The most serious disruption in the HIV response since the world came together to fight this disease
In Paris, the head of UNAIDS delivered a warning that carries the weight of decades of hard-won progress now placed in jeopardy: the withdrawal of international aid by the United States, United Kingdom, France, and Germany has fractured the global architecture built to contain HIV, leaving the world's most vulnerable populations exposed at precisely the moment when elimination seemed within reach. Prevention drugs, testing programs, and the community-led organizations that carried trust into places where stigma once made care impossible have all contracted sharply, and the full human cost will not be legible for years. The 2030 goal of ending AIDS as a public health threat remains technically possible, but only if the nations of the world choose solidarity over retreat.
- PrEP usage has fallen 38% across 62 countries and condom funding has collapsed by over 90%, dismantling the prevention infrastructure that took decades to build.
- Community-led organizations — formed by people living with HIV, sex workers, and gay men — have lost 80% of their program budgets, erasing the trusted spaces where stigma was set aside and care was sought without fear.
- The 570,000 AIDS-related deaths and 1.2 million new infections recorded last year do not yet reflect the damage from these cuts; the numbers, UNAIDS warns, will worsen in the years ahead.
- More than 50 countries have pledged to increase domestic HIV funding, but UNAIDS is clear that internal resources cannot fill the void left by the withdrawal of major international donors.
- A new injectable drug, lenacapavir, offers a powerful tool for both treatment and prevention, yet only 6,000 people across five African countries were receiving it as of early 2026 — against a stated need of 20 million.
- A UN General Assembly meeting on HIV opens June 22, where member states are expected to adopt a five-year political declaration, though whether it will translate into restored funding and reversed trajectories remains unresolved.
On a Friday in Paris, UNAIDS executive director Winnie Byanyima told reporters that the global HIV response is now facing its most serious disruption since nations first joined forces against the disease. The trigger was the dismantling of USAID under the Trump administration, a move that was quickly followed by aid cuts from the United Kingdom, France, and Germany. The cascade was swift and measurable.
A new UNAIDS report captures the scale of the damage. Between 2024 and 2025, PrEP uptake fell 38% across 62 countries. HIV testing rates dropped 22% in sub-Saharan Africa. Funding for condoms fell by more than 90%. Community-led organizations — often built by people living with HIV, sex workers, and gay men — lost 80% of their program budgets. These groups had been essential not only as service providers but as social spaces where stigma could be set aside. Their loss is as much a human rupture as a financial one.
Byanyima was careful to note that the worst consequences remain invisible for now. Last year's figures — 570,000 AIDS-related deaths and 1.2 million new infections — reflect a world before the full impact of these cuts landed. The numbers will rise. Some countries have compounded the crisis by passing new criminal laws targeting people with HIV and LGBTQ communities, layering legal risk onto the loss of medical support.
There are gestures toward resilience. More than 50 countries have pledged to expand domestic HIV funding, and a new long-acting injectable drug, lenacapavir, holds genuine promise for both treatment and prevention. But as of early 2026, only around 6,000 people in five African countries were receiving it — against a need Byanyima places at 20 million. A UN General Assembly meeting on HIV opens June 22, where member states are expected to adopt a political declaration for the next five years. The 2030 goal of ending AIDS as a public health threat, Byanyima insists, remains achievable — but only if nations decide to make it so.
In Paris on Friday, the head of the United Nations AIDS program delivered a stark warning: the world's fight against HIV is now in crisis. Winnie Byanyima, executive director of UNAIDS, told reporters that international aid cuts have triggered what she called the most serious disruption to the global HIV response since nations first united to combat the disease decades ago.
The damage began last year when the Trump administration dismantled USAID, the world's largest development agency, with assistance from then-adviser Elon Musk. The cuts rippled outward. The United Kingdom, France, and Germany followed suit, slashing their own aid budgets. Humanitarian organizations scrambled to absorb the shock. But for those fighting HIV—a disease that preys on the world's poorest and most vulnerable—the consequences have been swift and measurable.
A new UNAIDS report quantifies the collapse. Between 2024 and 2025, the number of people taking PrEP, a vital HIV-prevention drug, fell by 38 percent across 62 countries. In the regions hit hardest by the epidemic, mostly in sub-Saharan Africa, HIV testing rates under major programs dropped 22 percent. Funding for condoms plummeted by more than 90 percent. Programs designed to connect people with prevention services lost 80 percent of their budgets, with community-led organizations bearing the brunt. These groups—often formed by people living with HIV, sex workers, and gay men—had been essential precisely because they created spaces where stigma could be set aside and people could seek care without fear. Their collapse matters not just as a funding problem but as a social one.
Byanyima emphasized that the full toll will not be visible for years. New infections do not announce themselves immediately. The 570,000 AIDS-related deaths and 1.2 million new infections recorded last year—figures that had been declining steadily since 2010—do not yet reflect the impact of these cuts. The numbers will worsen. Some countries have also passed new criminal laws targeting people with HIV and LGBTQ communities, adding legal jeopardy to the loss of medical support.
There are small signs of resistance. More than 50 countries have committed to increasing their own domestic HIV funding in response to the international withdrawal. Byanyima welcomed this, but was clear-eyed about its limits: new money from within countries cannot replace what is disappearing from outside. She called for what she termed global solidarity—a recognition that HIV respects no borders and that the world's response must match that reality.
One potential tool exists: lenacapavir, a new long-acting injectable drug that both treats and prevents HIV. By the end of March 2026, just over 6,000 people across five African countries were receiving it. Byanyima said the world needs to get 20 million people on such treatments. What is happening now is, by her measure, a drop in an ocean of need. The UN has set a goal of ending AIDS as a public health threat by 2030. Byanyima insists it is still achievable—but only if nations choose to make it so. A UN General Assembly meeting on HIV and AIDS begins June 22, where member states are expected to adopt a political declaration to guide the response for the next five years. Whether that declaration will reverse course remains to be seen.
Notable Quotes
This is the most serious disruption in the HIV response since the world came together to fight this disease. It is now in peril because of sudden cuts.— Winnie Byanyima, UNAIDS executive director
When people living with HIV themselves or sex workers or gay men form groups and deliver services to their own—people come forward because they feel safe.— Winnie Byanyima, on the importance of community-led organizations
The Hearth Conversation Another angle on the story
When you say the HIV response is in peril, what does that actually mean on the ground for someone in, say, rural Uganda?
It means the clinic that was testing people for free twice a month might now test once every three months. It means the peer educator—someone from the community who people trusted—might lose their stipend and stop showing up. It means someone who was on PrEP and protected might stop taking it because the supply ran out.
The 38 percent drop in PrEP use—is that because people stopped wanting the drug, or because it became unavailable?
It became unavailable. The drug itself didn't change. The funding that paid for it, the logistics that got it to clinics, the health workers trained to prescribe it—all of that evaporated. When you cut funding by that magnitude, you don't get a proportional reduction in service. You get collapse.
Why does it matter that community groups were hit so hard? Couldn't governments just run these programs themselves?
Governments could try, but they won't reach the same people. A sex worker won't walk into a government clinic if she fears arrest. Someone with HIV won't seek care if they've internalized the shame. But a peer—someone who shares their identity, their risk—creates a space where that fear dissolves. When you defund those groups, you don't just lose a service provider. You lose trust.
The report says new infections will show up in coming years. Does that mean we won't see the real damage until 2027 or 2028?
Exactly. Someone who stops taking PrEP today might get infected in six months. They might not know for another three months. By then they're transmitting to others. The epidemic has a lag. We're looking at a crisis that's already baked in, but we won't fully see it until later.
Is there any scenario where this gets reversed?
Yes, but it requires political will. More than 50 countries have started increasing their own funding. If wealthy nations restored their contributions and if the world actually mobilized around lenacapavir and other new tools, you could still hit the 2030 target. But that's a choice, not an inevitability.