Global HIV programmes are facing severe setbacks due to significant cuts in international aid and a rising number of new infections, according to recent data and expert warnings. Funding for HIV initiatives has dropped by nearly 25 percent worldwide, with some of the most drastic reductions coming from the United States. Shortly after taking office for his second term, former President Donald Trump froze the majority of US foreign aid and subsequently cancelled around 80 percent of the country’s global aid projects. This decision included substantial funding for the President’s Emergency Plan for AIDS Relief (PEPFAR), widely recognized as one of the most successful health programmes targeting HIV.

Following the US lead, the United Kingdom and parts of Europe also redirected foreign aid budgets towards defence priorities, further diminishing resources for HIV response efforts. According to advocates, renewed US aid is limited and curbed by policies that have targeted the LGBTQ+ community, including executive orders that strictly define sex based on birth assignment. This policy environment has effectively cut access to funding for organizations supporting marginalized groups living with HIV.

The impact of these funding reductions has been swift and stark. UNAids, the United Nations agency coordinating the global HIV response, reported at least 570,000 AIDS-related deaths in 2025, more than double the initial target set for that year. Winnie Byanyima, the head of UNAids, described the current disruption as unprecedented, warning that years of progress are being reversed. She highlighted that vulnerable populations, particularly those criminalized or stigmatized, have been disproportionately affected.

Individuals living with HIV from marginalized communities in various countries face compounded challenges. In Nigeria, for example, strict laws require government-issued identification that notes sex at birth to access public healthcare, effectively outing transgender individuals and exposing them to heightened stigma and discrimination. As a result, many avoid public health facilities despite the risk of untreated HIV infections, often resorting to borrowing medication or foregoing treatment altogether.

One transgender activist and sex worker in Lagos, who contracted HIV following sexual violence, reported avoiding healthcare centres for over a year, relying on borrowed antiretroviral drugs but fearing she may soon suffer fatal consequences. This situation is echoed by others who argue that stigma often outweighs the fear of infection, pushing people away from formal medical services.

Experts stress the danger this presents to global HIV control efforts. Advances in treatment and prevention, including the development of lenacapavir—a twice-yearly injection described as the closest available protection to a vaccine—offer substantial hope. However, with decreased funding and rising stigma, access to these innovations is increasingly limited.

Anne Aslett, CEO of the Elton John AIDS Foundation, emphasized the importance of maintaining investment in cutting-edge treatments and prevention strategies, noting the broader public health implications including infections linked to international travel.

Medical professionals with organizations such as Médecins Sans Frontières express concern that without urgent action, the world may revert to an era when HIV led to widespread mortality and despair. Grounded experiences from healthcare workers and those living with HIV in affected communities underscore the critical consequences of funding shortages and entrenched discrimination.

Calls for renewed global commitment are mounting as advocacy groups and affected individuals urge governments and international bodies to address the escalating crisis and avert further setbacks in the global fight against HIV/AIDS.