The global fight against HIV/Aids is at a critical juncture, marked by scientific progress but hindered by declining international funding and disrupted health services. An estimated 41 million people are living with HIV worldwide, with 1.3 million new infections reported last year and 9.2 million lacking access to life-saving antiretroviral (ARV) treatment. UNAIDS Executive Director Winnie Byanyima has described the global response as facing its biggest setback in decades, emphasizing the urgent need for renewed global mobilization despite promising developments in prevention and treatment.
Scientific innovation, however, offers hope. Long-acting antiretroviral therapies now allow people to receive treatment once every two months instead of daily, improving adherence and convenience. Injectable pre-exposure prophylaxis (PrEP), such as lenacapavir recently recommended by WHO, provides six months of HIV protection in a single shot, with affordable pricing agreements for low-resource countries. South Africa, Eswatini, and Zambia have begun the first public rollouts of lenacapavir in Africa, aiming to reach two million people in high-burden countries over three years, although critics warn this is insufficient to meet actual demand.
Despite these breakthroughs, health systems and global funding constraints limit their impact. In 2025, development aid for health fell by 22 percent, leading to service disruptions and shortages in countries like Ethiopia and the Democratic Republic of Congo. Sub-Saharan Africa, home to 60 percent of people living with HIV, faces rising infections and treatment gaps, while community organizations, particularly those led by women, struggle to maintain essential programs. The combination of funding cuts and the ongoing effects of the Covid-19 pandemic has stalled progress, with condom distribution in Nigeria declining by 55 percent.
UNAIDS stresses that scientific advances alone cannot end the epidemic. Sustained global and domestic investment, strengthened health systems, and prioritization of at-risk communities are essential. Without significant changes to the funding model and increased national commitment in heavily affected countries, the world risks failing to meet the 2030 goal of ending HIV/Aids, with potential resurgence looming. The agency warns that current trends may only stabilize the epidemic rather than reduce it, highlighting the urgent need for coordinated global action.
