A new UNAIDS report shows that funding cuts, a growing backlash against human rights, and insufficient support for HIV prevention and community-led services risk undermining years of progress in the AIDS response.
“There is no doubt that this is the most serious disruption to the HIV response since the world came together to fight this epidemic. Funding cuts, combined with shrinking civic space and the further criminalization of marginalized communities, have created the strongest storm the HIV response has ever faced.”Winnie Byanyima, UNAIDS Executive Director
The funding gap is already affecting services
According to the report, the sharp reduction in international assistance has already had devastating consequences for low-income, high-HIV-burden countries that rely heavily on external support. In 2025, global development assistance from several countries fell by 23% — the steepest decline ever recorded. HIV programmes have been among those hit hardest.
Between 2024 and 2025, HIV testing programmes in high-HIV-burden countries declined by 22%. This means fewer people are able to learn their HIV status, access treatment in time, and prevent further transmission. In some cases, funding for condom procurement was cut by more than 90%. In 62 countries reporting data to UNAIDS, coverage of pre-exposure prophylaxis, or PrEP — the use of antiretroviral medicines to prevent HIV — dropped by 38%.
HIV prevention is being scaled back at the very moment when the world needs to expand it. This is especially urgent as new, groundbreaking long-acting prevention medicines are becoming available. Prevention was already underfunded: in 2024, it accounted for only 11% of all HIV spending. Now even these limited investments are shrinking, with no clear signs that domestic funding will be able to close the gap quickly.
Progress is significant, but fragile
Despite the current risks, the HIV response remains one of the greatest global health success stories of the past 25 years. AIDS-related deaths have fallen by 56% — from 1.3 million in 2010 to 570,000 in 2025. New HIV infections have declined by 43% since 2010, reaching 1.2 million. Today, 78% of the 40.9 million people living with HIV are receiving treatment — 32.1 million people.
Yet these achievements remain fragile. Nearly 9 million people are still not receiving treatment. As external financing declines, progress in expanding access to HIV treatment is under serious threat. For example, HIV treatment programmes in Western and Central Africa depend on external funding for around 90% of their resources. Without sustained international support and increased domestic investment, the risk of treatment interruptions rises — and with it the risk of more deaths and new HIV infections.
Progress remains deeply uneven. In some regions the situation is improving, while in others new HIV infections are increasing. Since 2010, new infections have risen in Eastern Europe and Central Asia, the Middle East and North Africa, and Latin America. Meanwhile, every week in sub-Saharan Africa, 3,000 adolescent girls and young women acquire HIV. This is one of the clearest signs that the global response is still failing to reach some of the people most in need of support.
Communities are losing resources — and with them, reach and trust
Community-led organizations, civil society organizations, networks of people living with HIV, youth organizations, and sex worker organizations play a critical role in the HIV response. They are often the most effective providers of services for people living with HIV and communities affected by the epidemic. They work on the frontlines of prevention, treatment and support, reaching up to 60% of people in their communities, including gay men and other men who have sex with men, sex workers, people who inject drugs, and their sexual partners.
Despite this, funding for community-led work has been sharply reduced, with no significant increase in domestic resources to fill the gap. A recent study involving 79 community-led organizations from 47 countries across three regions — Asia and the Pacific, Latin America and Africa — found that support services for people living with HIV had declined by 50%. Services for sex workers fell by 82%, while services for men who have sex with men fell by 85%. Support services for people who have experienced gender-based violence are also being reduced. When communities lose funding, the entire HIV response loses reach, trust and effectiveness.
The human rights rollback is increasing risks
The report also documents a dangerous rollback on human rights. For the first time since UNAIDS began monitoring these trends, the criminalization of marginalized communities is increasing. In 2025, two more countries criminalized same-sex sexual relations, and in 2026 one country increased penalties for such relations. When people fear arrest, discrimination or persecution, they are less likely to test for HIV or seek healthcare. This creates conditions in which the epidemic can continue to spread.
“Diseases spread fastest where human rights are weakest. The rollback of human rights and shrinking civic space are not accidental. They are an organized political process with real consequences for public health and catastrophic outcomes for the HIV response.”Winnie Byanyima
Opportunities for change remain
At the same time, the report shows that opportunities for progress remain. The share of domestic resources in HIV financing increased from 28% in 2010 to 52% in 2024. Since January 2025, more than 54 countries have committed to increasing domestic funding. However, many countries are facing a rapidly worsening debt crisis: 28 African countries now spend more on debt servicing than on health.
UNAIDS welcomes new donor commitments, particularly from the United States of America and the Global Fund to Fight AIDS, Tuberculosis and Malaria. These commitments create an opportunity to work with countries to expand domestic co-financing and plan a transition towards new financing models.
Integrating HIV services into broader health systems also offers promising results. In a quarter of 152 countries, the HIV response has already been integrated into wider health strategies. For example, in more than 80 countries, cervical cancer prevention and treatment services are included in national HIV guidelines.
Innovation can also help drive further progress. By the end of March 2026, more than 6,000 people in five sub-Saharan African countries were receiving lenacapavir, a long-acting medicine for HIV prevention. However, much more needs to be done to reach the 20 million people who, according to UNAIDS estimates, need antiretroviral medicines for HIV prevention.
A new Political Declaration should define the next steps
On 22–23 June, the United Nations General Assembly will hold a High-Level Meeting on HIV/AIDS, where countries are expected to adopt a new Political Declaration on HIV. This will be the final Political Declaration before the 2030 deadline to end AIDS as a public health threat. The new declaration is expected to set 2030 targets in line with the Global AIDS Strategy. These include ensuring that 40 million people receive antiretroviral treatment, providing 20 million people with access to HIV prevention medicines, and guaranteeing services for all people that are free from stigma and discrimination.
“We know how to end AIDS. The question now is political: will we invest, or will we retreat? If we follow the Global AIDS Strategy, and UN Member States commit to a strong Political Declaration to guide the HIV response over the next five years, we can still end AIDS by 2030. But if we fail to act, we risk undoing decades of hard-won progress.”Winnie Byanyima