Progress made in the global fight against HIV and AIDS faces significant challenges as the United Nations programme UNAIDS undergoes major restructuring amid declining international funding. Activists and some governments warn that cutbacks by key donors, including the United Kingdom and the United States, risk undermining efforts to end AIDS as a public health threat by 2030.

UNAIDS, which coordinates worldwide initiatives against HIV/AIDS, has reduced its staff by more than half since 2025, primarily due to aid reductions from major contributors such as the US. Its governing board is scheduled to meet later this month to decide on the organisation’s future operational model, including the scale of its country-level presence, its budget, and staffing levels at the central coordinating hub.

There is a clear division emerging between donors advocating for a smaller, low-cost UNAIDS with a limited global footprint, and civil society groups alongside governments from heavily affected countries, who argue that UNAIDS’ on-the-ground support remains vital in navigating increasingly constrained national budgets following the US funding withdrawal amid a complex geopolitical environment.

The UK provided approximately $5.5 million (£4.2 million) to UNAIDS in 2026 but plans to reduce its contribution to around £1 million in 2027. UK government officials have indicated that this cutback is part of a broader reduction in overseas aid, from 0.5% to 0.3% of gross national income over several years, to accommodate increased defence spending. This decision has drawn criticism from advocacy groups urging the UK to maintain or enhance funding commitments to safeguard HIV/AIDS programmes.

Asia Russell, executive director of Health GAP, criticized moves to reduce UNAIDS support, stating that ending the programme prematurely would be “absurd” and decried unnamed behind-the-scenes negotiations by powerful donors that risk sidelining legitimate concerns about transitioning UNAIDS’ responsibilities.

In 2025, an estimated 41 million people worldwide were living with HIV, with 1.2 million new infections and approximately 570,000 AIDS-related deaths reported. Recent data indicates a significant decline in funding for HIV responses in low- and middle-income countries, dropping by $2.1 billion (£1.6 billion) last year following US cuts under the Trump administration and contributing to the lowest global donor funding levels since 2007 — from $8.3 billion in 2024 to $6.2 billion in 2025.

Mike Podmore, CEO of UK health advocacy network STOPAIDS, emphasized the importance of sustained UK support, warning that aid decisions driven by budget constraints rather than the needs of affected communities could lead to the premature closure of UNAIDS and reversal of progress. He called on the UK to uphold its role in championing HIV response by funding UNAIDS adequately, preserving its country-level presence, and protecting community leadership within its governance structure.

Initial proposals by UN Secretary-General António Guterres to sunset UNAIDS by end of 2026 were abandoned, but a working group has developed transition plans. These include downsizing UNAIDS’ central operations to focus on advocacy, data, and governance, with some activities potentially transferred to other UN agencies like the World Health Organization. Proposed annual budgets range from $35 million to $90 million, compared to the current $63 million core budget. However, some donors have suggested significantly lower funding levels, between $25 million and $35 million.

More than 300 civil society organisations have signed an open letter to the UNAIDS Programme Coordinating Board, warning of the critical juncture facing HIV response efforts. The letter expresses concern that parallel discussions outside official channels might result in decisions effectively ending UNAIDS without consensus. It describes certain budget and staffing scenarios under consideration — such as a $30 million budget and a 34-person staff team over a 12-month transition — as inadequate and urges protection of UNAIDS’ country presence, cautioning that other UN bodies may lack the resources and political will to prioritize HIV amid their own budget constraints.

A UNAIDS spokesperson reaffirmed the importance of solidarity among countries and communities in sustaining the fight against AIDS, stressing that it remains too early to consider sunsetting the programme. The spokesperson emphasized that future steps should align with the needs and readiness of affected countries and communities to safeguard the gains achieved.

The UK Foreign, Commonwealth and Development Office stated that the government’s priority is securing an effective, efficient, and sustainable future for UNAIDS, noting a commitment of an additional £1 million on top of existing funding to support the organisation’s reform and transition efforts.