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The United States President’s Emergency Plan for AIDS Relief (PEPFAR) was launched by President George W. Bush in 2003 and is a global health fund to address the HIV/AIDS epidemic. PEPFAR is the largest commitment to address a single disease by any nation in history, and has saved an estimated 26 million lives. As of the end of September 2024, PEPFAR was responsible for around 20.6 million people being on life-saving antiretroviral treatment and had reached 2.3 million adolescent girls and young women with comprehensive HIV prevention services. The future of PEPFAR is uncertain, as the Trump Administration has cut foreign aid and limited PEPFAR activity. A reduction in funding for PEPFAR or a complete dissolution of the initiative would undoubtably result in an increase in HIV infections and AIDS-related deaths, especially in high-impact countries.