Challenges and opportunities of foreign aid cuts and HIV/AIDS response in Nigeria: A focus on orphans, vulnerable children, and the Families Matter! Program.

Abstract

For more than two decades, United States foreign assistance, particularly through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), has been central to Nigeria's HIV response, supporting antiretroviral therapy (ART), laboratory systems, and community-based prevention initiatives. Among these are programs for orphans and vulnerable children (OVC) and the Families Matter! Program (FMP), which equips parents and caregivers to guide adolescents away from behaviours that increase HIV risk and help reduce HIV-related stigma within families and communities.The temporary freeze on U.S. foreign aid announced in January 2025 disrupted these interventions and raised concerns about the sustainability of Nigeria's HIV response. While much attention has focused on the risk of treatment interruptions and ART stock-outs, less attention has been given to the suspension of OVC and FMP programs despite their role in prevention, psychosocial support, and household stability.This paper examines the short-and long-term implications of the aid freeze for Nigeria's HIV response, with particular focus on adolescents, vulnerable children, and family-centred prevention initiatives. It argues that disruptions to these programs may undermine prevention gains and weaken social protection systems, while also highlighting the need for stronger domestic resource mobilisation and institutionalisation of community-based HIV interventions to ensure a more sustainable and resilient response.