The global fight against HIV/AIDS amid financial pressures and an uncertain future for UNAIDS

Although the global fight against HIV/AIDS has achieved considerable epidemiological and medical progress, its political and financial foundations have suffered increasing pressure in 2026. Over the past two decades, both new HIV infections and AIDS-related deaths have fallen significantly. Antiretroviral therapy has fundamentally changed the outlook for people living with HIV, while new long-acting prevention options are creating additional opportunities to reduce transmission. The twice-yearly injectable lenacapavir is seen as particularly promising for reaching people for whom daily medication intake, stigma or limited access to health services have so far posed major barriers.
 

For decades, the global HIV/AIDS response has relied heavily on US-funded programmes such as PEPFAR. The abrupt freezing, reduction and political redirection of US assistance from January 2025 onwards coincided with a broader decline in international development financing. Additional expected cuts by other donors, together with mounting pressure on national health budgets, are forcing a reassessment of how the responsibility for the HIV response is shared globally. Countries with high HIV prevalence and limited fiscal space are especially vulnerable, as external funding has long helped sustain essential services ranging from prevention and testing to treatment.

In parallel, UNAIDS, the Joint United Nations Programme on HIV/AIDS established in 1996, is itself under pressure to reform. Recent votes on the new Political Declaration on HIV and AIDS, as well as deliberations within the UNAIDS Programme Coordinating Board, show that the global response is being weakened not only by a funding crisis, but also by an increasingly fragmented normative consensus.

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