8 former CDC directors: Reform PEPFAR, don’t dismantle it - Report - MDSpire

8 former CDC directors: Reform PEPFAR, don’t dismantle it

  • By

  • William Roper

  • Jeffrey Koplan

  • Richard Besser

  • Tom Frieden

  • Anne Schuchat

  • Robert Redfield

  • Rochelle Walensky

  • Mandy Cohen

  • May 26, 2026

  • 0 min

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Eight former CDC leaders advocate for PEPFAR reform rather than its elimination

Overview

Former CDC leaders emphasize the critical importance of PEPFAR in maintaining global health security and preventing the dismantling of U.S. public health capabilities abroad. They warn that proposed reforms could jeopardize HIV treatment for millions and undermine established health systems.

Background

PEPFAR, initiated in 2003, has been instrumental in combating the HIV epidemic, saving over 26 million lives and providing treatment to 20 million people. Recent proposals to reform PEPFAR risk destabilizing the infrastructure that supports these efforts, particularly in the context of emerging global health threats. The ongoing Ebola outbreak and hantavirus cases highlight the necessity of robust public health programs like PEPFAR.

Data Highlights

No numerical data or trial data provided in the source material.

Key Findings

  • PEPFAR has saved more than 26 million lives since its inception.
  • It currently supports HIV treatment for 20 million individuals.
  • Recent funding freezes threaten 105 active CDC cooperative agreements.
  • Without a transition plan, up to 85% of CDC’s global presence could be lost in two years.
  • Rapid dismantling of USAID previously harmed global health relationships and institutional knowledge.

Clinical Implications

The potential reform of PEPFAR necessitates careful consideration to avoid disrupting HIV treatment and public health infrastructure. Maintaining U.S. presence and expertise in global health is crucial for effective outbreak response and ongoing HIV management.

Conclusion

The future of PEPFAR reform must prioritize a structured transition to ensure continued support for HIV treatment and global health security.

Related Resources & Content

  1. Kaiser Family Foundation (KFF), The U.S. President's Emergency Plan for AIDS Relief (PEPFAR), 2023 -- Overview of PEPFAR
  2. Kaiser Family Foundation (KFF), Assessing PEPFAR’s Health Spillover Effects Beyond HIV: An Update, 2023 -- Evaluation of PEPFAR's Impact
  3. The Journal of Infectious Diseases, Implementation of All-inclusive Global Purchasing Agreements for Viral Load and Infant Diagnosis in PEPFAR-Supported Countries, 2023 -- Article on PEPFAR Implementation
  4. The Journal of Infectious Diseases, Laboratory Implementation Approach within PEPFAR's Five-Year Strategic Framework, 2023 -- Strategic Framework Analysis
  5. Guidelines on lenacapavir for HIV prevention and testing strategies for long-acting injectable pre-exposure prophylaxis, WHO, 2023 -- WHO Guidelines
  6. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women | New England Journal of Medicine, 2023 -- Study on Lenacapavir
  7. Update to the Perinatal HIV Clinical Guideline | NIH, 2023 -- Perinatal HIV Guidelines Update
  8. Guidelines on lenacapavir for HIV prevention and testing strategies for long-acting injectable pre-exposure prophylaxis
  9. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women | New England Journal of Medicine
  10. Update to the Perinatal HIV Clinical Guideline | NIH

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