Direct Relief Delivers Donated HIV Treatment for Children in Rwanda

Direct Relief has taken a step to address emerging gaps in HIV treatment following changes in U.S. government aid, delivering a specialized antiretroviral medicine to Rwanda for treating children with HIV.

While Direct Relief has long supported care for HIV-related opportunistic infections through programs such as the Diflucan Partnership Program, it has historically provided limited antiretroviral medicines, an area that has been largely supported through government-funded programs.

Direct Relief recently delivered a batch of pediatric dolutegravir to Rwanda's Ministry of Health. Dolutegravir is an antiretroviral medicine used in combination with other antiretroviral agents to treat HIV in adults and children.

This is significant because, for years, treating young children with HIV has historically been more difficult than treating adults, with fewer child-friendly options, more complicated dosing, and medicines that were often harder for children and caregivers to use consistently. Pediatric dolutegravir changed that. It offered a highly effective, once-daily treatment that is easier to administer, generally well tolerated, and has a high barrier to drug resistance.

The dolutegravir was donated by ViiV Healthcare, a London-based pharmaceutical company specializing in research and development for HIV/AIDS treatments.

The U.S. government has been the primary funder of HIV/AIDS medicine in Africa since 2003, when it established President's Emergency Plan For AIDS Relief (PEPFAR). On January 20, 2025, the U.S. government froze most foreign aid including PEPFAR, though a subsequent waiver permitted some HIV programs to continue. UNAIDS documented treatment interruptions across the region, stock-outs of HIV medicines in multiple countries, and the suspension of community health programs that support treatment adherence.

The dolutegravir donation is for pediatric HIV patients who have lost access to their treatment because of stock-outs. Even short interruptions can create serious risks.

"If a patient goes a month without treatment, that can lead to resistance, and if you bring that same treatment back, it may be less effective because the virus can mutate," said Dr. Jeffrey Samuel, Direct Relief's Regional Director for Africa. "You don't want anyone to go without treatment for any period, because that's when resistance is most likely to develop."

U.S. government funding for HIV remains in transition, and it isn't yet clear which gaps will remain that non-governmental donors like Direct Relief can fill. In September, the U.S. State Department released its "America First Global Health Strategy," which called for recipient countries to take over funding and managing HIV prevention programs.

"If reductions in government funding for HIV medicines leave a gap that Direct Relief is positioned to fill, we are ready to work with pharmaceutical donors and local recipient organizations to help protect continuity of treatment for vulnerable patients," said Dr. Samuel.