The new US administration froze foreign aid in January 2025 and then shut down USAID. PEPFAR also went through freezes and cuts.
That year, international funding for HIV in low- and middle-income countries fell by 18%, or US$ 1.6 billion. It was the largest decline in almost twenty years. International aid for health was about 40% lower than in 2023.
Total HIV funding fell to US$ 17.6 billion. The amount needed by 2030 is US$ 21.9 billion a year.
The effect has been clearest in services run close to the people who need them. A survey of 79 community-led organisations in 47 countries found that delivery of PrEP, an HIV prevention medicine, halved. Services for gay men and other men who have sex with men fell by 85%, while services for sex workers fell by 82%.
These organisations have little room to absorb a loss of aid. In countries where UNAIDS could track the money, community organisations providing HIV care received 99.4% of their funding from abroad. The number of people receiving medicine to reduce risk fell from 1.4 million in 2024 to 1.1 million in 2025.
Access to generic medicines is also limited by Gilead's agreement, according to Médecins Sans Frontières. At least 26 middle-income countries are excluded, including countries where HIV infections are rising and some that helped test the drug.
The institutional response has faced its own uncertainty. In September 2025, Secretary-General António Guterres proposed to 'sunset UNAIDS by the end of 2026'. More than a thousand civil society organisations protested the proposal, and the UNAIDS Board's Working Group unanimously rejected it.
At the AIDS2026 conference in July, UNAIDS presented a special report on the effects of the cuts. The figures describe a funding shortfall reaching the community groups that deliver prevention and care, alongside a decline in the number of people receiving prevention medicine.
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