UNAIDS Warns of 'Perilous Moment' as Funding Cuts Threaten to Reverse Decades of HIV/AIDS Progress
核心洞察
Global development assistance for HIV fell by 23% in 2025, the sharpest drop on record, with HIV testing programs down 22% and condom funding cut by more than 90% in some settings.
New HIV infections declined to 1.2 million and AIDS-related deaths to 570,000 in 2025, but both remain far above UNAIDS (搜索) 2025 targets of 370,000 and 250,000 respectively.
PrEP uptake dropped 38% between 2024 and 2025 across 62 reporting countries, while community-led organizations saw service reductions of up to 85% for marginalized populations.
A new UNAIDS (搜索) report released on June 12, 2026, paints a stark picture of the global HIV response, warning that external funding cuts, a rollback of human rights, and underinvestment in prevention are converging to create what the agency calls "the biggest storm the HIV response has ever seen."
"There's no question that this is the most serious disruption in the HIV response since the world came together to fight this disease," said Winnie Byanyima, Executive Director of UNAIDS (搜索). "The funding cuts, combined with the reduction in civic space and the further criminalization of marginalized populations have come together to create the biggest storm the HIV response has ever seen."
Historic gains now at risk
The HIV response has been one of global health's most remarkable success stories over the past quarter-century. AIDS-related deaths have fallen by 56%, from 1.3 million in 2010 to 570,000 in 2025. New HIV infections declined by 43% over the same period, reaching 1.2 million last year. Today, 78% of the 40.9 million people living with HIV — approximately 32.1 million individuals — are receiving antiretroviral treatment.
Yet these gains remain fragile. Nearly 9 million people living with HIV are still not on treatment. The 2025 figures, while representing dramatic improvements, fall far short of UNAIDS (搜索) targets of 370,000 new infections and 250,000 deaths. Progress toward the 95-95-95 goal for 2030 — 95% of people with HIV knowing their status, 95% of those diagnosed on treatment, and 95% of those treated achieving viral suppression — stood at 88-89-95 in 2025. Among children aged 0 to 14 years, the cascade was even more concerning: 64% knew their status, 84% were on treatment, and 85% achieved viral suppression.
"Every week, 3,000 adolescent girls and young women in sub-Saharan Africa are newly infected with HIV," said Angeli Achrekar, PhD, deputy executive director at UNAIDS (搜索). "This is one of the clearest signs that we are failing to reach some of the most vulnerable populations."
The funding crisis deepens
Global development assistance from multiple countries fell by 23% in 2025 — the sharpest drop on record — and HIV programs have been disproportionately affected. HIV testing programs declined by 22% in high-burden settings between 2024 and 2025, meaning individuals are unable to access treatment and the virus continues to spread. Funding for condoms has been cut by more than 90% in some cases. Pre-exposure prophylaxis (PrEP) uptake dropped sharply, falling by 38% between 2024 and 2025 across 62 countries reporting to UNAIDS (搜索).
Prevention, already underfunded at just 11% of total HIV spending in 2024, has been hit hardest. In sub-Saharan Africa, 80% of prevention funding came from international aid — much of which was cut in 2025. "It is both a decline of resources, but also a bit of complacency because we are not seeing that death and despair like we saw 30 to 35 years ago," Achrekar noted.
In the United States, the President's Emergency Plan for AIDS Relief (PEPFAR (搜索)), credited with saving more than 25 million lives since its launch in 2003, has faced significant service disruption due to the foreign aid freeze and the dissolution of the U.S. Agency for International Development, which coordinated much of PEPFAR's work.
Community-led services decimated
Community-led organizations — which deliver HIV prevention, treatment, and support services to up to 60% of their own communities, including men who have sex with men, sex workers, people who inject drugs, and their sexual partners — are being pushed to the brink. A community-led study of 79 organizations across 47 countries and three continents revealed a 50% drop in community support services for people living with HIV, an 82% reduction in services for sex workers, and service reductions of 85% for men who have sex with men. Support services for survivors of gender-based violence are also declining.
"When communities lose funding, the entire response loses reach, trust and effectiveness," the report states.
Compounding these challenges, the report documents a dangerous rollback of rights. Criminalization of marginalized populations is increasing for the first time since UNAIDS (搜索) began tracking these trends. In 2025, two additional countries introduced criminalization related to same-sex sexual activity, and one country increased penalties in 2026.
"Diseases spread fastest where human rights are weakest," said Byanyima. "The rollback on human rights and civic space is not accidental — it is organized, it is political, it has real public health consequences and dire HIV outcomes."
Windows of opportunity remain
Despite the sobering trends, the report identifies pathways forward. The share of domestic resources for HIV response in low- and middle-income countries rose from 28% in 2010 to 52% in 2024. Since January 2025, more than 54 countries have committed to increasing domestic financing. However, many nations face spiraling debt crises — 28 African countries spend more on debt than on health.
Innovation offers another avenue for progress. By the end of March 2026, more than 6,000 people were accessing the long-acting prevention medicine lenacapavir across five sub-Saharan African countries, though far more effort is needed to reach the 20 million people UNAIDS (搜索) estimates require antiretroviral prevention medicines. A quarter of 152 countries have integrated HIV into broader health strategies, and cervical cancer services have been included in national HIV guidelines in more than 80 countries.
The United Nations General Assembly will convene a High-Level Meeting on HIV/AIDS (搜索) on June 22-23, where countries will adopt a new Political Declaration on HIV — the final such declaration before the 2030 deadline to end AIDS as a public health threat. New overarching targets include reaching 40 million people with antiretroviral treatment by 2030 and ensuring 20 million people have access to medicine to prevent HIV.
"We know how to end AIDS," said Byanyima. "The question now is political: will we invest, or will we retreat? If we follow the Global AIDS Strategy and UN Member States commit to adopting a strong Political Declaration to guide the response over the next five years, we can still end AIDS by 2030. However, if we fail to act, we risk reversing decades of hard-fought progress."
Reaching the 2030 targets could avert an estimated 3.2 million additional new infections, according to UNAIDS (搜索). "Ending AIDS requires shared responsibility," Achrekar said. "We know what it takes to end AIDS, but now the question is, will we invest or will we retreat?"