A trove of recent reviews highlights the scope of cuts to worldwide funding for the HIV response in limited-resource international locations, and the affect these cuts are having on the organizations that ship HIV providers.
In a joint report revealed yesterday, KFF and the Joint United Nations Programme on HIV and AIDS (UNAIDS) discovered that donor authorities funding for HIV decreased by $2.1 billion, or 25%, in 2025 in contrast with the earlier yr. The decline lowered donor authorities funding for HIV to $6.2 billion, which is beneath pre-2008 ranges, the report notes.
The $2.1 billion decline matched the quantity of funding that was lower by the US authorities. The US cuts had been pushed by modifications the Trump administration has made to international help, highlighted by the dismantling of the US Company for Worldwide Improvement (USAID) and the shifting of international support administration to the State Division.
“Collectively, these actions briefly halted, after which slowed, U.S. HIV disbursements in 2025,” the report states.
The drop in US funding is critical, as a result of the US authorities, for the reason that institution of the President’s Emergency Plan for AIDS Aid (PEPFAR) in 2003, has been the first funder for the HIV response in low- and middle-income international locations (LMICs). And the nation has taken on a bigger and bigger function since 2011.
From 2011 to 2025, the quantity of HIV response funding from different nations was lower in half, falling from $3.2 billion to $1.6 billion. Mixture funding from all different donor governments in 2025 remained flat in contrast with 2024. The US accounted for 74% of whole donor authorities funding in 2025, up from 59% in 2011. The following greatest donor was France, at $280 million.
And US funding for HIV is more likely to decline even additional, the report notes, with the Trump administration making clear that it plans extra international support cuts going ahead.
Cuts may erode life-saving progress
In one other report for the twenty sixth Worldwide AIDS Convention happening this week, UNAIDS mentioned the unprecedented cuts resulted in substantial reductions in HIV prevention applications in sub-Saharan Africa in 2025, with knowledge displaying main declines in condom purchases, the variety of folks receiving pre-exposure prophylaxis (PrEP) treatment, and HIV testing in international locations the place home funding for HIV response efforts is restricted.
Since 2010, the estimated variety of new HIV infections has fallen by 42%, and the variety of folks dying from AIDS-related causes is at its lowest degree in additional than 30 years. However UNAIDS warned the funding cuts may reverse that progress.
“Whereas the world has turned the tide towards HIV, the progress is fragile and the bottom beneath our ft continues to be shifting,” the report states. “The worldwide neighborhood has entered a interval of profound political and monetary upheaval that threatens many years of hard-won good points towards HIV.”
A ‘system-wide breakdown’
The on-the-ground affect of the funding cuts is highlighted in a third report, revealed final week by the American Basis for AIDS Analysis (AMFAR), Funders Involved About AIDS, the Johns Hopkins Bloomberg Faculty of Public Well being, and Information And many others.
The report highlights responses from the PEPFAR Pulse examine, a survey of 166 PEPFAR-funded organizations from 46 international locations carried out from November 2025 by means of April 2026. As the first pillar of the worldwide HIV response, PEPFAR has been credited with saving greater than 26 million lives in 50 international locations. PEPFAR funding consists of direct contributions to different international locations and contributions to multilateral organizations just like the World Fund to Combat AIDS, Tuberculosis and Malaria.
The worldwide neighborhood has entered a interval of profound political and monetary upheaval that threatens many years of hard-won good points towards HIV.
The report authors observe that whereas publicly launched PEPFAR knowledge have proven drops in service supply, the affect on the teams that depend on PEPFAR to supply HIV providers hadn’t beforehand been calculated.
“Documenting what occurred to PEPFAR’s service supply companions is a key query to grasp what was misplaced, what stays, and the way these modifications reshaped HIV service supply,” they wrote.
Over 77% of the implementing companions mentioned they’d no less than one award terminated or delayed in 2025, which contributed to the closure of no less than 1,700 service-delivery websites, like clinics and drop-in facilities, and to layoffs of over 16,000 full-time employees members. Lower than 2% of the organizations had been capable of change the misplaced funding.
Among the many hardest-hit applications had been HIV prevention efforts, which noticed spending fall by 51% from 2024 to 2025. Forty-three p.c of organizations reported stopping no less than one prevention exercise, together with PrEP and condom applications.
Additionally affected had been the populations most affected by HIV, together with intercourse employees, males who’ve intercourse with males, transgender populations, and injectable-drug customers. Almost three-quarters (73%) of the organizations that had beforehand serving these populations reported completely ending a service.
Survey respondents additionally reported that the applications the US authorities mentioned would proceed to obtain funding—equivalent to HIV therapy, testing, and prevention of mother-to-child HIV transmission—had been affected. Sixty-three p.c reported interruptions to those providers, and 22% mentioned they ended them altogether.
Masen Davis, govt director of Funders Involved About AIDS, mentioned the responses reveal a “system-wide breakdown that has weakened prevention, community-led organizations, and the HIV workforce.”
“PEPFAR has saved hundreds of thousands of lives and stays indispensable to the worldwide HIV response,” Davis mentioned in a amfAR press launch. “This report ought to be understood as each an pressing warning and a sensible roadmap for restoring that progress.”
