A divided U.S. Court of Appeals for the District of Columbia Circuit ruled on Wednesday that the Trump administration may continue to suspend or terminate billions of dollars in congressionally appropriated foreign aid. The decision partially vacates a lower-court injunction issued by Judge Amir Ali and rejects grant recipients’ request for a preliminary injunction, with Judges Karen LeCraft Henderson and Gregory Katsas forming the majority and Judge Florence Pan dissenting. At stake is almost $10 billion—about $4 billion earmarked for USAID global health programs and more than $6 billion for HIV and AIDS work. The freeze was ordered by President Donald Trump on his first day back in office this January. Health specialists warn that the halt threatens the President’s Emergency Plan for AIDS Relief (PEPFAR), a two-decade-old initiative credited with saving roughly 26 million lives, and has already disrupted testing, treatment purchases and supply chains in several partner countries. The appeals court ruling comes amid broader retrenchment in U.S. public-health spending. Earlier this month Health and Human Services Secretary Robert F. Kennedy Jr. cancelled about $500 million in contracts for mRNA vaccine research, arguing the technology lacks public support. Scientists say the cut jeopardises preparedness for future outbreaks and slows work on next-generation vaccines and therapies. Senator Richard Blumenthal and other lawmakers have pressed the administration to reverse course on both foreign and domestic health funding, citing mounting skepticism toward medical authorities and the potential erosion of gains against infectious diseases.