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Hasn’t the strictly medical stuff like that been exempted from the freeze anyway?

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No, they've definitely frozen funding to PEPFAR, but it's not clear that that would mean an immediate shutdown of any clinics or services - grants and government funding aren't disbursed biweekly like payroll for a company, recipients are usually granted six months or a year of funding at a time.

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It wouldn't require immediate shutdown

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It does, stop work orders were issued.

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I saw a video of someone I think in congress saying that Pepfar funding had been restored?

https://nypost.com/2025/02/13/us-news/clueless-protestors-interrupt-usaid-hearing/

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It was reported a few weeks ago a limited waiver was received for some activities under PEPFAR, but from what I've heard that's not been good enough. Because there's a few issues with a partial waiver. If you say x% of activities are ok,do you pay healthcare staff x% of their salary? Do you only owe x% of the clinic's rent? Then a lot of agencies with waivers are reporting no funds being disbursed anyway. Then the fact it's just totally disorganised and unclear what the long term plan is, means no implementing agencies can actually make any plans. They are in limbo.

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A stop work order was issued, meaning implementers have to stop working unless they have a waiver. 95% of USAID staff were put on leave, which means waivers aren't getting processed. Prior to being put on leave, they were placed under a gag order, which meant they could not communicate about new processes to implementers. For those who do get waivers to operate, the payment system is not being operated, which means they don't get the funds anyway. You are correct that funds are disbursed in large tranches, but this is after work is done, leaving implementing organisations to carry the debt. The issue is the US is using the 'pause' to not pay its debts.

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The waiver system is widely reported not to be working effectively and payments are not being disbursed.

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