By Gcina Ntsaluba
The worldwide fight against HIV has encountered its most severe disruption in decades, with sharp cuts to international funding threatening to reverse years of hard-won progress, according to a report released on Monday by UNAIDS ahead of World AIDS Day 2025.
The report, titled “Overcoming Disruption, Transforming the AIDS Response,” reveals that abrupt reductions in international HIV assistance this year have caused widespread service disruptions, particularly affecting prevention programmes and community-led organisations serving vulnerable populations.
External health assistance is projected to plummet by 30-40% in 2025 compared with 2023, according to estimates from the Organisation for Economic Co-operation and Development. The cuts have sent shockwaves through low- and middle-income countries that depend heavily on international support for HIV services.
“The funding crisis has exposed the fragility of the progress we fought so hard to achieve,” said Winnie Byanyima, Executive Director of UNAIDS. “Behind every data point in this report are people—babies and children missed for HIV screening or early HIV diagnosis, young women cut off from prevention support, and communities suddenly left without services and care.”
Prevention services hit hardest
The crisis has dealt a particularly severe blow to HIV prevention efforts. Several countries have reported dramatic declines in access to pre-exposure prophylaxis (PrEP), a medication that prevents HIV infection. Uganda saw a 31% drop in people receiving PrEP, while Burundi experienced a 64% decline between December 2024 and August 2025.
Programmes designed for adolescent girls and young women have been dismantled in multiple countries, cutting off access to HIV prevention, mental health services, and support for survivors of gender-based violence. This comes as globally 570 new HIV infections occur every day among young women and girls aged 15-24.
Community-led organisations, which form the backbone of HIV outreach to marginalised populations, have been devastated. More than 60% of women-led organisations have suspended essential programmes, while 77% of harm reduction services for people who inject drugs report severe disruptions.
Warning of rising infections
At the end of 2024, approximately 9.2 million people living with HIV were not receiving treatment, and 1.3 million people newly acquired HIV during the year. Without renewed commitment, UNAIDS projects that annual new infections could reach 1.4 million by 2030—resulting in an additional 3.3 million people acquiring HIV between 2025 and 2030 compared to a scenario of meeting global targets.
The crisis has unfolded against a deteriorating human rights landscape. For the first time since UNAIDS began tracking in 2008, the number of countries criminalising same-sex sexual activity and gender expression increased in 2025.
Signs of resilience emerge
Despite the grim outlook, the report identifies encouraging signs of resilience. Several countries, including Nigeria, Uganda, Côte d’Ivoire, South Africa, and Tanzania, have committed to increasing domestic investments in HIV services. Many nations have maintained steady or even increased numbers of people starting antiretroviral therapy through swift action.
Innovation offers additional hope. New HIV prevention technologies, including twice-yearly injections, have the potential to prevent tens of thousands of infections. Recent partnerships announced in 2025 aim to ensure access to affordable generic formulations of life-saving medicines for as little as $40 per person annually.
The Global Fund’s recent replenishment conference generated pledges of $11.34 billion, while the United States is establishing bilateral agreements with approximately 70 countries to continue funding during a transition to self-reliant national responses over the next two to five years.
Call to action
With 40.8 million people living with HIV worldwide, UNAIDS is calling on global leaders to reaffirm funding for prevention, testing and treatment; invest in innovation; and defend human rights while strengthening community-led action.
“We know what works—we have the science, tools, and proven strategies,” Byanyima said. “What we need now is political courage.”
The new Global AIDS Strategy 2026-2031, launched this year, provides a roadmap for ending AIDS as a public health threat by 2030. UNAIDS estimates that $21.9 billion annually will be needed through 2030 to achieve global HIV targets in low- and middle-income countries, compared with $18.7 billion available in 2024.
“This is our moment to choose,” Byanyima urged. “We can allow these shocks to undo decades of hard-won gains, or we can unite behind the shared vision of ending AIDS. Millions of lives depend on the choices we make today.”
