By working closely together, the Global Fund and PEPFAR have supported nearly 20 million people to access life-sustaining antiretroviral treatment, reducing dramatically a runaway infectious killer that was destabilizing communities and imperiling economic growth. Both programs have consistently drawn strong bipartisan praise and support, even in tough budget environments. Yet today, their continued success is imperiled by potential retrenchment of U.S. political and financial support, even as experts report that controlling HIV epidemics is within reach. The administration has requested a more than $1 billion cut to these programs in its FY 2018 budget request to Congress and is also moving to scale back U.S. diplomatic leadership more generally. Budget numbers from the House and Senate look more promising, but without administration support for increases considerable risk remains.