Relief for HIV patients after Trump announces limited waiver for USAID programs

A number of employees working under programs funded by the US government can breathe a sigh of relief after President Donald Trump’s administration announced a limited waiver of the 90-day “stop work order,” allowing the resumption of some critical life-saving programs.

At least 568 health workers who had been sent home in Homa Bay County have now been asked to resume work immediately.

Homa Bay County Chief Officer for Medical Services, Dr. Kevin Osuri, however confirmed that the waiver, which lapsed on April 19, 2025, has left a huge staffing gap and uncertainty over the other programs that remain frozen.

"Nilipopata hiyo barua jana nilikuwa na furaha, furaha kwa vile unajua utapata kitu mwisho wa mwezi," said Clinical Officer Delish Herman.

Peer Counselor Onyango Gideon added: "What we have seen within the past one or two weeks is a real indication that we really need to move towards being independent as a government."

Dr. Osuri clarified that only four categories of human resources for health have been directed to report to work with effect from February 7 to April 19, 2025.

"Not every staff member has been brought back. We have brought back a good chunk of them, about 568. A number of them have not been approved for this waiver period. It’s still a big shock and a big bump on the healthcare system," said Dr. Osuri.

Onyango Gideon on his part said, "A short relief, let me say so because we do not know what will happen after the 19th of April."

Amidst the uncertainty, Dr. Osuri terms this as an opportunity for the county to bolster domestic health financing strategies.

"Solutions from the national government, solutions from agencies like NSDCC, agencies like CoG and county governments to see what happens next in terms of if this waiver period ends if it’s not extended, are we in a capacity to take up these services on our own and continue serving our people?" He posed.

Kisumu County’s Chief Officer for Medical Services, Dr. Lusi Ojwang’, has confirmed that plans to wean off donor funding have been underway long before Trump’s executive order was issued.

Dr. Ojwang stated in a statement that the integration of HIV services in level 2 and 3 facilities will continue.

He, however, clarified that the waiver means that staff who had been affected by the executive order in the affected facilities will be back to work but will operate in the outpatient department.

The county plans to employ special strategies to avert instances where some people living with HIV will fail to go for their drugs out of fear of being stigmatized.

The limited waiver by the US government temporarily resuscitates its landmark HIV/AIDS initiative under PEPFAR, which supports life-saving HIV care and treatment and prevention of mother-to-child transmission (PMTCT) services.

"Madawa ya kupunguza makali ya virusi ni madawa muhimu sana katika maisha ya mwanadamu. Na hawa watu wanatumia dawa wengine si kupenda kwao, wengine ni watoto, wengine ni wamama wajawazito ambao wamebeba maisha ya watu ndani yao. Kwa hivyo, kukosa dawa kwao itawaelekeza wengine hata kujiua ama kufariki kutokana na makali ya magonjwa ambayo yanatokana na virusi," Herman said.

According to a document released by the Global Health Security and Diplomacy, which is under the US Department of State, activities approved under the PEPFAR 90-day limited waiver include: HIV testing services for all populations, HIV care and treatment services for all PLHIV, laboratory support, and supply chain management for the procurement of HIV medicines and other commodities to prevent stock-outs in national HIV programs.

HIV pre-exposure prophylaxis (PrEP) should be offered only to pregnant and breastfeeding women during the pause of U.S. foreign assistance.

People other than pregnant and breastfeeding women who may be at high risk of HIV infection cannot be offered PEPFAR-funded PrEP until further notice.

In the meantime, salaries for health workers, laboratory, and supply chain staff necessary to carry out these specific activities are also included in the waiver.