Godbole, Ramona https://orcid.org/0009-0009-1211-5810
Wachinger, Jonas https://orcid.org/0000-0002-5480-3138
Nichols, Catherine
Courey, Marissa
Bärnighausen, Till https://orcid.org/0000-0002-4182-4212
Mpembeni, Rose
Tanser, Frank
McMahon, Shannon A. https://orcid.org/0000-0002-8634-9283
Article History
Received: 27 March 2026
Accepted: 3 June 2026
First Online: 24 June 2026
Competing interests
: R.G., C.N. and M.C. are former employees of the US Agency for International Development, which implemented PEPFAR programming. R.G. is currently employed by the Clinton Health Access Initiative (CHAI). This work was conducted independently, and the analyses and conclusions presented are solely those of these authors. The other authors declare no competing interests.
: This analysis used public programme results and financial data at aggregate levels. No individual- or patient-level data are used, exempting this study from institutional review board approval.