As the 26th International AIDS Conference convenes in Rio de Janeiro, a stark contradiction defines the global HIV response. Despite revolutionary new prevention drugs that could nearly eliminate new infections, funding shortfalls and high medication costs threaten to stall progress.
UNAIDS reports that over 1.2 million people contracted HIV in 2025, with 570,000 AIDS-related deaths. Alarmingly, international HIV funding dropped by 18% between 2024 and 2025—the sharpest decline in two decades—forcing cuts in essential services and closure of community organisations.
Breakthroughs Out of Reach
Lenacapavir, a long-acting injectable requiring just two doses annually, offers almost 100% protection against HIV infection. However, due to patent restrictions and exclusion from voluntary licensing agreements, many countries cannot access affordable generic versions, which could cost as little as $40 per person yearly.
Brazil, the conference host, exemplifies this issue. Despite its role in clinical trials, it is barred from producing generic lenacapavir domestically. The patented drug costs over $20,000 per patient annually—untenable for Brazil’s public health system—while domestic production could reduce this to about $75.
Calls for New Financing Models
UNAIDS Executive Director Winnie Byanyima emphasized that innovation without access equates to injustice. The agency estimates 20 million people require antiretroviral-based prevention to significantly curb new infections globally.
With international aid declining sharply and new infections rising in multiple regions, UNAIDS warns the world faces a potential resurgence of HIV. The current funding landscape demands a shift from reliance on external aid to sustainable domestic investment, including sovereign debt restructuring to prioritize health spending.
Unless urgent measures are taken to ensure equitable access to lifesaving prevention tools, the global HIV epidemic risks reversing decades of hard-won progress.
