2025)") in this counter's Model Explorer, where readers who prefer its rates can apply them and see the difference.
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Executive branch culpability for these deaths is not due to the lack of funding but to the abrupt termination of funding, which did not allow time for the aid effort to transition to other world aid agencies and NGOs. Regardless of whether other aid is now arriving, it could be, and that possibility reduces executive branch culpability over time, although the amount and schedule are debatable.
The agencies responsible for the transition have published a transition plan spanning five fiscal years, FY2026 through FY2030, with annual funding step-downs at the start of each year. For attenuation modeling purposes, the funding ratio at each step-down is rescaled to model culpability — from 100% at the start of the plan down to zero at the fourth and final step-down at the end of September 2029, marking the end of the four-year attenuation period.
Readers who weigh this differently can adjust it: the Model Explorer on this counter allows choosing other culpability schedules — including a smooth S-curve and this site's original two-year taper — as well as a maximum-culpability cap for those who attribute only a share of these deaths to executive branch policy.
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