Case study of PEPFAR funding cuts on HIV infections and deaths: reversing hard-won gains.

Using a validated HIV transmission model for Zimbabwe, we simulated January 2025 U.S. President's Plan for AIDS Relief (PEPFAR) funding cuts' impacts on HIV incidence and HIV-related deaths. We found extending funding cuts through 2030 would increase HIV incidence by 78% and add 85 000 infections, producing 25 000 additional HIV-related deaths. However, if PEPFAR reinstated funding within 12  months, much or all of this harm could be offset through more efficient resource allocation, specifically, reallocating funds for oral PrEP towards long-acting PrEP.