The 2025 UNAIDS report, Overcoming Disruption: Transforming the AIDS Response, warns that abrupt funding cuts have created “perilous risks” for the global HIV response, threatening the health and well-being of millions worldwide. Service disruptions have led to deaths among people living with HIV, left millions at high risk without access to prevention tools, and forced many community-led organisations to close, affecting essential care and outreach programmes. Over two million adolescent girls and young women have lost access to vital health services, while UNAIDS itself has had to reduce staff by more than half due to funding freezes from the US government.
The funding cuts have caused immediate and severe consequences for individuals. In Mozambique, people with HIV lost peer support and community counselling, while in South Africa, a sex worker reported being unable to access antiretroviral (ARV) therapy for four months, highlighting the human cost of service interruptions. Community organisations, such as those in Uganda, have had to retrench staff who conducted critical community-based monitoring, further weakening the HIV response.
PEPFAR-supported programmes, which provide antiretroviral treatment to millions across 55 countries, have been particularly affected. UNAIDS estimates that the funding freeze has contributed to over 132,000 adult deaths and more than 14,000 child deaths. Service disruptions have impacted HIV testing, prevention, and care, especially in West and Central Africa, where donors cover 90% of ARV costs. Stock-outs of HIV medicines have been reported in countries including the Democratic Republic of the Congo, Ethiopia, and Kenya, while essential monitoring tests such as CD4 counts and viral loads have sharply declined.
Key populations, including adolescent girls, young women, men who have sex with men, sex workers, transgender people, and people who inject drugs, have been disproportionately affected. Many clinics serving these groups in Kenya, Nigeria, and Zimbabwe have closed, and harm reduction programmes have been severely disrupted. Access to pre-exposure prophylaxis (PrEP) has been curtailed, with millions losing coverage, and male condom distribution and HIV testing have fallen sharply in multiple countries.
Community-led organisations, critical for prevention, testing, and treatment, have been decimated. Over 60% of women-led HIV organisations have lost funding or been forced to suspend programmes, and youth organisations have faced similar losses. Staff reductions among community-based organisations in Kenya, Mozambique, and Viet Nam have further limited outreach to key populations.
UNAIDS highlights the importance of increasing domestic financing for HIV to reduce dependency on donor funding. Some African countries, including Nigeria, Uganda, Côte d’Ivoire, and South Africa, have begun increasing health budgets to mitigate funding shortfalls. The Accra Reset and upcoming African Union initiatives emphasize national ownership, investment, and local manufacturing of medical products to strengthen health systems.
Looking ahead, UNAIDS will adopt a new Global AIDS Strategy for 2026–2031, focusing on person-centred care, integration into national health programmes, reducing stigma, and ensuring sustainable financing. The agency estimates that $21.9 billion annually will be needed until 2030 to achieve global HIV targets in low- and middle-income countries. Despite the challenges, UNAIDS stresses that political will, community resilience, and sustained investment offer hope for maintaining progress and ultimately ending AIDS by 2030.
