Memo Details Data on HIV/AIDS Treatment Program Under Trump Administration

The State Department memo shows steady treatment numbers despite cuts to foreign aid funding.

Apr. 18, 2026 at 1:48am

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A translucent, ghostly X-ray photograph showing the detailed internal structures of the human heart and lungs, conveying the clinical and scientific nature of the PEPFAR HIV/AIDS treatment program.An X-ray view of the human heart and lungs reveals the intricate inner workings of a critical public health program.Washington Today

An internal State Department memo sent to Secretary of State Marco Rubio reveals data on the President's Emergency Plan for AIDS Relief (PEPFAR) program during the Trump administration. The memo indicates that the number of people receiving anti-retroviral treatment through PEPFAR remained steady at 20.6 million in 2025, despite a roughly 30% drop in overall spending on the initiative. However, the memo also notes a potential 15 million decrease in the number of individuals receiving testing and counseling services due to interruptions to some programs during the Trump administration's foreign aid freeze in early 2025.

Why it matters

PEPFAR is a critical global health initiative that has saved millions of lives worldwide. The data in this memo provides insight into how the program fared under the Trump administration's cuts to foreign aid, which raised concerns about the potential impact on HIV/AIDS treatment and prevention efforts in developing countries.

The details

The memo, which is marked sensitive but unclassified, was sent from Jeremy Lewin, the State Department's senior official for foreign and security assistance, to Secretary of State Marco Rubio. It shows that while overall PEPFAR spending fell by around 30%, the number of people receiving anti-retroviral treatment remained the same as the previous year at 20.6 million. However, the memo notes that the number of individuals receiving testing and counseling services through PEPFAR could have fallen by more than 15 million in 2025 due to interruptions to some programs during the Trump administration's foreign aid freeze. The memo also highlights progress in other areas, such as a more than doubling in the number of pregnant and breastfeeding mothers who began pre-exposure prophylaxis through PEPFAR, and an increase in the number of treatment programs being managed by national governments rather than organizations working on behalf of PEPFAR.

  • The memo was sent to Secretary of State Marco Rubio on April 7, 2026.
  • The data in the memo covers the 2025 fiscal year.
  • The Trump administration's foreign aid freeze occurred in early 2025.

The players

Marco Rubio

The current Secretary of State, who received the internal State Department memo.

Jeremy Lewin

The State Department's senior official for foreign and security assistance, who authored the memo.

President Trump

The former president whose administration implemented cuts to foreign aid funding that impacted the PEPFAR program.

George W. Bush

The former president who launched the PEPFAR initiative in 2003.

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What they’re saying

“The data collected in 2025 shows progress towards other Trump administration goals, including ending mother-to-child transmission of HIV.”

— Jeremy Lewin, State Department's senior official for foreign and security assistance

“The 2025 data demonstrates 'an important shift toward country self-reliance,' indicating that treatment programs for 3 million people with HIV/AIDS were now being managed by national governments rather than organizations working on behalf of PEPFAR.”

— Jeremy Lewin, State Department's senior official for foreign and security assistance

What’s next

The Bureau of Global Health Security and Diplomacy will confidentially brief members of Congress on the 2025 PEPFAR data before releasing it to the public on Friday.

The takeaway

This memo provides a glimpse into how the critical PEPFAR program fared under the Trump administration's cuts to foreign aid, highlighting both the resilience of the treatment program and the potential impact on testing and prevention efforts. As the Biden administration works to rebuild global health initiatives, this data will likely inform future policy decisions and funding priorities.