Congo Braces for HIV Surge After U.S. Funding Stops
The virus is quickly spreading in what should be the country’s most economically productive regions
Eastern Congo faces an HIV crisis due to U.S. funding cuts for antiretrovirals after Trump and Musk reduced foreign aid.
Rape victims in Congo are being turned away from clinics due to shortages of post-exposure prophylaxis treatment kits.
The U.N. reports sexual assaults in eastern Congo have spiked 38% and estimates a child was raped every half-hour.
The mineral-rich provinces of South and North Kivu along the eastern flank of the Democratic Republic of Congo should be among its most productive.
They are home to a fifth of the vast country’s population and are the site of some of its most valuable mines, where men flock to extract coltan and other critical minerals used to produce smartphones, laptops and electric vehicles. Women run roadside restaurants and bars. Millions of people live in camps, displaced by roaming militias, near the borders with Rwanda and Uganda.
Rape is rife. So is HIV.
For years, Congolese women relied on U.S.-supplied antiretrovirals such as post-exposure prophylaxis kits, to prevent infection after an assault. But the funds for those programs dried up after President Trump and his then-right-hand man, Elon Musk, cut funding for most of America’s foreign-assistance programs, including many anti-HIV initiatives.
Now, nearly six months on, the region is threatened by a destabilizing cycle of infection and death, puncturing whatever economic gains might be possible in such a volatile corner of Africa.
Health workers say they have had to start turning away sexual-assault victims looking for post-rape treatment kits. “Most of the women call me crying,” said Noella Ndoole, a protection officer for CARE International, a global charity, who receives several calls a day from distressed women. “They are very worried, but we have no drugs to give them.”
A State Department spokesman says the U.S. supports other programs such as rapid HIV testing and the provision of antiretroviral drugs in other parts of Congo, including the capital, Kinshasa. But it is unable to extend them to the conflict zones in the east, one of the worst affected regions. Humanitarian officials worry that new infections among the working-age population will soar, stirring fresh concern about the region’s future.
A fresh wave of cases is especially worrying in Congo, where PEP and other drugs have helped reduce deaths from HIV/AIDS to around 14,000 a year, from as high as 200,000 before the onset of the U.S. funding programs, according to UNAIDS, the United Nations’ HIV/AIDS agency.
Part of the reason is the level of violence, which is especially high in South and North Kivu.
Humanitarian officials now refer to the region as the rape capital of the world, with the U.N. reporting sexual assaults there spiking 38% over the same period last year after a rebel group known as M23, backed by Rwanda, staged a violent takeover of two major cities.
Before Rwanda and Congo signed a U.S.-brokered deal last week to stop sponsoring armed groups in eastern Congo, the U.N. estimated that a child was raped every half-hour in the region. It is too soon to determine whether the pact will effectively rein in the patchwork of militias operating there.
Jeremy Kahindo said that in April she was pinned to the ground by two armed men, who took turns raping her in Kibumba, a small town 10 miles north of the rebel-held city of Goma. The 42-year-old mother of three walked two hours to a CARE clinic, where a nurse gave her painkillers and antibiotics to treat wounds sustained in the attack. Then the nurse sent her home because the clinic had run out of PEP treatments, Kahindo said.
“The health workers told me there was nothing more they could do for me—there were no drugs,” she said.
Kahindo soon tested positive for HIV. CARE officials confirmed her account.
In Congo’s eastern provinces, charities distributed some 97,560 post-rape treatment kits to women and girls last year, procured largely with U.S. funds, according to CARE. Aid workers say women in the region now need nearly double that number, even as the supply is drying up.
Until this year, the U.S. had been Congo’s largest aid donor, providing more than $1 billion annually in assistance through charities providing medical care, food and other vital supplies to millions of vulnerable people. Worldwide, the U.S. President’s Emergency Plan for AIDS Relief had been providing the bulk of PEP kits and other antiretroviral drugs to poor countries. U.S. officials say the program, launched in 2003 by then-President George W. Bush, has saved more than 25 million lives.
PEP treatment can reduce the risk of HIV infection by more than 90% if administered within 72 hours of an assault. The drug must be taken daily for 28 days, health experts say.
“If taken correctly, it prevents the majority of rape victims from contracting HIV,” said Dr. Chris Rawlings Kaganda, a Ugandan physician.
Aid agencies now warn the funding cuts will lead to soaring HIV infection rates in Congo, especially in the east. HIV prevalence rates in eastern Congo are already as high as 3.5%, more than double the 1.4% national rate. The shortage of PEP kits is so dire that sometimes survivors of sexual violence visit several clinics, only to return home unsuccessful and exhausted, the 72-hour treatment window having passed, according to humanitarian officials.
Kanzira Kihanga says she wasn’t surprised to learn in May that she was infected by the virus that causes AIDS. The 21-year-old believes she contracted the virus after back-to-back rapes by armed men. After the first attack, she went to a clinic but was only given half a dose of the PEP medication. Two weeks later, she was raped again as she walked to the clinic to pick up the remainder of the dosage.
“I just went home to prepare my mind for the worst,” she said. “My parents are very worried. They think I will die very soon.”
A recent survey of more than 100 hospitals in eastern Congo by the International Committee of the Red Cross found nearly three-quarters of them had run out of essential medicines because of the supply issues triggered by the U.S. funding cuts.
“Even pain medicines like paracetamol and ibuprofen are running out,” said Etienne Penlap, the Red Cross health coordinator in Congo.
And while stories of suffering abound, the toll could get significantly worse. Further foreign-aid cuts in Trump’s 2026 budget proposal could result in 675,000 additional AIDS deaths across the world that year, according to the Washington-based Center for Global Development. Congo may run out of antiretroviral drugs by August, according to its Health Ministry.