HIV prevention and treatment services faltering, warns UNAIDS

Decades of gains in the fight against AIDS are under growing threat as donor funding declines and community-based health services collapse in some of the world’s most vulnerable countries, the head of the joint UN programme on HIV/AIDS warned on Thursday.

The sudden funding decline is hitting the HIV response “like a shock wave,” said Winnie Byanyima, Executive Director of UNAIDS, adding that “the world is pulling back just when we need to push forward.”

Many countries are unprepared to sustain programmes previously supported by international funding, Ms. Byanyima told reporters at UN Headquarters in New York, noting that prevention and support services are already collapsing in several countries.

Today, 9.3 million people living with HIV are still waiting to begin treatment, while there were 1.3 million new infections worldwide in 2024.

‘Real consequences’

Ms. Byanyima warned that the funding crisis is having “real consequences” across developing countries as treatment expansion stalls and community organizations – often the backbone of the HIV response – are forced to scale back or close entirely.

In Uganda, uptake of PrEP (pre-exposure prophylaxis), which can reduce the risk of acquiring HIV through sexual transmission by up to 99 per cent, fell by 31 per cent between December 2024 and September 2025.

In Burundi, uptake fell by 64 per cent over the same period.

Even basic prevention tools are becoming less accessible. In Nigeria, condom distribution dropped by 55 per cent between December 2024 and March 2025.

Funding shocks

Charities and groups working on HIV/AIDS are increasingly strained by funding cuts, with many reducing operations or shutting down altogether.

In eight countries where UNAIDS operates, 99.9 per cent of HIV prevention services are funded externally, with only 0.1 per cent financed domestically, leaving programmes highly vulnerable to aid reductions.

“The fiscal constraints of the most heavily burdened countries are huge,” Ms. Byanyima said.

In 2024, around 570 girls and young women were infected with HIV every day. Yet 60 per cent of women-led HIV organizations have either lost funding or shut down completely.

Most vulnerable caught up in ‘proxy wars’

“It is proxy wars for critical minerals, for energy, for influence that are being fought, instrumentalising the rights of the most marginalised people,” Ms. Byanyima said.

In Kenya, most drop-in centres serving key populations, including LGBTQ communities, have closed. Nigeria has lost at least five similar clinics.

In Uganda, 45 per cent of programmes supporting key populations have partially or fully shut down. In Zimbabwe, services for sex workers – including access to prevention, testing and treatment – have collapsed entirely in 2025.

Science offering solutions

Despite the setbacks, Ms. Byanyima stressed that scientific advances still offer a pathway to ending AIDS as a public health threat by 2030.

“Science is offering us solutions that could end this epidemic by 2030; long-acting PrEP, long-acting prevention, long-acting treatments, medicines that we would not have thought about 10 years ago. All these are there,” she said.

But she warned that abrupt funding cuts, combined with growing pushback against human rights, are pulling the world further away from that goal.