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The global HIV response is facing its most serious crisis in decades, according to a new report from the Joint United Nations Programme on HIV/AIDS (UNAIDS). The document analyzes the widespread impact of reduced international funding. Low- and middle-income countries, where HIV prevalence is highest, are particularly hard hit, according to the UN press service.
According to UNAIDS, 40.8 million people are currently living with HIV. In 2024, 1.3 million new cases were registered, and 9.2 million people are still not receiving treatment.
The sharp reduction in international aid in 2025 has exacerbated the funding shortfall in the HIV response. According to estimates from the Organisation for Economic Co-operation and Development (OECD), external aid to health systems will decline by 30–40 percent in 2025 compared to 2023, which has already led to significant disruptions.
“The financial crisis has exposed how fragile the gains we fought so hard to achieve were,” said UNAIDS Executive Director Winnie Byanyima.
"Behind every number in this report are real people: infants and children who were not tested and whose HIV status was not detected early; entire communities suddenly left without services and support. We cannot abandon them. We must overcome this crisis," she added.
Discontinuation of HIV control programs
Prevention services have been hit the hardest, UNAIDS emphasizes. Specifically, they note a significant reduction in access to pre-exposure prophylaxis (PrEP) and a sharp decline in voluntary medical male circumcisions.
The dismantling of prevention programs developed with young women has deprived them of access to HIV prevention services, mental health support, and gender-based violence. In 2024, 570 new HIV infections were recorded daily among girls aged 15–24.
Community-based organizations playing a key role in the HIV response are reporting widespread closures: over 60 percent of women's initiatives have been forced to suspend critical programs. Programs for men who have sex with men, sex workers, people who inject drugs, and transgender people have also been significantly impacted.
UNAIDS warns that if the trend continues and the global community fails to achieve the HIV targets set by the Global Strategy for 2030, 3.3 million more people could become infected between 2025 and 2030 than currently projected.
Human rights situation
The financial crisis is unfolding against a backdrop of deteriorating human rights conditions, which are particularly hard on marginalized groups.
In 2025, the number of countries criminalizing same-sex relations and gender expression increased for the first time since 2008. Increased pressure on civil society – particularly organizations working with key populations in sub-Saharan Africa – further limits access to essential services.
Innovation and new financing opportunities
Despite serious challenges, a number of countries took prompt action to reduce funding gaps. As a result, many countries have managed to maintain the stability of their HIV treatment systems, with some reporting stable or even increasing rates of antiretroviral therapy.
Nigeria, Uganda, Côte d'Ivoire, South Africa, and Tanzania have pledged to increase domestic investment in HIV services. UNAIDS is working with over 30 countries to catalyze national funding plans.
Innovation is playing an increasingly important role in the fight against HIV. New HIV prevention mechanisms—including injections administered just twice a year—have the potential to prevent tens of thousands of new cases in regions with high infection rates.
In 2025, the Bill & Melinda Gates Foundation, UNITAID, the Global Fund to Fight AIDS, and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) announced work to ensure widespread access to affordable versions of essential drugs—in some cases, costing as little as $40 per person per year.
Plans for the future
Events in the second half of 2025 offer hope for continued international funding. The United States has unveiled a new strategy and begun concluding bilateral agreements with approximately 70 countries to support funding during the gradual transition to independent national systems over the next five years.
Ahead of World AIDS Day on 1 December, UNAIDS is calling on world leaders to sustain international funding for this area and invest in innovations, including affordable, long-term prevention and treatment options.
“Our choices now determine the future,” Byanyima emphasized.
"We can… unite around a common goal – ending the AIDS epidemic. Millions of lives depend on the decisions we make today," she added.
