USAID is in charge of ordering the drugs used by the President's Emergency Plan for AIDS Relief (PEPFAR) in its programs that keep 20 million people with HIV alive, Gawande said. This work stoppage means that pharmacy stocking in more than 25 countries suddenly stops, as do payments to partner organizations, which are mostly locally run.

The Trump administration has directed clinics in foreign countries that provide HIV medications paid for by the United States to stop disbursing those drugs, according to the New York Times. The directive means that even medications sitting in local clinics ready to be given to people with HIV or at risk for HIV are not allowed to be distributed.