Botswana
Service Status: Partial disruption
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- Botswana received 10,125 doses from PEPFAR in late 2024 and began delivering services in February 2025, with two clients served to date
- Number of planned users: 1,500
- Lack of essential supplies, including test tube and laboratory reagents, have slowed the rollout, and one of the implementing partners, which was funded by USAID, has had to stop work
- Planned receipt of an additional 10,125 doses later in the year is no longer anticipated
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Eswatini
Service Status: Partial disruption
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- Eswatini had received CAB supply from PEPFAR and was offering it in 25 sites, with plans to scale up to seven more
- Unknown number of planned users
- Scale-up plans have been cancelled, and two existing sites that were serving KPs have been closed; mobile units that were serving KPs and adolescent girls have also closed
- CAB is still available in 23 sites and the MoH is requesting additional supply from Global Fund
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Malawi
Service Status: Partial disruption
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- Malawi’s Gates-funded Path2Scale project, which was scaling up to deliver PEPFAR-supplied CAB to 10,000 people through 2026, was suspended when the stop work order was issued
- Number of planned users: 11,000
- Following an order issued by Malawi’s Secretary of Health on 27 February, services are able to restart, but only for existing CAB for PrEP clients or new clients who are pregnant/breastfeeding
- The full supply of CAB for the project is available
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Mozambique
Service Status: Good service
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- Mozambique has provided CAB to 94 users as part of a pilot at a public facility in Nampula, which is continuing as planned with a target of scaling up to 400 users
- Number of planned users: 600
- While CAB is available, there has been a reduction in returning users since the stop work order
- MSF has received an additional 1,350 doses from PEPFAR, which it plans to use in a pilot in Beira focussed on sex workers and LGBTQ+ individuals once local ethical approval is granted
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Namibia
Service Status: Suspended
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- Namibia had planned to begin delivery of CAB in 11 facilities
- Number of planned users: 150
- Sites were in the final stages of preparation when the stop work order was given, so no CAB has been delivered, though 1,000 doses have arrived in country
- Early CAB implementation was going to focus on KPs, but ministers now fear KP-related work may lead to blacklisting by the US government
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South Africa
Service Status: Partial disruption
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- South Africa anticipated receiving PEPFAR CAB supply in early 2025 but now suspended; the government explored procuring CAB for PrEP directly but the price quoted was unaffordable
- Number of planned users: 21,290
- Oral PrEP is procured by the government, who supply all public facilities and donor funded implementers, including PEPFAR, Global Fund, Unitaid, and the Gates Foundation
- There are four large-scale CAB studies still running that are not supplied via PEPFAR
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Ukraine
Service Status: Partial disruption
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- Ukraine’s CAB pilot began in August 2024 with the intention of scaling up to 200 MSM in the first phase and to an additional 500 general population participants in the second phase
- Number of planned users: 600
- As of March 2025, 158 MSM participants have enrolled, and recruitment to reach 200 continues
- The second phase has been cancelled, and once the pilot ends, current participants will be only be able to access oral PrEP, though many have expressed they would not take a daily pill
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Zambia
Service Status: Good service
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- Zambia obtained half their CAB supply from PEPFAR and half from a combination of Global Fund and MoH procurement, with about 40,000 doses remaining, and plans to procure more
- Number of planned users: 12,000
- The MoH plans to continue CAB delivery as normal and is willing to reimburse PEPFAR for stock used if required
- Most PEPFAR-supported NGOs and 32 Wellness Centres serving KPs have closed
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Zimbabwe
Service Status: Partial disruption
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- Zimbabwe had been delivering CAB in 15 sites, 12 of which were funded by USAID and are now suspended
- Number of planned users: 2,000
- CAB delivery via outreach is also suspended
- Many CAB users have had to switch to oral PrEP as a result of CAB sites closing
- The MoHCC is continuing to deliver CAB via the remaining three sites, with about 30,000 doses remaining; no additional supply is currently anticipated
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