Tens of thousands of sexual assault survivors in eastern Democratic Republic of Congo have been left without access to life-saving anti-HIV drugs after the U.S. cut funding for key foreign aid programs. The funding halt, initiated under President Trump and his adviser Elon Musk, has crippled the delivery of post-exposure prophylaxis (PEP) kits that once helped limit the spread of HIV in conflict-ravaged regions like South and North Kivu.

Spike in Sexual Violence and HIV Risk

The mineral-rich eastern provinces—where violence, displacement, and rape are rampant—are now facing what humanitarian officials describe as a rapidly worsening health emergency. Aid workers from CARE International report daily pleas for help from women who can no longer access essential post-rape treatment. “They are very worried, but we have no drugs to give them,” said Noella Ndoole, a CARE protection officer.

Sexual assaults have surged 38% since the M23 militia group’s recent takeover of major cities. The U.N. previously reported that a child was raped every half hour in the region. Without PEP treatment—which must be administered within 72 hours of exposure—the risk of HIV transmission increases dramatically. HIV prevalence in eastern Congo has already risen to 3.5%, more than double the national average.

Women like Jeremy Kahindo and Kanzira Kihanga describe harrowing experiences: walking for hours to clinics, only to be turned away or given incomplete treatment. Kahindo tested positive for HIV after failing to receive PEP. Kihanga was raped twice while seeking her second dose. “I just went home to prepare my mind for the worst,” she said.

A Program in Collapse

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), launched in 2003, had supplied most of the PEP kits distributed across poor countries, saving over 25 million lives globally. In Congo alone, the number of HIV/AIDS deaths had dropped from 200,000 to 14,000 annually before the funding stopped. Now, clinics are running out not only of PEP but also of basic medicines like paracetamol, with further aid reductions threatening even more devastation.

According to the Center for Global Development, proposed U.S. budget cuts in 2026 could cause 675,000 additional AIDS-related deaths worldwide. The Congolese Health Ministry warns that the country may run out of antiretroviral drugs entirely by August.