The global response to HIV is facing its most serious setback in decades, UNAIDS warned on Tuesday, as abrupt funding cuts and a deteriorating human rights environment disrupt prevention and treatment services across dozens of countries.
Launching its 2025 World AIDS Day report, Overcoming Disruption, Transforming the AIDS Response , UNAIDS said international assistance has sharply declined, with OECD projections showing external health funding could fall by 30-40 per cent in 2025 compared with 2023.
The impact has been immediate and severe, especially in low- and middle-income countries highly affected by HIV.
"The funding crisis has exposed the fragility of the progress we fought so hard to achieve," said Winnie Byanyima, Executive Director of UNAIDS, who was speaking in Geneva.
"Behind every data point in this report are people… babies missed for HIV screening, young women cut off from prevention support, and communities suddenly left without services and care. We cannot abandon them."
Prevention services 'hit hardest'
UNAIDS reports widespread disruption to HIV prevention, testing and community-led programmes:
- Across 13 countries, the number of people newly initiated on treatment has fallen.
- Stock-outs of HIV test kits and essential medicines have been reported in Ethiopia and the Democratic Republic of the Congo.
- Distribution of preventive medicines plummeted - down 31 per cent in Uganda, 21 per cent in Viet Nam, and 64 per cent in Burundi.
- 450,000 women in sub-Saharan Africa lost access to "mother mentors," trusted community workers who link them to care.
- Nigeria recorded a 55 per cent drop in condom distribution.
Before the crisis, adolescent girls and young women were already severely affected - 570 new HIV infections occur every day among young women aged 15-24. UNAIDS warns that dismantled prevention programmes leave them even more vulnerable.
Community-led organisations, the backbone of HIV outreach, are also under pressure. Over 60 per cent of women-led organisations say they have had to suspend essential services.
UNAIDS modelling now suggests that failure to restore prevention efforts could lead to an additional 3.3 million new HIV infections between 2025 and 2030.
Human rights reversals deepening risk
The funding crisis is unfolding amid growing restrictions on civil society and a rise in punitive laws targeting marginalised groups most affected by HIV.
For the first time since UNAIDS began tracking such legislation, the number of countries criminalising same-sex relations and gender expression increased in 2025. Globally:
- 168 countries criminalise some aspect of sex work
- 152 criminalise small-scale drug possession
- 64 criminalise same-sex relations
- 14 criminalise transgender people
Restrictions on civil society, including onerous registration rules and limits on receiving international assistance, are further undermining access to services.
Zimbabwe: 'People have not stopped needing services - they've lost access'
Speaking from Harare, Dr. Byrone Chingombe, Technical Director at the Centre for Sexual Health and HIV/AIDS Research (CeSHHAR), described the real-world impact of funding cuts in Zimbabwe.
"2025 has been a hard year," he said. "When funding stopped in January, service providers were laid off overnight. Medicines were on the shelves, but the people who deliver them were gone. That disrupted adherence, and more importantly, it disrupted trust."
CeSHHAR's HIV testing "case finding" rates have fallen by more than 50 per cent, a drop he says reflects loss of access, not reduced need. Community-led teams, already overstretched, are trying to fill the gap.
He highlighted two areas of hope: community resilience and new long-acting prevention technologies, including the injectable lenacapavir - recently fast-tracked for approval in Zimbabwe and now expected to reach the country in early 2026.
A call to action
UNAIDS is urging world leaders to:
- Reaffirm global solidarity and multilateralism, including commitments made at the recent G20 Leaders Summit in South Africa
- Maintain and increase HIV funding, especially for countries most dependent on external assistance
- Invest in innovation, including affordable long-acting prevention
- Uphold human rights and empower communities, which remain central to successful HIV responses
"This is our moment to choose," Ms. Byanyima said. "We can allow these shocks to undo decades of hard-won gains, or we can unite behind the shared vision of ending AIDS. Millions of lives depend on the choices we make today."
