US spells out life-saving HIV treatment that can continue during aid pause

By Andrea Shalal

WASHINGTON (Reuters) - The U.S. State Department said on Saturday that the President's Emergency Plan for AIDS Relief (PEPFAR) — the world's leading HIV initiative - was covered by a waiver for life-saving humanitarian assistance during a 90-day pause in foreign aid. 

Just hours after taking office on Jan. 20, President Donald Trump ordered the pause so foreign aid contributions could be reviewed to see if they align with his "America First" foreign policy. The U.S. is the world's largest aid donor.

Secretary of State Marco Rubio initially issued a waiver for emergency food aid and then on Tuesday for life-saving medicine, medical services, food, shelter and subsistence help. However, the lack of detail in Trump's order and the ensuing waivers has left aid groups confused as to whether their work can continue.

So on Saturday the State Department's Bureau of Global Health Security and Diplomacy issued a memo, seen by Reuters, clarifying that PEPFAR was covered by the Jan. 28 memo and spelling out what activities were allowed. 

These include: life-saving HIV care and treatment services, including testing and counseling, prevention and treatment of infections including tuberculosis (TB), laboratory services, and procurement and supply chain for commodities/medicines. It also allows prevention of mother-to-child transmission services. 

"Any other activities not specifically mentioned in this guidance may not be resumed without express approval," it said. 

More than 20 million people living with HIV, who represent two-thirds of all people living with the disease receiving treatment globally, are directly supported by PEPFAR. 

Under Trump's foreign aid pause, all payments by U.S. Agency for International Development (USAID) stopped on Tuesday - for the first time since the fiscal year began on Oct. 1 - and have not resumed, according to U.S. Treasury data. On Monday USAID paid out $8 million and last week a total of $545 million.

The Trump administration is also moving to strip a slimmed-down USAID of its independence and put it under State Department control, two sources familiar with the discussions said on Friday, in what would be a significant overhaul of how Washington allocates U.S. foreign aid.

(Reporting by Andrea Shalal, writing by Michelle Nichols; Editing by Nick Zieminski)