Assessing PEPFAR’s Economic and Educational Spillover Effects: An Update Authors: William Crown, Jennifer Kates, Deborah Stenoien, and Allyala Nandakumar Published: May 20, 2026

https://www.kff.org/global-health-policy/assessing-pepfars-economic-and-educational-spillover-effects-an-update/ This analysis updates earlier work that assessed whether PEPFAR, the U.S. global HIV/AIDS program credited with saving 26 million lives, had impacts beyond health (a companion update looks at broader health spillover effects). Specifically, the earlier analysis found that PEPFAR investments were associated with a significant increase in the GDP per capita growth rate and reductions in the shares of girls and boys who were out of school between 2004 and 2018, positive spillover effects that suggest the program has had a greater impact beyond health alone; this was the case even though PEPFAR funding has been relatively flat for more than a decade. The current analysis updates these estimates through 2022 both to capture additional years of data as well as the potential impact of the COVID-19 pandemic, which severely affected the global economy and resulted in widespread school closures. It similarly finds that PEPFAR was associated with continued improvement in these non-health indicators. These findings suggest that more recent changes to the PEPFAR program by the Trump administration, including significantly scaling back funding and services with plans to further do so in the coming years, could not only have negative impacts on the HIV response, but dampen improvements beyond health.