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Position Letter

POSITION PAPER

Impact of U.S. Foreign Aid Freeze on HIV services in South Sudan

On behalf of the network of People Living and affected by HIV in south Sudan, I would like to bring to your attention that the recent 90-day suspension of U.S. foreign aid, initiated by the Trump administration, poses a significant threat to the health and well-being of People Living with HIV (PLHIV) in South Sudan. This funding freeze affects critical programs supported by the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and USAID, which has been instrumental in providing life-saving antiretroviral therapy (ART) and related services across the country. Although our treatment come with support from Global fund through UNDP, but the biggest donor is PEPFAR.

 

South Sudan, with an estimate of nearly 200,000 individuals living with HIV, relies heavily on international assistance to manage and curb the epidemic. PEPFAR’s contributions have been pivotal in ensuring access to treatment, prevention, and care services. The abrupt halt in funding jeopardizes these essential services, threaten to reverse years of progress made in the fight against the HIV epidemic. And potentially leading to:

 

  1. Disruption of access to life-saving medications, leading to potential health crisis for those dependent on continuous treatment. Inconsistent use of ARVs can result in drug resistance and increased new HIV transmission rates, TB and other sexual transmitted infections such as Hepatitis among others.
  2. Threats to Prevention Programs, Prevention efforts, including awareness campaigns, condom distribution, access to PrEP (pre-exposure prophylaxis) and Pep (Post exposure prophylaxis) to the key and vulnerable population such as IDPs, Refugees among others. Scaling back these initiatives will likely result in higher rates of new HIV infections in the country.

 

With support from USIAD, we were providing essential support for children Living with and affected by HIV, particularly in high-prevalence town like Juba, this support includes nutritional support, educational and psychosocial support which is key to their wellbeing. While Secretary of State Marco Rubio has issued a waiver for “lifesaving” aid, the implementation details of the Orphan and Vulnerable Children (OVC) remains unclear

 

As I deliberate now, most of these children living with and affected by HIV are not going to school, lack emotional support which may result in mental catastrophe, this is the most worrying situation because they are the future leaders.

 

Within this short time of the stop work order, 1,500 PLHIV missed appointments and drugs, as the result, they are Interrupted In Treatment (IIT). Similarly, the Community Outreach Workers (COWs) who were delivering ARVs, collect viral load sample and providing continuous adherence counseling in the community as far as 25 kilometers from the ART centers have been laid off. Should this freeze continue, the viral load of our clients will rise leading to AIDS and possibly premature death among others.

 

For this reason, we urge the policymakers to reconsider these funding freeze and prioritize investments in HIV care, treatment, prevention and OVC programs. Sustained support is critical to safeguarding the health of millions and maintaining the progress achieved over the past decades. In this country where healthcare infrastructure is fragile, the aid freeze exacerbates existing challenges in delivering HIV services

 

As the network of People Living with HIV in South Sudan, we belief this is a call to our government and an eye opener to not depend only on foreign Aids. We therefore urge our government to:

  • Take immediate action in filling the gap left by the freeze on foreign Aids
  • Inject more domestic fund to strengthen fight against HIV epidemic
  • Take full control of the lives of the citizens
  • Improve health centers providing full treatment packages to its citizens (taxpayers)
  • Improve condition of Living of the citizens
  • Improves all road networks to the states and grassroot level to facilitate easy movement of medicines and food items.

 

We strongly belief we have enough resources to do all these without any foreign Aids. Health is wealth to the country.

 

Yours Truly,

Mama Evelyn Letio Unzi Boki,

Executive Director-NEPWU.

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Empowering Key and Vulnerable Populations: A Community-Led HIV Prevention Program

In the fight against HIV, community-led interventions remain a vital tool in reaching key and vulnerable populations. A network of People Living with HIV (PLHIV) has taken the lead in implementing a comprehensive HIV prevention program, ensuring that those most at risk receive the support they need.

With support from Global Fund through UNFPA, NEPWU have been implementing HIV prevention services for Key Populations, Other Vulnerable Populations, People who Use Drugs and Community Systems Strengthening project in five states across South Sudan (Eastern Equatoria, Western Equatoria, Central Equatoria, Jonglei and Lake state respectively)

The program focuses on psychosocial support, helping individuals navigate the emotional and social challenges associated with HIV. Through peer support groups and counseling, and community outreach programs. These initiatives help individuals cope with their diagnosis, improve adherence to treatment, and empower them to live healthier, more fulfilling lives. By fostering a supportive environment, the program reduces isolation and builds resilience among people living with and affected by HIV.

Being the network of PLHIV, NEPWU also reach wide range of KPs (specially Sex Workers and their clients eg Boda-Boda Riders, Truck Drivers and General population) with HIV prevention packages, one is the distribution of condoms, pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP). These tools are essential in preventing new infections, particularly among sex workers and other vulnerable groups (IDPs and Refugees). The network ensures that these prevention methods are accessible, free, and accompanied by proper education on their correct and consistent use. Through targeted outreach, they break down barriers to access and encourage individuals to take proactive steps in protecting their health.

Many individuals, especially women and girls, experience violence that puts them at higher risk of HIV infection. The network provides a safe space for survivors to seek guidance, psychological support, and referrals to legal and medical services. By addressing GBV, the program not only supports survivors but also works to reduce HIV vulnerability in affected communities

By addressing both the physical and psychological aspects of HIV prevention, this initiative not only reduces infection rates but also strengthens communities. Such programs, led by those with lived experience, play a critical role in ensuring no one is left behind in the global fight against HIV.

Beyond providing services, this also works to combat HIV stigma and discrimination by promoting awareness, education, and advocacy. Through community engagement and policy discussions, they challenge misconceptions about HIV and encourage a more inclusive and supportive society

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From Bondage of Stigma to Positive Living-Together We Can

From 2014-15 and 2019-2020, South Sudan conducted the first ever and a subsequent Stigma Index Surveys, the surveys were conducted in the 10 states of South Sudan; mainly in the communities and health facilities across the country. The findings shed light on experiences of HIV related stigma and discrimination by people living with HIV. Most respondents felt that stigma and discrimination against People Living with HIV PLHIV was largely motivated by lack of correct knowledge and fear of infection.

The most common form of manifestation of stigma and discrimination include rejection by family, friends and community, reproductive rights abuse, avoidance and isolation, moral judgments and self-exclusion.

Stigma and discrimination associated with HIV/AIDS remain significant barriers to combating the disease in South Sudan. These social injustices not only affect the mental and physical well-being of individuals living with HIV but also undermine public health efforts aimed at prevention, testing, and treatment. Understanding the negative impact of HIV stigma and discrimination is essential for fostering a more inclusive, supportive, and health-conscious society.

Among the 10 states affected by high rate of stigma in South Sudan were Lake state (Yirol) and Eastern Equatoria State particularly Kapoeta, Magwi and Torit County among others., the rate of stigma and discrimination have been shown to have major negative impact on HIV care, treatment and support continuum; uptake of HIV prevention services and HCT; disclosure; care, treatment and support services; women and girls; and magnified effects among the socially vulnerable

With support from Global fund between 2016-2024, NEPWU scaled up effort to reached the civil population in parts of Eastern Equatoria State, Lake State, western Bahr-el-ghazal state among others and steered several awareness sessions on adverse impact of stigma and discrimination in the society and individual life, the session brought together Local Government officials, CSOs, Community Leaders, Community Members, PLHIV and the Key Population

Kapoeta South County coordinator of South Sudan Aid Commission Mr. Okot Daniel underscored that before Global fund intervention through NEPWU in Kapoeta, stigma and discrimination was high among PLHIV with others deserting their homes with depression while others quit their medication.

Following intensive awareness, the local government and local leaders established to work collectively and hold perpetrators of stigma accountable, conduct civic education through community gathering and hold series of radio talk-show to create awareness on danger of stigma and discrimination

The South Sudan Aid Commission Coordinator reiterate that “currently rate of stigma and discrimination against people living with HIV/AIDs in Kapoeta south is decreasing compared to the previous years back, this is all brought by the partnership of global fund, NEPWU and the government of South Sudan, we therefore urge NEPWU to continue supporting our locals, I believe continuous advocacy and awareness will yield fruit we want. We need environment where people live freely with stigma and discrimination”

The negative impact of HIV stigma and discrimination extends far beyond the individual, affecting communities and public health outcomes. By fostering a culture of empathy, education, and inclusivity, society can break down the barriers created by stigma and discrimination. Only then can we create an environment where individuals living with HIV are empowered to live healthy, fulfilling lives without fear or prejudice

As we strive for an HIV-free world, one of the greatest barriers remains stigma and discrimination against people living with HIV. misinformation, and prejudice continue to prevent individuals from seeking testing, treatment, and support—deepening the crisis rather than solving it, but we have the power to change this. By fostering compassion, spreading accurate information, and advocating for policies that protect the rights of those affected, we can create a world where HIV is no longer a source of shame or fear. Ending stigma isn’t just an act of kindness—it’s a necessity for public health, human rights, and social justice.

Let us stand together, challenge discrimination, and build communities where every person, regardless of their HIV status, is treated with dignity and respect. Because when we fight stigma, we bring hope, health, and healing to all.

With support from Global Fund through UNDP and other partners, NEPWU will continue to advocate for right of PLHIV, support them to overcome stigma and discrimination, conduct awareness through radio talk show to reach general population.

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Reaching Out: Community Heroes Serving in Flooded Areas to Restore Hope and Healing

In a remote village along the banks of River Nile in South Sudan’s Lakes state, A 28-year-old Maria has become a beacon of hope in Minkaman-a community facing an ongoing crisis of flood. For the past two months, parts of the region have been submerged under devastating floodwater, affecting thousands of lives. As a trained peer counselor, Maria’s mission is simple but essential: to educate, support, advocate for change and empower her community in their health darkest times.

Maria’s role extended beyond just education—she became a bridge between the community (KPs) and humanitarian partners. As a Peer Educator, she worked closely with other local health workers and community leaders to ensure that recipients of care in the most remote areas received psychosocial support, HIV prevention message and peer to peer counseling.

“Peer educators like Maria are invaluable in disaster-stricken areas,” said Mr. Paul, a health official working in the region. “They are trusted by the KPs, they understand the local dynamics, and they can communicate essential health information in ways that outsiders often can’t.”

In the face of overwhelming adversity, Maria’s work as a peer educator has made an indelible mark on her community. Her tireless efforts have not only helped reduce the spread of HIV among KPs by widening their knowledge on preventive measures and provided critical health support but have also fostered a sense of unity and hope.

As floodwaters slowly recede and the village begins the long process of rebuilding, Maria’s story serves as a reminder of the power of grassroots efforts. In times of disaster, it is often those closest to the crisis who are best positioned to bring about real, lasting change.

“Being a Peer Educator isn’t just a job,” Maria reflects. “It’s a responsibility to the specific community I serve, to ensure that we can survive and rebuild, no matter what challenges come our way.”.

Currently, NEPWU with support from Global fund through UNFPA is reaching Sex Workers and IDPs with HIV, TB, STIs and GBV prevention messages in Mingkaman County.