AMNA NAWAZ: A scathing report by the acting inspector general of USAID, the agency almost completely dismantled in the first weeks of this Trump administration, says thousands of tons of food set to ship are liable to spoil, and that more than $8 billion in money yet to be disbursed now has no oversight nor personnel to put it to use.

It also says an exception for some lifesaving aid is leading to confusion.

The same is true for an initiative started 20 years ago under another Republican president, George W. Bush, fighting HIV and AIDS around the world.

Stephanie Sy has that story.

STEPHANIE SY: The Bush initiative is called PEPFAR, or President's Emergency Plan for AIDS Relief.

It was the largest health commitment ever made by a nation to combat a single disease.

It has saved 25 million lives.

But the Trump administration's cuts in foreign aid has thrown this initiative into a tailspin.

A few days after the White House announced it was pausing foreign aid for 90 days, the State Department granted a waiver that allows the continuation of lifesaving HIV treatment.

But global health advocates say the waivers are not being implemented adequately and don't address prevention efforts.

With me to discuss this shift in HIV funding is Angeli Achrekar, a deputy executive director at UNAIDS, which helps coordinate the global fight against AIDS and provides services in 55 countries.

Angeli, thank you so much for joining the "News Hour."

I want to start with who is being the worst impacted by this foreign aid freeze when it comes to the global fight against HIV-AIDS.

ANGELI ACHREKAR, Deputy Executive Director, United Nations Program on HIV/AIDS: The people that are most impacted by this freeze, by this pause are the people served at the country level in the communities, the 20.6 million people that PEPFAR supports on lifesaving treatment.

Those are the people that we're talking about.

These include mothers, babies, fathers, adults.

These are 20.6 million people on lifesaving services.

These are the people most affected.

STEPHANIE SY: Are you hearing about people that actually cannot access, for example, the antivirals that are so crucial for people living with AIDS, especially pregnant mothers?

ANGELI ACHREKAR: What has happened, because it is -- the pause that happened so quickly, is that lifesaving services have come to an abrupt stop.

We are seeing nurses, doctors, community health workers, laboratorians, people that provide these services not working, not in the clinics.

We have seen clinics themselves not functioning during this freeze and this pause.

It's caused a lot of devastation actually across the globe.

STEPHANIE SY: And that's just a few weeks after freezing aid.

Now, just a few days after the freeze, lifesaving aid was issued a reprieve by Secretary of State Marco Rubio.

He said that the freeze would not apply to lifesaving HIV treatment.

How much has that helped?

ANGELI ACHREKAR: What was really important, and this was a really positive step by Secretary Rubio, was a waiver that was provided for lifesaving treatment services.

This included everything from testing to treatment itself to the ARVs, the lifesaving medications that are required to making sure prevention of mother-to-child transmission, to make sure babies are born HIV-free.

The problem that we're seeing, however, is that waiver for those critical lifesaving interventions has to be implemented across the globe.

And that's where we're seeing some real challenges and why we're seeing some real disruption in services at the moment.

STEPHANIE SY: Even if treatment and testing are spared from the chopping block, what about prevention services in care?

ANGELI ACHREKAR: What's not covered in the waiver is equally important.

Prevention services are not covered, except for PrEP for pregnant and breast-feeding women.

We need to make sure that prevention services for all people, especially adolescent girls and young women, especially for marginalized populations, especially for those that are most at risk.

Every year, we are seeing 1.3 million new HIV infections.

Without prevention, we will never get to end AIDS as a public health threat by 2030.

Those goals that we're all after will not be achieved.

STEPHANIE SY: I understand that your group has looked at what could happen if the U.S. were to completely cease funding in the global fight against HIV/AIDS.

Talk about the potential consequences.

ANGELI ACHREKAR: If PEPFAR were stopped completely, we would be talking about a tenfold increase in the number of AIDS deaths, going from 630,000 AIDS deaths per year to over 6.3 million people dying from AIDS.

We are talking about -- if PEPFAR were halted, we are talking about going to 8.7 million additional new infections by -- in the next four to five years.

That is a major backslide.

That is a major movement in the wrong direction.

STEPHANIE SY: Angeli Achrekar with UNAIDS, thank you so much for joining us.

ANGELI ACHREKAR: Thanks so much.