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UNAIDS, the Joint United Nations Program on HIV/AIDS and the main body in charge of coordinating the global response to the virus, warned this week that the world is experiencing the biggest setback in decades. The reason?: sharp funding cuts and a worrying deterioration in human rights that are seriously affecting prevention and treatment services in many countries.
According to forecasts from the Organization for Economic Co-operation and Development (OECD), external financing for health could be reduced by 30% to 40% compared to 2023. The impact has been immediate and severe, especially in low- and middle-income countries heavily affected by HIV, the entity says.
“The funding crisis has highlighted the fragility of our hard-won progress,” explained Winnie Byanyima, Executive Director of UNAIDS, speaking in Geneva. “Behind every piece of information in this report are people… babies who have not been able to be tested for HIV, young women who have been deprived of prevention support, and communities who have suddenly been left without services and care. We cannot abandon them.”
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The figures are disturbing. UNAIDS warns that programs to prevent, detect and care for HIV are being disrupted in many parts of the world. In 13 countries, the number of people starting treatment has decreased, which is worrying because starting therapy on time is key to controlling the virus and avoiding new infections. In some places, the problems are more serious. Ethiopia and the Democratic Republic of the Congo have reported shortages of both diagnostic kits and treatment medications. Without tests or drugs, it is impossible to sustain an effective response.
Prevention is also suffering a dramatic setback, adds the UN entity. Distribution of prophylactic drugs – a critical tool to prevent new infections – has plummeted, falling 31% in Uganda, 21% in Vietnam and 64% in Burundi. Additionally, around 450,000 women in sub-Saharan Africa have lost access to “mentor mothers”, community women who accompany them and connect them to maternal health and HIV services. These figures are very important, says the UN, to ensure adequate monitoring during pregnancy and breastfeeding.
The situation is no better for basic tools like condoms either. In Nigeria, for example, its distribution has fallen by 55%, reducing one of the simplest and most effective barriers against HIV transmission. All of this occurs in a context where adolescents and young women were already at high risk: every day, 570 women between 15 and 24 years old acquire HIV. UNAIDS warns that if prevention programs are dismantled, this group – which is already vulnerable – will be even more exposed.
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Community organizations, which are at the heart of the HIV response because they reach the hardest to reach people, are also in crisis. More than 60% of women-led organizations say they have had to suspend essential services due to lack of resources. UNAIDS projections are stark: if prevention efforts are not immediately restored and strengthened, Between 2025 and 2030, there could be 3.3 million new HIV infections.
The HIV funding crisis is occurring at a particularly delicate time: many countries are imposing increasingly harsh restrictions on civil society and passing punitive laws that directly affect the groups most vulnerable to HIV. For the first time since UNAIDS has been tracking these laws, the number of countries criminalizing same-sex relationships and gender expression increased in 2025. On a global scale, the legal landscape is especially restrictive:
- 168 countries criminalize some aspect of sex work
- 152 countries criminalize small-scale drug possession
- 64 countries criminalize relationships between people of the same sex
- 14 countries penalize transgender people
Furthermore, restrictions aimed at civil society (such as complex registration processes, surveillance, or limitations on receiving international funding) further weaken the response to HIV. Many community organizations that work directly with key populations are seeing their ability to operate reduced, just when they are needed most. “This is our time to choose,” said Byanyima, Executive Director of UNAIDS. “We can allow these crises to undo decades of hard-won gains, or we can unite around the shared vision of ending AIDS. Millions of lives depend on the decisions we make today“.
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