US Cuts Threaten AIDS Fight

UN warns of potential setbacks after decades of progress.

Abrupt withdrawal of U.S. funding for AIDS programs risks reversing decades of progress, potentially causing millions of additional deaths and infections, according to U.N. officials.

Funding Freeze Effects

A new UNAIDS report indicates that funding losses have already disrupted supply chains, shuttered health facilities, and hindered HIV testing, forcing many organizations to scale back their activities.

The report expressed concerns that other major donors might also reduce their support, jeopardizing international cooperation due to geopolitical tensions, wars, and climate change.

Vanishing Lifeline

The $4 billion pledged by the United States for the global HIV response in 2025 disappeared in January, following **President Donald Trump**’s order to suspend foreign aid and plans to close the U.S. AID agency.

**Andrew Hill**, an HIV expert at the University of Liverpool, noted the sudden nature of the cuts: “any responsible government would have given advance warning so countries could plan,” instead of leaving patients stranded.

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), launched in 2003 by **President George W. Bush**, has been a critical initiative. UNAIDS called the program a “lifeline” for countries with high HIV rates, supporting testing for 84.1 million people and treatment for 20.6 million. In Nigeria, PEPFAR funded nearly all (99.9%) of the country’s budget for medicines to prevent HIV.

**U.N. Assistant Secretary-General Angeli Achrekar** stated the program is under review, though **Secretary of State Marco Rubio** issued a waiver “to continue life-saving treatment.”

“The extent to which it will continue in the future, we don’t know,” she said, expressing hope that PEPFAR will continue to support prevention and treatment services.

Irreplaceable Gap

In 2024, there were approximately 630,000 AIDS-related deaths globally, a figure that has remained relatively stable since 2022 after a peak of about 2 million deaths in 2004. Even before the U.S. funding cuts, progress against HIV was uneven, with half of all new infections occurring in sub-Saharan Africa.

According to the World Health Organization, in 2023, 39 million people globally were living with HIV, highlighting the ongoing need for prevention and treatment efforts (WHO).

**Tom Ellman** of Doctors Without Borders warned that poorer countries cannot compensate for the loss of U.S. support: “There’s nothing we can do that will protect these countries from the sudden, vicious withdrawal of support from the U.S.”

Experts also fear the loss of HIV surveillance data in African countries, which was primarily funded by the U.S., according to **Dr. Chris Beyrer**, director of the Global Health Institute at Duke University. “Without reliable data about how HIV is spreading, it will be incredibly hard to stop it,” he said.

Hope Remains

A twice-yearly injectable drug offers renewed hope for preventing HIV. Studies last year showed the drug from Gilead was 100% effective. South Africa’s health minister **Aaron Motsoaledi** said his country would “move mountains and rivers to make sure every adolescent girl who needs it will get it.”

The U.S. Food and Drug Administration recently approved the drug, called Yeztugo. **Peter Maybarduk** of Public Citizen called it a “threshold moment” for stopping the AIDS epidemic. However, activists warn that Gilead’s pricing could make it inaccessible to many countries in need, even with generic versions offered in 120 poor countries, excluding most of Latin America.

“We could be ending AIDS,” **Maybarduk** said. “Instead, the U.S. is abandoning the fight.”