Millions at Risk if US HIV Funding is Not Restored: UNAIDS

The United States has cut foreign aid for global HIV programs, affecting testing, treatment, and prevention. This has led to clinic closures, medicine shortages, and halted research, reports the Joint United Nations Programme on HIV and AIDS (UNAIDS). Many countries are adopting emergency measures and seeking alternative funding, while UNAIDS tracks the impact and works with governments to sustain AIDS responses.

“Despite efforts by governments and partners to mobilize domestic resources to mitigate risks, US funding cuts continue to severely impact the HIV response, putting millions at risk,” says UNAIDS Global.

UNAIDS is issuing weekly updates on the impact of US foreign aid cuts on HIV services. These reports, based on status reports from UNAIDS’ Country Offices, provide insight into how low- and middle-income countries are responding to funding reductions. As of March 13, 2025 at least one status report has been received from 67 countries, covering 84% of PEPFAR-funded nations and 20 other countries receiving US support for their AIDS response.

Governments and health authorities in affected countries are implementing emergency measures and developing long-term strategies to sustain their HIV programs. UNAIDS’ Country Offices are working with national authorities, Ministries of Health, and other stakeholders to assess the full impact of the funding cuts and ensure the continuation of essential HIV services. Many countries have conducted UNAIDS-supported surveys to gauge the effects on service recipients. 

One survey in a high-burden East African country found that 62% of respondents had difficulty accessing pre-exposure prophylaxis (PrEP), 46% of people living with HIV experienced treatment disruptions, and 23% received smaller amounts of antiretroviral medicines than usual. Other critical services, including viral load testing, community outreach, condom distribution, and tuberculosis diagnostics, have also been affected.

“African countries are trying to become more self-sufficient — some of the poorest trying to stretch fragile health systems to absorb people living with HIV,” says Winnie Byanyima, Executive Director, UNAIDS.

While some HIV treatment and prevention services, such as those preventing mother-to-child transmission, have continued despite funding reductions, several countries have reported the closure of US-funded facilities providing these services. HIV testing programs, particularly community-led efforts targeting high-risk populations, have been significantly affected. Pregnant women are among the most vulnerable, as testing disruptions at antenatal care centers may result in missed diagnoses and increased mother-to-child transmission. UNAIDS estimates that an additional 350,000 children could be newly infected over the next four years if these gaps persist.

"If the US assistance for HIV is not restored after the pause in April, and it is not replaced by other funding, there will be an additional 6.3 million AIDS-related deaths in the next four years,”says Byanyima.

HIV prevention programs have also suffered, with cuts affecting PrEP, voluntary medical male circumcision, and condom distribution. UNAIDS staff in Armenia, Ecuador, Ethiopia, Madagascar, Namibia, Rwanda, South Sudan, and Uganda have reported specific challenges in maintaining these services. In several countries with high HIV transmission rates among people who inject drugs, opioid substitution therapy and harm reduction services have been reduced or stopped altogether.

UNAIDS and the World Health Organization (WHO) recommend comprehensive harm reduction strategies to curb HIV and viral hepatitis transmission and reduce overdose deaths.

Across regions, numerous community-led HIV service projects have received termination notices from the US government. Some civil society organizations still receive support, particularly those engaged in HIV treatment, but funding for projects addressing stigma, discrimination, and legal barriers has largely been halted.

For example, in Latin America, in addition to biomedical services, some human rights promotion programs have been suspended, and many others have been significantly reduced, reports UNAIDS. The lack of monitoring of human rights issues has raised concerns about increased discrimination, as affected individuals are forced to transition from tailored, community-supported services to government-run programs.