UNAids warns funding cuts and repressive laws risk new HIV epidemic

Winnie Byanyima, head of UNAids, said the current situation is the biggest disruption since the global HIV response was established and poses a major threat to progress made. Although annual new HIV infections and AIDS-related deaths are at record lows, a new UN report warns of a significant risk of resurgence without renewed commitment and action.

Last year, 570,000 AIDS-related deaths and 1.2 million new HIV infections were recorded. However, amid an unprecedented 23% drop in aid spending, HIV testing fell sharply in 2025 in high-prevalence countries. In one program, testing dropped 22% from the previous year. “That’s huge,” Byanyima said. “This means people don’t know they are HIV positive, continue transmitting the virus, and the disease will continue to spread, leading to rising new infections.” She added that more people may die because they don’t get early treatment.

The report warns that prevention services, such as condom distribution or medication to prevent infection, were hard hit by aid cuts. These services were already underfunded, receiving only 11% of HIV spending in low- and middle-income countries in 2024. “Today we are seeing money for prevention disappearing completely,” Byanyima said. New domestic funding does not match the scale of losses and tends to go to treatment rather than prevention. She predicted rising new infections and rising deaths from HIV-related illness in coming years.

The report also found that the number of countries with new or stricter laws against same-sex relations continues to increase, which “risks undermining decades of progress and pushing the people who need services the most away.” Byanyima highlighted damage from “laws to reduce civic space,” citing Uganda’s “sovereignty bill” that restricts external funding for civil society groups and their operations.

Community-led organizations, which have played a key role in providing HIV services to vulnerable groups, are disappearing, the report found. A survey of 79 such organizations across 47 countries found an 85% reduction in services for men who have sex with men and an 82% reduction for sex workers—both groups at highest HIV risk.

Byanyima noted opportunities, such as a new “miracle” twice-yearly injectable drug, lenacapavir, but said it needs to be used at a far greater scale to “bend the curve.”

UNAids itself has been hit by Trump administration funding cuts, and the UN secretary-general has proposed sunsetting the agency by the end of this year. Byanyima said a working group will present proposals to the UNAids board in October, but she foresees “a much smaller joint programme that is more dispersed within the UN but continues to have a hub – leading for the UN and for the world.”