After receiving significant push back following a cut in the distribution of HIV medications through PEPFAR, the Trump administration has quickly reversed its stance.

The U.S. President’s Emergency Plan for AIDS Relief, (PEPFAR) was momentarily banned from giving out its life-saving medication on Marco Rubio’s order on the night of January 26. Part of the wording used in Rubio’s order extended to “even if the drugs have already been obtained and are sitting in local clinics,” according to The New York Times. The following Monday, numerous appointments had been canceled, and patients were being turned away at clinics because of PEPFAR’s block on funding.

The public outcry to the new administration’s move was swift. The overwhelming resentment to the directive moved Trump to issue ambiguous waivers for programs that provide lifesaving humanitarian assistance the following Tuesday. Even after Trump and Rubio backtracked, there are several organizations and clinics in other countries that have yet to see any funding return.

“The partners we collaborate with are in shock, and they do not know what to do because their lifesaving mission and commitment has been breached,” said Asia Russell, executive director of the advocacy group Health Gap.

The impact of the medication black has sent ripples through Africa, where PEPFAR’s resources are largely utilized. Since the organization’s inception in 2003, initially conceived as an African HIV-prevention program launched by President George W. Bush’s administration, the PEPFAR has been estimated to have saved over 25 million lives. Today, around 20 million people across the world rely on the programs funded by PEPFAR for their medication, many of which would not be able to afford the prescriptions otherwise.

On the Republican side of the aisle, the program has been a priority to shut down, with a few right-wing senators having campaigned against PEPFAR’s reauthorization for five years. The senators have alleged that the program also promoted abortions, an assertion that has been repeatedly denied by PEPFAR.

Without treatment, virus levels in people with HIV will quickly spike, suppressing the immune systems of those infected and increasing the odds they will spread the virus to others. Interrupted treatment may also lead to the emergence of resistant strains that can spread across the world.

“We can very rapidly return to where the pandemic is exploding, like it was back in the 1980s,” said Dr. Steve Deeks of the University of California, San Francisco. “This really cannot happen.”

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