Michael Olugbode in Abuja
The global fight against HIV/AIDS is at a critical turning point, with new data from the Joint United Nations Programme on HIV/AIDS (UNAIDS) warning that reductions in international funding and cuts to prevention and community health services are threatening decades of progress against the epidemic.
A special report released on Monday at the 26th International AIDS Conference in Rio de Janeiro, Brazil, revealed that an estimated 1.2 million people acquired HIV in 2025, while 570,000 people died from AIDS-related illnesses, underscoring the fragility of the global response despite significant scientific advances.
According to UNAIDS, unless urgent action is taken to meet global targets by 2030, more than three million additional people could become infected with HIV over the coming years.
Although HIV infections and AIDS-related deaths remain at their lowest levels in more than three decades, the agency warned that the gains achieved since the peak of the epidemic are increasingly under threat.
The report showed that around nine million of the estimated 41 million people living with HIV were not receiving life-saving antiretroviral treatment in 2025, while nearly half of all children living with the virus lacked access to treatment.
Progress has also become increasingly uneven. While seven countries—Benin, Eswatini, Kenya, Lesotho, Nepal, Rwanda and Zimbabwe—have reduced new HIV infections by almost 80 per cent since 2010, infections increased across three regions and in 21 countries during 2025.
UNAIDS Executive Director Winnie Byanyima said recent scientific breakthroughs have transformed HIV prevention, with long-acting injectable medicines now offering protection levels approaching those of vaccines.
However, she stressed that these innovations will have little impact without affordable and equitable access.
“Scientific breakthroughs are giving us tools that previous generations could only dream of,” Byanyima said. “However, innovation without access is not innovation—it is injustice. The real measure of success is whether people who need these medicines can obtain them at prices they can afford.”
Countries such as Brazil, Ethiopia, Uganda and South Africa have expanded access to HIV prevention medicines through domestic investments and negotiations to lower drug prices.
However, UNAIDS noted that access remains limited globally, despite promising developments including twice-yearly injectable prevention drugs such as lenacapavir.
While UNITAID, the Global Fund to Fight AIDS, tuberculosis and malaria, and development partners aim to reach three million people with lenacapavir by 2028, UNAIDS estimates that at least 20 million people require access to antiretroviral-based prevention to significantly reduce new HIV infections worldwide.
A major concern highlighted in the report is the sharp decline in international financial support.
Global official development assistance fell by 23 per cent in 2025, representing the steepest annual decline on record. International HIV financing also dropped by more than US$1.5 billion, from US$8.8 billion in 2024 to US$7.3 billion in 2025, the lowest level recorded in nearly two decades.
The funding reductions have had particularly severe consequences for low-income African countries, many of which relied on international donors for more than 90 per cent of their HIV response.
“The era of relying on international aid is over,” Byanyima said. “Countries cannot wait and they cannot go backwards. The world must urgently repair the global financial system and accelerate debt restructuring so governments can invest in health, education and the future of their people.”
The report warned that HIV prevention programmes are especially vulnerable because they have traditionally depended heavily on donor funding. In sub-Saharan Africa, approximately 80 per cent of prevention funding came from international assistance.
Community-led organisations, which provide essential services to people living with HIV and vulnerable populations, are also facing severe financial pressure.
UNAIDS said some countries have already recorded reductions of 50 per cent in community-led HIV prevention and care services, 85 per cent for programmes serving gay men and other men who have sex with men, 82 per cent for sex workers, and 72 per cent for survivors of gender-based violence.
Funding for condom distribution has also fallen by more than 90 per cent in some countries, raising concerns over increased HIV transmission.
Beyond funding challenges, UNAIDS warned that shrinking civic space and growing criminalisation of vulnerable populations are undermining the HIV response. For the first time since the agency began tracking legal trends, the number of countries criminalising key populations has increased.
In 2025, Burkina Faso and Niger introduced laws criminalising same-sex sexual activity, while Senegal strengthened penalties in 2026. UNAIDS reported that globally, 66 countries criminalise same-sex sexual relations, 168 criminalise sex work, 152 criminalise possession of small quantities of drugs, and 14 criminalise transgender people.
“You cannot end AIDS while criminalising people living with or most at risk of HIV,” Byanyima said, warning that fear of arrest, discrimination and violence discourages people from seeking HIV testing, prevention and treatment services.
Despite these setbacks, UNAIDS pointed to a positive development in June 2026 when 149 United Nations Member States adopted a new Political Declaration on HIV and AIDS aligned with the Global AIDS Strategy 2026–2031.
The declaration sets ambitious targets to place 40 million people on treatment, provide 20 million people with access to antiretroviral-based prevention, and significantly reduce stigma, discrimination, gender inequality and punitive laws by 2030.
UNAIDS estimates that achieving these commitments could prevent an additional 3.2 million new HIV infections and 1.3 million AIDS-related deaths before the end of the decade.
The agency urged governments, international partners and donors to renew their commitment to financing, innovation and human rights to prevent a resurgence of the epidemic.
“Despite enormous challenges, ending AIDS is still within reach,” Byanyima said. “The choice before us is clear: retreat and risk resurgence, or rethink, rebuild and rise to end AIDS as a public health threat by 2030.”