Africa-Press – Rwanda. Mutsinzi (not his real name), a resident of Gatsibo District, learned in 2017 that he was HIV positive. After starting antiretroviral drugs (ARVs) under government support, his health improved significantly and his weight increased from 40 kilogrammes to around 70 kilogrammes, allowing him to regain a normal life.
He told The New Times that earlier this year, however, he began hearing rumours that ARVs might soon stop being distributed. Although he was healthy again, the rumours caused deep anxiety for him and his neighbours.
This was the result of the US’s decision to halt funding through the United States Agency for International Development (USAID), which was the primary US government agency for humanitarian and development aid.
Some even advised Mutsinzi to take the medicine less frequently so that it would last longer, telling him that “living in an unhealthy condition is better than dying.”
He followed their advice for a few days, taking his doses every two days instead of daily, but soon noticed his strength dropping. He eventually went to the health facility to seek clarity and was reassured that supplies were stable and he should continue taking his medication properly.
Mutsinzi is one of the people living with HIV who were affected by uncertainty about ARV access, resorting to rationing their medication. But the government is assuring them of adequate stock of this lifesaving medication.
Another person living with HIV, who spoke on condition of anonymity, told The New Times that confusion deepened earlier when hypertension medicines stopped being provided for free. Many people assumed ARVs would be next, leading some to reduce or stop treatment.
She is also a community health worker in Karongi District, who lives with hypertension.
As a health worker, she kept taking her own medication as prescribed, but several colleagues living with HIV began cutting back. Community health workers, she said, had to reassure them repeatedly.
Commenting on concerns about uncertainty in ARV access and some people rationing their medication, Dr Gisele Mujawamariya, Ag. Director of HIV/AIDS Care and Treatment at Rwanda Biomedical Centre (RBC), told The New Times that while there might be those “isolated” concerns, there has not been any nationwide stock-out of ARVs.
“The government of Rwanda continues to ensure that all people living with HIV have uninterrupted access to lifesaving ARVs medication,” she said.
“We are closely monitoring our stock status. Our message to all people living with HIV is clear: they should not ration or reduce their medication dosage. ARVs remain fully available, and treatment adherence is essential for a good outcome.”
Managing the impact of the USAID funding pause
Mujawamariya said that the international funding cuts created temporary operational and financial pressure, particularly on implementing partners that depended on USAID support.
However, core HIV prevention and treatment services provided at health facility and community level continued without interruption.
“This is because of strong government leadership and decentralised services that have ensured provider retention and continuity of services, which are supported by reliable digital platforms and laboratory networks,” she stated.
While the pause required some programmatic adjustments, there was no disruption to essential HIV services for Rwandans, she indicated.
She observed that a few innovative, community-based activities implemented through partners experienced temporary slowdowns, but the government of Rwanda was ensuring efficiency to ensure full continuity of service delivery across all levels of care.
On how many people living with HIV were benefiting from USAID support, Mujawamariya said that the US Government aid, primarily through the President’s Emergency Plan for AIDS Relief (PEPFAR) programme, had been one of the partners supporting Rwanda’s national HIV response.
The national HIV programme, she said, currently has an estimated 222,986 people living with HIV, who are on ARVs medication.
Through PEPFAR support, people living with HIV have historically benefited from activities funded under this programme either directly through treatment support or indirectly through system-strengthening interventions such as supply chain, laboratory services, community follow-up, and data systems, she indicated.
To mitigate the impact of the USAID funding halt, she said, Rwanda national HIV programme took immediate steps mainly through prioritisation and re-alignment.
This includes maintaining HIV prevention and treatment interventions, but reducing non-lifesaving activities, and the Rwandan government committing to support HIV commodities procurement.
Under Rwanda’s health sector budget, Rwf2.8 billion was allocated for ARV procurement in 2025/2026.
“This allocation reflects the Government of Rwanda’s increasing commitment to sustainable HIV financing,” Mujawamariya said, pointing out that combined with development partners support, the allocation ensures Rwanda maintains a steady national ARV coverage.
According to Dr Deo Mutambuka, the Executive Secretary of the Rwanda Network of People Living with HIV/AIDS (RRP+), said that the concerns over ARV access after the external financing halt were expressed in an assessment the network conducted in March this year.
The assessment showed that 85 per cent of respondents were worried about potential future shortages of ARVs and other essential HIV services. “This level of concern reflects how important ARVs are in people’s lives,” said Mutambuka.
“Any perceived interruption can disrupt adherence and undo years of progress in Rwanda’s HIV response. But to date, there have been no nationwide ARV stock-outs, and treatment remains free and accessible in all health facilities.”
Dr Mutambuka stated “Rwanda’s HIV response remains strong, but continued investment, communication, and support for health workers are essential to prevent local disruptions.”
RRP+ continues to monitor service continuity through its field officers, district and sector representatives, and over 4,700 community peer educators supporting more than 166,000 people living with HIV nationwide.
The organisation, he said, also works to counter misinformation and reassure communities. “We urge everyone living with HIV to continue taking their treatment and to seek information from health facilities or trusted community networks,” he said.
How many people currently need ARVs in Rwanda?
Mujawamariya said that Rwanda has approximately 230,000 people living with HIV with 96.9 per cent of them are on ARVs treatment, she said, indicating that “this high coverage reflects Rwanda’s long-standing commitment to universal access and the 95-95-95 targets.”
The UNAIDS 95-95-95 targets are meant to address AIDS as a public health threat. They are intended to ensure that 95 per cent of people living with HIV know their status; 95 per cent of those diagnosed receive sustained antiretroviral therapy; and 95 per cent of those on treatment achieve viral suppression.
“There is no current gap in ARV availability in Rwanda,” Mujawamariya observed, adding that the national programme maintains adequate stock.
To further strengthen sustainability, she said, Rwanda is expanding domestic financing, improving supply chain efficiency, enhancing data systems for early detection of risks, and engaging diverse partners to support resilience.
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