[KIGALI/JOHANNESBURG, SciDev.Net] Countries worldwide must step up to support the fight against HIV or face the “ticking time bomb” left by the wholesale withdrawal of US funding, warns UNAIDS.
A permanent halt in funding from the biggest contributor to the HIV/AIDS effort could set back decades of progress and put millions of lives at risk, despite efforts by many low- and middle-income countries to plug the gap, the UN agency said in its annual report.
It comes after the US permanently closed its international development agency USAID and halted funding to the President’s Emergency Plan for AIDS Relief (PEPFAR), which had committed US$4.3 billion in bilateral support across more than 50 countries in 2025.
According to the 2025 UNAIDS report, 1.3 million people were newly infected with HIV globally in 2024. A permanent withdrawal of US funding could lead to an additional 6 million new infections and 4 million HIV related deaths by 2029, the report warns.
“This is not just a funding gap — it’s a ticking time bomb,” said UNAIDS executive director Winnie Byanyima during the launch of the report in Johannesburg today (Thursday).
“If the world doesn’t plug this hole, we are going to see an unnecessary, preventable surge in new infections and deaths,” Byanyima cautioned.
She said UNAIDS had seen HIV services “vanish overnight” after the US suddenly changed its strategy on foreign aid in January.
“Health workers have been sent home. And people — especially children and key populations — are being pushed out of care,” she added.
Funding cuts have hit prevention more than treatment, according to the report, which calls all countries to step up with domestic funding.
Byanyima urged global solidarity with affected communities in low- and middle-income countries. “Communities are showing what works … Developing countries are putting their foot forward,” she said.
“Rich countries must also maintain support to end the global disease.”
Research at risk
The launch comes ahead of IAS 2025, the 13th IAS Conference on HIV Science, taking place in Kigali, Rwanda, next week (13-18 July).
IAS president Beatriz Grinsztejn says the conference is taking place at a paradoxical moment for all who have dedicated their careers to ending the HIV pandemic.
“We’re witnessing extraordinary scientific breakthroughs that could transform prevention and treatment and even bring us closer to a cure,” Grinsztejn told an online press briefing on Tuesday (8 July).
“On the other hand, these very advances are under threat from massive funding cuts that risk stalling clinical trials, slowing our progress, and jeopardising the progress we’ve fought so hard to achieve.”
According to Grinsztejn, the sweeping US cuts threaten to undermine systems supporting HIV research, prevention and care, at the very moment when the scientific tools and knowledge are becoming available to end the HIV pandemic.
IAS president-elect Kenneth Ngure said: “The sudden cuts to US funding have been deeply felt across the African continent by the millions of people who rely on HIV prevention, testing and treatment services, and by the researchers and health workers striving to end the pandemic.”
In 2024, 630,000 people died from AIDS-related causes, 61 per cent of them in Sub-Saharan Africa. Over 210,000 adolescent girls and young women aged 15—24 acquired HIV in 2024 — an average of 570 new infections every day according to the 2025 UNAIDS report.
Ngure noted that studies to be presented at IAS 2025 offer real-world insights into the impacts of these actions on vulnerable populations now and in the future.
An online survey of 40 community-based HIV organisations in Latin America and the Caribbean earlier this year found that the majority (21 out of 24) had had US funding suspended.
Meg Stevenson, a senior research data analyst at Johns Hopkins Bloomberg School of Public Health in the US, noted that the losses represented an average of nearly half the annual budget of the organisations surveyed.
“In some cases, it was 100 per cent of their budgets,” she said during the IAS event.
“Funding cuts affected programmes that were providing HIV prevention and treatment, as well as ancillary services, to adults and children.
“These 21 organisations alone reported that over 150,000 beneficiaries will lose access to HIV treatment and prevention services,” she added.
Terminated programmes included sexual health programmes such as condoms and contraceptives, HIV testing services, psychosocial support, and care services.
Zackie Achmat, founder of the Treatment Action Campaign, a South African activist organization, and a member of the Global HIV Treatment Coalition, a UN initiative, called for urgent need for debt refinancing to protect the HIV response in low- and middle-income countries.
“The convergence of crushing debt and funding cuts threatens everything we’ve built,” said Achmat, who has long campaigned for action on the disease that he is afflicted with.
“We need urgent debt restructuring so African countries can invest in saving lives instead of servicing debt.”
This piece was produced by SciDev.Net’s Global desk.