(Afrocab corrects total number of patients returned to treatment to 3,356 from around 1,000 in paragraph 17. Figure includes 1,095 patients aged under 24 years.)
For months last year, Josephine Angev walked the dirt tracks and lanes that link villages across Benue State with a single objective - to find people who had stopped taking antiretroviral drugs and bring them back to care. The 40-year-old volunteer is one of dozens of locally organised "HIV champions" who carried out face-to-face follow-up after a freeze in U.S. aid interrupted drug supplies for many people living with HIV.
Angev and her fellow volunteers worked in a setting where stigma remains a reality and where some patients had not grasped the clinical consequences of interrupting antiretroviral therapy. "They don’t understand the implications," she said, describing how people can appear well but still be at risk when medicine runs out. Without continuous treatment, the virus can rebound, increasing the risk of HIV-related illness within months and raising the chance of onward transmission.
One vivid instance she recounted involved a 65-year-old woman who ceased medication once her home supply was exhausted and subsequently fell ill. Repeated visits and support from Angev led to the woman returning to therapy; she is now on treatment and doing well, according to the volunteer.
The challenges followed an abrupt policy action: U.S. President Donald Trump’s 90-day pause on foreign aid, which began on January 20 last year, had immediate consequences for programmes in Nigeria. The United States had previously financed around 90% of the country’s HIV treatment costs and paid for health workers. In the months after the pause, both patients and aid groups reported a collapse in the usual dispensing routines.
Rather than receiving six months of medication from major clinics, patients were limited to supplies lasting one to two weeks. In Benue’s capital, Makurdi, all 10 treatment centres closed for a month, and the World Health Organization warned of the prospect that medication stocks could be depleted.
As national and international actors responded, volunteers from community networks stepped into the immediate breach. A continent-wide community support network, Afrocab, mobilised volunteers who traced patients, relayed accurate information about treatment, and redirected people back to care centres when services resumed with fresh funding. Volunteers also worked to rebut misinformation, including claims that prayer alone could cure HIV, and encouraged pregnant women to return to antenatal services to protect their infants.
Nigeria’s government moved to fill gaps with a $200 million health funding package announced within six weeks, which included support for HIV programmes. The U.S. government also issued a waiver in February 2025 for "life-saving" aid, covering antiretroviral drugs. Nevertheless, community volunteers provided an essential bridge in the period of disruption.
Dinah Adaga, who coordinates the Benue volunteer teams, described their methods: "If we couldn’t reach someone by phone, we went to their house - we traced the address and knocked on their door." That hands-on approach proved critical for people who feared clinics might close permanently or who worried about the affordability of medicines after the aid cuts.
One 41-year-old mother said volunteers helped her to resume treatment in November after she had been left in despair by the aid freeze and feared medicines would become unaffordable. She described how antiretroviral drugs are central to her future, noting she is the only person in her household living with HIV while all three of her daughters are HIV negative. "So I believe the drugs were truly made for people like me," she said.
Community teams in Benue reported that between June and December 2025 they brought 3,356 people back into care, including 1,095 children and young people under 24 years and 95 children under five. The volunteers estimate this total equals everyone who had stopped treatment in February and March during the initial phase of disruption.
UNAIDS’ country director in Nigeria, Krittayawan Boonto, said the absence of reported deaths from lack of antiretrovirals was a "good sign" for the immediate period. Still, the interruption left gaps in prevention programmes and testing that experts warn could have longer-term consequences.
Nigeria has one of the world’s largest populations of people living with HIV, with roughly two million affected, and Benue State - home to approximately 4.25 million people - had just over 200,000 people on treatment, according to Afrocab estimates.
After the aid pause, a UNAIDS tracker initially suggested 200,000 fewer Nigerians were receiving treatment. By the end of 2025, however, national data indicated 1.7 million people were on treatment, a slight increase from 2024’s figure of 1.6 million. A U.S. State Department spokesperson said the number of those receiving drugs at the end of 2025 was "very similar" to 2024 and criticised narratives suggesting widespread treatment loss as "inaccurate, misleading and irresponsible." Nigeria’s government did not respond to requests for comment.
While treatment numbers stabilised, prevention services were hit harder and remained more constrained for longer. Civil society coordinators reported a steep drop in the number of people accessing pre-exposure prophylaxis medicines - from 43,000 in November 2024 to below 6,000 in April 2025 - and condom distribution reportedly fell by 55% during the disruption. Dr Oluwafunke Odunlade, head of WHO Nigeria’s HIV unit, cautioned that any gap in prevention efforts can contribute to increased incidence, and testing shortfalls mean cases may have been missed; preliminary figures indicated more than a million fewer people were tested for HIV in 2025 compared with 2024.
In December, the United States and Nigeria signed a health agreement covering 2026-2030 under which the U.S. will contribute $2.1 billion and Nigeria $3 billion. The accord prioritises the HIV response and includes a commitment to expand treatment coverage, with Nigeria taking over funding in full over the next five years. The agreement specifies that U.S. funds will support only workers "formally recognised within government structures," and places a "strong emphasis on Christian faith-based healthcare providers," reflecting a broader U.S. policy focus stated in the agreement.
Volunteers in Benue say they will continue their work. Angev acknowledged the strain of sustained outreach - "It can be exhausting" - but emphasised the personal rewards of restoring lives through treatment. "When you see them living better lives and truly changed, that’s when you feel happy," she said.