International funding to combat HIV declined sharply by 18 percent in 2025, marking the largest reduction in decades, according to a recent UNAIDS report presented at the 26th International AIDS Conference in Rio de Janeiro.

UNAIDS deputy executive director Angeli Achrekar expressed alarm over the faltering global response, attributing part of the decline to significant aid cuts by the United States and several European countries, including France, Germany, and the UK. Despite cuts by the Trump administration, the US still accounts for 74 percent of donor government funding for HIV programs.

Since 2011, European contributions have decreased by 58 percent, while domestic funding from developing countries, particularly in sub-Saharan Africa, increased by 4 percent in 2025 and now represents 60 percent of total HIV financing. However, many low-income African nations remain heavily dependent on external aid for up to 90 percent of their HIV response budgets.

Implications and Calls to Action

  • UNAIDS warns that without renewed global collaboration, there is a risk of HIV resurgence.
  • New infections rose in 21 countries despite overall declines in new HIV cases and AIDS-related deaths reaching their lowest levels in over 30 years.
  • Access to antiretroviral drugs remains uneven, with nearly half of children living with HIV not receiving treatment last year.
  • Pharmaceutical companies are urged to make breakthrough drugs more affordable and accessible worldwide.

In a positive development, US pharmaceutical firm Merck announced plans to license production of a new monthly antiretroviral pill, alimatravir, to manufacturers in Africa and India to reduce costs. Meanwhile, Doctors Without Borders has called on Gilead Sciences to expand access to its twice-yearly injectable preventative drug, lenacapavir, highlighting current exclusions of countries where clinical trials occurred.

UNAIDS emphasizes leveraging the momentum from the recent UN political declaration aiming to end AIDS as a public health threat by 2030, which includes a target of providing 20 million people with effective antiretroviral therapy.