Eight former directors of the U.S. Centers for Disease Control and Prevention have urged the government to reform rather than dismantle the President's Emergency Plan for AIDS Relief [1].

The move comes in response to a State Department plan scheduled to take effect June 1, 2026 [1], [2]. This policy change would end CDC support for PEPFAR programs in most partner countries worldwide [2].

In an opinion piece published Tuesday, the former directors said that dismantling this support would strip the U.S. of decades of disease-defense capacity [1]. They said that such a shift threatens the stability of global HIV/AIDS treatment and prevention efforts [1], [2].

The former officials said they advocate for a strategy of reform to modernize the program instead of a complete removal of CDC involvement [1]. They said that the proposed changes could undermine the infrastructure used to track and combat infectious diseases globally.

Other health experts have expressed similar concerns regarding the State Department's timeline. One HIV expert said that without this support, "PEPFAR… will crumble" [2].

The current plan originates from the State Department and aims to restructure how the U.S. manages its global health initiatives [1], [2]. The former directors said that the CDC's technical expertise is essential to the program's success.

“PEPFAR… will crumble”

The tension between the State Department and public health experts highlights a shift in how the U.S. balances diplomatic goals with technical health surveillance. By removing the CDC's direct role in PEPFAR, the U.S. risks losing the granular data and medical expertise required to prevent new pandemics, potentially trading long-term global health security for short-term administrative restructuring.