A narrative review

On 20 January 2025, the U.S. administration issued an Executive Order freezing all foreign assistance funds for 90 days, including funds distributed by the US President’s Emergency Fund for AIDS Relief (PEPFAR). The following months saw sweeping cuts, reversals, and mass firings (USAID’s staff were cut from 10,000 personnel to 15), and a series of lawsuits and appeals (see KFF’s helpful timeline for more on this). Researchers and advocates began immediately to document the impact and forecast future scenarios. This narrative review summarizes reports and analysis that I could find to date (August 2025).