Why it matters
- 1.2 million people contracted HIV and 570,000 died of AIDS-related illnesses by 2025
- 22 percent of people living with HIV are still not on treatment
- International HIV funding fell by 18 percent, the steepest drop in nearly 20 years
- Such new drugs as lenacapavir are almost 100 percent effective in preventing HIV infection
- 20 million people need access to antiretroviral-based prevention to make a meaningful impact on the epidemic
- Generic versions of lenacapavir can cost as little as $40 per person per year, but they will remain unavailable in many countries
Defined by a paradox
The conference, which will take place in Rio from 27 to 31 July, is defined by a paradox.
By the end of this decade, more than three million people could be infected with HIV, yet the tools to stop this crisis exist, from cutting-edge preventive medicine to community-led interventions with a proven track record. What is lacking is sustained funding.
This widening funding gap is already forcing countries to cut essential services and close community organizations, according to the new report by UNAIDS, the agency working to end the epidemic by 2030.
Unless urgent action is taken, the agency warns, the world is headed for a resurgence of the epidemic.
That contradiction defines the 26th International AIDS Conference.
On the one hand is a revolution in HIV prevention, with a new generation of drugs now offering protection against HIV comparable to a vaccine.
On the other hand, there is a growing concern that these breakthroughs will remain out of reach for millions because they are priced too high and controlled by pharmaceutical patent holders.
Brazil excluded from generic production
Few countries illustrate this paradox more clearly than the conference host himself.
Although Brazil played a key role in the clinical trials that helped bring lenacapavir to market, it was excluded from the list of countries approved to make cheaper generic versions.
Lenacapavir is a long-acting injectable medication that requires only two injections a year and prevents HIV infection in nearly 100 percent of cases, according to recent studies.
Universal access is ‘distant reality’ for most people
“Fair and universal access is still a distant reality for millions of people due to high prices and the exclusion of many countries from voluntary licensing agreements,” said Variano Terto Jr., vice president of the Brazilian Interdisciplinary AIDS Association (ABIA).
He was speaking at a conference side event organized by the Community of Portuguese Language Countries (CPLP).
He added that patents on essential drugs have been “reinforcement of monopolies and privatization of public knowledge”.
One of the conference’s co-organizers, ABIA, recently published a study showing that Brazil could manufacture lenacapavir domestically for approximately US$75 per patient per year.
In contrast, the patented version costs more than $20,000, a price considered unsustainable for Brazil’s public health system.
Risk of unfairness
The true measure of success is not whether medicines exist, but whether the people who need them can actually get them and at an affordable price, said UNAIDS Executive Director Winnie Byanyima.
“Innovation without access is not innovation; it is injustice” she said.
UNAIDS estimates that 20 million people need access to antiretroviral-based prevention if the world is to significantly reduce new HIV infections.
A safe space for HIV/AIDS support in Lahore, Pakistan, where marginalized communities come together for health awareness and social support.
Calls for a new financing model
While HIV infections and AIDS-related deaths are at their lowest level in more than three decades, the global response remains dangerously fragile.
International HIV funding fell by more than $1.5 billion between 2024 and 2025, an 18 percent drop that marked its lowest level in nearly two decades, and global development aid fell by 23 percent last year, the largest annual drop on record, with health programs, including HIV initiatives, among the hardest hit.
Meanwhile, new HIV infections increased in three regions and in 21 countries during 2025.
The current moment must be understood as “the end of the era of dependence on international aid”, the UNAIDS chief said, calling for a new funding model, including measures such as sovereign debt restructuring to enable governments to invest in “the future of their people”.
