Keeping the Promise: Protecting HIV Gains Through Global Action

A global funding crisis is threatening to undermine decades of hard-won progress against HIV, warns the latest 2025 Global AIDS Update from UNAIDS, launched on 10 July in Geneva and Johannesburg. The report, AIDS, Crisis and the Power to Transform, paints a stark picture: without urgent action, millions of lives could be at risk.

According to UNAIDS, dramatic funding cuts from international donors have already triggered widespread disruption of essential HIV services. These cuts have forced frontline health workers out of their posts, halted HIV prevention programmes and put treatment services in jeopardy.

The scale of the crisis is striking. In Mozambique alone, more than 30,000 health personnel have been affected. In Nigeria, the number of people starting pre-exposure prophylaxis (PrEP) each month has plunged from 40,000 to just 6,000. UNAIDS warns that if US-supported HIV treatment and prevention services collapse completely, the consequences between 2025 and 2029 could include an additional 6 million new HIV infections and 4 million more AIDS-related deaths.

“This is not just a funding gap, it is a ticking time bomb,” said UNAIDS Executive Director Winnie Byanyima. “We have seen services vanish overnight. Health workers have been sent home. And people, especially children and key populations, are being pushed out of care”.

Even before the funding crisis fully unfolded, the data for 2024 showed alarming gaps: 9.2 million people living with HIV were still not accessing life-saving treatment services, including 620,000 children aged 0 to 14. That year alone, 630,000 people died from AIDS-related causes, with 61 per cent of those deaths occurring in sub-Saharan Africa.

HIV prevention services have also been severely disrupted. Over 60 per cent of women-led HIV organisations surveyed in early 2025 reported losing funding or suspending services. Community-led services, which play a vital role in reaching marginalised populations, are being defunded at an alarming rate.

Legal and social barriers are compounding the crisis. Recent punitive laws criminalising same-sex relationships, gender identity and drug use in countries like Uganda, Mali and Trinidad and Tobago are driving key populations away from essential services, increasing their risk of acquiring HIV.

Yet, despite the bleak picture, there are signs of resilience and hope. Some countries are stepping up their domestic funding to protect gains made. South Africa, for instance, now funds 77 per cent of its AIDS response. Its 2025 budget review includes a 5.9 per cent annual increase in health spending over the next three years, with a 3.3 per cent annual increase specifically for HIV and tuberculosis programmes.

Seven countries Botswana, Eswatini, Lesotho, Namibia, Rwanda, Zambia and Zimbabwe have reached the 95-95-95 targets: 95 per cent of people living with HIV know their status; 95 per cent of those are on treatment; and 95 per cent of those on treatment are virally suppressed. These successes show what is possible with political commitment and sustained investment.

Innovative new prevention tools are also emerging. Long-acting injectable PrEP, including Lenacapavir, has demonstrated near-complete efficacy in clinical trials. However, questions remain over affordability and access in the countries that need these tools the most.

Ms Byanyima called for urgent global solidarity to bridge the funding gap and to support countries in scaling up prevention and treatment services, removing legal and social barriers and empowering communities to lead the response.

“There is still time to transform this crisis into an opportunity. Countries are stepping up with domestic funding. Communities are showing what works. We now need global solidarity to match their courage and resilience”.

UNAIDS underscores that every dollar invested in the HIV response does more than save lives: it also strengthens health systems and advances broader development goals. Since the start of the epidemic, treatment has averted 26.9 million deaths, and prevention efforts have protected 4.4 million children from HIV infection.

“In a time of crisis, the world must choose transformation over retreat,” Ms Byanyima concluded. “Together, we can still end AIDS as a public health threat by 2030 — if we act with urgency, unity and unwavering commitment”.

The 2025 Global AIDS Update comes just days before the Scientific AIDS Conference IAS 2025, to be held in Kigali, Rwanda from 13–17 July, where global experts and community leaders will discuss next steps in the fight against HIV.

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