London | 11 July 2025
By TPO Staff | Agencies Input
A new United Nations report has issued a grave warning that the world’s fight against HIV could suffer a catastrophic setback following the sudden withdrawal of US funding from global AIDS programmes. According to the UN agency UNAIDS, unless replacement funds are urgently mobilised, over four million people could die of AIDS-related illnesses and six million more could contract HIV by 2029.
The development comes six months after US President Donald Trump ordered an immediate halt to all foreign aid — a decision that effectively suspended the $4 billion the United States had committed to the global HIV response for 2025. The move has shocked health experts, strained vulnerable healthcare systems, and raised concerns that decades of hard-won progress against HIV/AIDS could unravel in mere months.
“The current wave of funding losses has already destabilised supply chains, led to the closure of health facilities, left thousands of clinics without staff, set back prevention programmes, and disrupted HIV testing efforts,” UNAIDS said in its latest global assessment released on Thursday.
PEPFAR: A Lifeline Cut Short
At the heart of the crisis is the sudden halting of the President’s Emergency Plan for AIDS Relief (PEPFAR) — a landmark US government initiative launched in 2003 by President George W. Bush. Over the last two decades, PEPFAR has been credited with saving millions of lives by providing antiretroviral treatment, HIV testing, and prevention education across low- and middle-income countries, especially in sub-Saharan Africa.
According to UNAIDS, PEPFAR supported HIV treatment for more than 20.6 million people and testing for over 84 million individuals globally. In countries such as Nigeria, the programme funded up to 99.9% of the national budget for medicines used to prevent HIV transmission.
That progress is now at risk.
“The withdrawal has created a systemic shock, especially for countries where US funding accounted for the bulk of HIV-related health budgets,” the report states.
Devastating Ground Impact
Health experts say the abrupt nature of the funding cut has been particularly damaging. There was no warning, no transition period, and no alternative plans presented to affected countries. Clinics were forced to shut overnight. Lifesaving medication supplies dried up. Community health workers — often the only connection between HIV-positive patients and the formal healthcare system — were left without salaries or support.
“Any responsible government would have provided advance notice to allow contingency planning. Instead, patients were stranded mid-treatment,” said Dr. Andrew Hill, an HIV expert at the University of Liverpool.
In some of the hardest-hit areas, patients are reportedly going weeks without antiretroviral therapy, putting them at risk of developing AIDS and spreading the virus. Prevention efforts, including education campaigns, condom distribution, and outreach to at-risk populations, have also collapsed.
In South Africa, which has the world’s largest HIV epidemic, community-based organisations report a sharp uptick in new infections — a trend they say mirrors the early 2000s before international funding scaled up.
“We are witnessing the erosion of two decades of effort in real time,” said Tom Ellman, Director of the South Africa Medical Unit at Doctors Without Borders. “Without immediate intervention, mortality will surge.”
Data Infrastructure Also in Jeopardy
Beyond the immediate impact on healthcare delivery, UNAIDS warns of another looming crisis — the loss of data infrastructure. For years, the US funded the majority of HIV surveillance and reporting systems across Africa and parts of Asia, including electronic health records, lab networks, and national registries. With funding now gone, those systems are rapidly deteriorating.
“Without reliable data, we’re flying blind. It becomes nearly impossible to track the spread of HIV, allocate resources, or tailor interventions,” said Dr. Chris Beyrer, Director of the Global Health Institute at Duke University.
Hope on the Horizon? Maybe, but Not for All
Ironically, the crisis comes at a time when science has made major strides in HIV prevention. Just last month, the US Food and Drug Administration approved Sunleca, a twice-yearly injectable medication developed by pharmaceutical giant Gilead. Clinical trials suggest it is 100% effective in preventing HIV transmission.
UNAIDS and health activists hailed the drug as a potential game-changer in ending the AIDS epidemic — but there’s a catch. The drug’s price tag makes it unaffordable for many countries hardest hit by HIV. While Gilead has agreed to license generic production for 120 low-income countries, nearly all of Latin America and parts of Asia have been excluded from the deal.
“This could have been a threshold moment in the global fight against HIV,” said Peter Maybarduk, of the US-based advocacy group Public Citizen. “Instead, we’re facing a grim new chapter defined by inequality and inaction.”
Geopolitics, Climate, and a Fractured Global Response
The UNAIDS report also flagged broader structural threats to the global HIV response, citing increased geopolitical tensions, climate-induced displacement, and a weakening of multilateral cooperation.
Officials fear that the US decision could prompt other major donors — such as the UK, Germany, or the EU — to reevaluate their contributions, especially amid rising domestic political pressures and inflation.
“We are at a crossroads,” UNAIDS Executive Director Winnie Byanyima said in a press conference. “Do we let millions slip through the cracks, or do we recommit — as a global community — to the promise of ending AIDS?”
The coming months will be critical. Emergency fundraising efforts are underway, but replacing the scale and infrastructure of US support will be difficult, if not impossible, in the short term. And for those already affected, delays will mean the difference between life and death.
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