Key facts
- Global HIV response funding saw an 18% decrease in 2025, the largest decline in nearly two decades.
- The United States, a significant donor, has withdrawn support through the dismantling of USAID.
- Funding cuts have led to job losses, abrupt service terminations, and overburdened health systems.
- Pre-exposure prophylaxis (PrEP) uptake has dropped by more than 50% in Cameroon, Nigeria, and Zambia.
- Decades of progress in reducing HIV infections and AIDS-related deaths are now at risk of reversal.
Global health experts are warning that significant cuts to HIV funding, particularly from the United States, risk undoing decades of progress in combating the epidemic. The Joint United Nations Programme on HIV/AIDS (UNAIDS) reported that external financing for the global HIV response in low- and middle-income countries fell by 18% in 2025 compared to 2024, marking the largest decline in international HIV resources in nearly two decades.
These funding reductions are severely impacting crucial HIV prevention, testing, and treatment programs, especially community-led services that reach the most affected populations. Mwelwa Phiri, an expert in HIV/AIDS at the Antwerp Institute of Tropical Medicine and Zambart in Zambia, stated that donor funding was instrumental in achieving current progress and that continued underfunding will lead to a regression of the situation. She highlighted that the abrupt nature of these cuts has resulted in job losses, the cessation of services, and an overburdened health system, making it difficult for people to access essential care.
The withdrawal of support by the United States, through the dismantling of the United States Agency for International Development (USAID), has particularly strained health facilities. Phiri noted that stretched staff and overburdened systems make it harder for individuals to access services, including HIV testing, as many are deterred from visiting crowded facilities. The absence of community outreach volunteers further limits testing accessibility for those unable to reach health centers.
Early detection and treatment are critical for managing HIV, preventing progression, and achieving an undetectable viral load. However, national data submitted to UNAIDS indicate major declines in pre-exposure prophylaxis (PrEP) uptake between 2024 and 2025 in Cameroon, Nigeria, and Zambia, with each country recording a drop of over 50%. This trend jeopardizes the hard-won gains that have reduced annual HIV infections and AIDS-related deaths to their lowest levels in over 30 years. Despite these successes, experts warn that these achievements could be reversed by the abrupt defunding, and countries are not on track to meet the 2030 HIV elimination targets.
The UNAIDS report emphasizes the need to shift away from donor dependence towards country ownership and domestic financing, coupled with continued global solidarity. Phiri echoed this sentiment, stressing the importance of a phased approach to funding withdrawal and addressing fundamental structural issues across various sectors, not just within health systems, to ensure a sustainable transition.