At the 13th IAS Conference on HIV Science, leading experts are sounding the alarm about the dangers posed by a sharp decline in funding for HIV response. Predictive models and real-world data from Africa and Latin America show rising incidence rates, treatment interruptions, and increased strain on health systems.
The IAS 2025 event, which will be held online from Kigali, Rwanda, on July 13–17, focuses on the political and financial challenges affecting the global response to the HIV epidemic.
Sudden cuts in international aid are negatively affecting prevention, research, and medical care that save millions of lives. The conference takes a deep dive into the impact of these cuts and the ways scientists and advocates are working to fight back.
IAS President Dr. Beatrice Greenstein emphasizes: “Despite significant scientific breakthroughs in prevention and treatment, our progress is threatened by funding cuts that could halt clinical research and slow the fight against HIV.”
Professor Kenneth Ngure, the newly elected president of the IAS, highlights the acute impact of US funding cuts on millions of people in Africa who depend on HIV prevention, testing, and treatment services.
One study, presented by Dr. Jack Stone of the University of Bristol, predicts a significant increase in new HIV cases in sub-Saharan Africa due to the termination of PrEP funding under PEPFAR. Approximately 700,000 people who were receiving PrEP are at risk of losing access to this drug, which will lead to several thousand additional HIV infections, particularly among key populations.
Real consequences for health systems: the experience of Mozambique
A study conducted in Mozambique demonstrates the real impact of the US funding freeze on the HIV service system and the burden on national health care. According to an analysis of district information system data for February 2024 and 2025, the number of new antiretroviral therapy (ART) starts among adults decreased by 25%, and the number of viral load tests decreased by 38%. A similar decline occurred among children, indicating a disproportionate impact of service reductions on the young population.
If this situation continues, experts predict a 15% increase in new HIV cases (approximately 83,000 cases) and a 10% increase in HIV-related deaths (over 14,000 cases) by 2030.
Progress in South Africa undermined by grant funding cuts
In Johannesburg, South Africa, the termination of the PEPFAR-funded APACE grant has slowed progress toward the 95-95-95 targets. Analysis showed an 8.5% decline in HIV testing, a 31% decline in diagnosis, and a 30% decline in ART initiation between 2024 and 2025. This highlights the importance of grant funding to support health workers and services for vulnerable populations.
Impact of funding cuts in Latin America and the Caribbean
A survey of 40 civil society organizations working in Latin America and the Caribbean found that 87% of those receiving US funding had experienced funding suspensions. Budget cuts averaged 50%, and in some cases reached 100%, significantly affecting HIV prevention, treatment, and support services for adults and children.
Call for debt refinancing to support the fight against HIV
Zaki Achmat, founder of the Treatment Action Campaign and member of the Global Coalition on HIV Treatment, stressed the urgent need for debt restructuring for low- and middle-income countries. She warns that the combination of funding cuts and debt burdens threatens to undermine progress in the fight against HIV and calls on the global community to take action to protect the lives of millions of people.
These studies and statements underscore that without adequate political will and stable funding, the global fight against HIV could suffer serious setbacks that would jeopardize years of scientific progress and community efforts.
It is estimated that more than six million people could die from HIV and AIDS in the next four years if the administration of US President Donald Trump ends global funding for programs, according to the UN AIDS agency UNAIDS. Against the backdrop of overall funding cuts in the US, AIDS deaths will increase by 400% if PEPFAR financial support stops between 2025 and 2029.
Ultimately, the Joint United Nations Programme on HIV/AIDS (UNAIDS) announced a massive reduction in its staff – by more than 50% – in response to a sharp drop in funding from major donors, including the US, Europe and Asia. This decision could have irreversible consequences for the global fight against the epidemic.