Launching its 2025 World AIDS Day report, Overcoming disruptions, transforming the AIDS responseUNAIDS said international aid has fallen sharply, with OECD projections showing external health funding could fall by 30-40 percent in 2025 compared to 2023.
The impact has been immediate and severe, particularly in low- and middle-income countries heavily 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 spoke 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 ‘hardest hit’
UNAIDS reports widespread disruption of HIV prevention, testing and community-led programs:
- Across 13 countries, the number of newly started treatment has fallen.
- Stockouts of HIV test kits and essential medicines have been reported in Ethiopia and the Democratic Republic of Congo.
- The distribution of preventive medicine plummeted — down 31 percent in Uganda, 21 percent in Vietnamand 64 percent in Burundi.
- 450,000 women in sub-Saharan Africa lost access to “mom mentors,” trusted community workers who connect them with care.
- Nigeria recorded one 55 percent decrease when distributing condoms.
Before the crisis, young girls and young women were already hard hit – 570 new HIV infections occur every day among young women aged 15-24. UNAIDS warns that dismantled prevention programs make them even more vulnerable.
Community-led organizations, which are the backbone of HIV outreach, are also under pressure. Over 60 percent of women-led organizations say they have had to suspend essential services.
UNAIDS modeling now suggests that failure to restore prevention efforts could lead to a an additional 3.3 million new HIV infections between 2025 and 2030.
Human rights reversals and deepening risk
The funding crisis unfolds amid growing restrictions on civil society and an increase in criminal laws targeting marginalized groups hardest hit by HIV.
For the first time since UNAIDS began tracking such legislation, the number of countries criminalizing same-sex relationships and gender expression increased in 2025. Globally:
- 168 countries criminalize some aspects of sex work
- 152 criminalize minor possession of drugs
- 64 criminalize same-sex relationships
- 14 criminalize transgender people
Restrictions on civil society, including burdensome registration rules and restrictions on receiving international aid, further undermine access to services.
Zimbabwe: ‘People haven’t stopped needing services – they’ve lost access’
Dr. Byrone Chingombe, technical director at the Center for Sexual Health and HIV/AIDS Research (CeSHHAR), speaking from Harare, described the real impact of funding cuts in Zimbabwe.
“2025 has been a tough year,” he said. “When funding stopped in January, service providers were made redundant overnight. Medicines were on the shelves but the people delivering them were gone. It disrupted adherence and, more importantly, it disrupted trust.”
CeSHHAR’s HIV testing “case finding” rates have fallen with more than 50 per centa decline, he says, reflects loss of access, not reduced need. Already overburdened, community-led teams 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 woman living with HIV receives medication at a hospital in Zimbabwe.
A call to action
UNAIDS calls on world leaders to:
- Reaffirm global solidarity and multilateralismincluding commitments made at the recent G20 leaders’ summit in South Africa
- Maintain and increase HIV fundingespecially for countries that are most dependent on external aid
- Invest in innovationincluding affordable long-term prevention
- Uphold human rights and strengthen communitieswhich remain central to successful HIV responses
“This is our moment to choose,” said Ms. Byanyima. “We can let these shocks 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.”
