HIV medications need to be taken regularly to keep the virus under control. Significant cuts to HIV funding have threatened people's access to the medications they need. (Image credit: Marco Di Lauro via Getty Images)
Editor's note: This article was first published on March 26, 2025.
We could see an additional 10.8 million new HIV cases over the next five years if planned cuts in international HIV funding are implemented.
Rising incidence in low- and middle-income countries will lead to an increase in HIV-related deaths to 2.9 million by 2030.
The alarming findings come from new modelling published March 26 in The Lancet HIV. The researchers sought to analyse the potential impact of reduced international funding for HIV/AIDS programmes aimed at preventing transmission and deaths caused by the infection.
As of February 2025, the five largest donors to this funding – the United States, the United Kingdom, France, Germany and the Netherlands – have reported significant cuts in foreign aid, threatening HIV programmes around the world. The study predicts how these cuts will impact low- and middle-income countries (LMICs), which have relied on international sources for 40% of their HIV funding since 2015.
“These results are a sober reminder that progress in the fight against HIV is not guaranteed – it depends on sustained political will and investment,” said Dr Ali Zumla, professor of infectious diseases and international health at University College London, who was not involved in the study.
Still, “the predicted increase in new infections and deaths is not inevitable; it is the result of decisions being made today,” Zumla added in an email to Live Science. “If funding cuts continue, we risk undoing decades of progress, leaving millions more vulnerable and pushing global HIV targets further out of reach.”
Unprecedented aid cuts
As of 2023, five donors provided more than 90% of international funding for HIV programming, with the United States providing more than 72% of the total. Certain groups at high risk of HIV—including people who inject drugs, men who have sex with men, female sex workers and their clients, and transgender and gender-diverse people—particularly rely on these international funding sources to access HIV prevention and testing.
Most U.S. funding comes from the President’s Emergency Plan for AIDS Relief (PEPFAR), which is largely implemented by the U.S. Agency for International Development (USAID). However, PEPFAR and USAID faced an unprecedented funding pause and staffing cuts in January following an executive order from President Donald Trump.
PEPFAR later received temporary waivers for some services, including antiretroviral therapy (ART), drugs that prevent HIV from progressing to AIDS. These treatments must be taken regularly or the virus can reactivate.
“The widespread adoption and use of internationally funded antiretroviral therapy has been one of the key factors in the decline in AIDS-related deaths in low-income countries,” said Justin Parkhurst, an associate professor of global health policy at the London School of Economics and Political Science, who was not involved in the study. ART also reduces new infections by suppressing the virus in people living with HIV, thereby preventing transmission, he added in an email to Live Science.
“In the worst case, if PEPFAR funding is completely cut off and no equivalent mechanism is put in place, the surge in HIV cases could potentially reverse almost all the progress made since 2000.”
ten B
Sourse: www.livescience.com
