UNAIDS warns HIV response in crisis as US funding cuts leave millions without care

Global efforts to treat and prevent HIV have plunged into crisis after major funding disruptions, with millions now losing access to essential care, according to a new report from UNAIDS.

The agency said the situation deteriorated rapidly after the United States halted foreign aid funding when Donald Trump took office in January.

“The global response to the disease immediately entered crisis mode,” the report stated, pointing to the administration’s decision to suspend all new foreign aid on January 25, aside from military assistance to Israel and Egypt.

Although some HIV funding was later restored, key programmes remain frozen following Trump’s move to dismantle the US Agency for International Development (USAID). UNAIDS said the impact has been intensified by “intensifying economic and financial pressures on many low and middle-income countries”, creating what it called “profound, lasting effects” on vulnerable populations.

“People living with HIV have died due to service disruptions, millions of people at high risk of acquiring HIV have lost access to the most effective prevention tools available, over 2 million adolescent girls and young women have been deprived of essential health services, and community-led organizations have been devastated, with many being forced to close their doors,” the report said.

The data paints a stark picture. Use of preventive HIV medication, known as PrEP, fell by 64 percent in Burundi, 38 percent in Uganda and 21 percent in Vietnam, while condom distribution in Nigeria dropped by 55 percent.

“The funding crisis has exposed the fragility of the progress we fought so hard to achieve,” said UNAIDS executive director Winnie Byanyima. “Behind every data point in this report are people … babies missed for HIV screening, young women cut off from prevention support, and communities suddenly left without services and care. We cannot abandon them.”

Despite the bleak assessment, UNAIDS noted some signs of resilience. Several countries have moved to increase domestic funding and protect treatment access, with some even maintaining or expanding the number of people receiving HIV care.

Still, the report argues this will not be enough without structural change. It calls for restructuring international debt for lower-income countries and suspending repayments until 2030, alongside promoting “innovation with prizes instead of patents” and treating health technologies as global public goods in times of pandemics.

Beyond finances, UNAIDS also warned of a worsening human rights environment.

“In 2025, for the first time since UNAIDS began monitoring punitive laws in 2008, the number of countries criminalizing same-sex sexual activity and gender expression increased,” the report said, noting the growing influence of “anti-gender and anti-rights movements”.