The 2025 Global AIDS Update released on Thursday by UNAIDS – the global body’s agency fighting AIDS and HIV infection – warns that a historic funding crisis now threatens to unravel decades of hard-won gains unless countries radically rethink how they fund and deliver HIV services.

Yet even amid these challenges, many of the most-affected countries are stepping up. Of the 60 low and middle-income nations surveyed in the report, 25 have signaled plans to increase domestic HIV budgets in 2026 – a clear sign of growing national leadership and commitment to the response.

Although promising, such efforts are not sufficient to replace the scale of international funding in countries that are heavily reliant on global donors.

Global emergency

Despite marked progress in the HIV response in 2024, this year has seen many disruptions to HIV prevention programmes and treatment services, due to abrupt funding shortfalls in Washington and other major donor capitals.

Even before the large-scale service disruptions, reported data for 2024 showed that 9.2 million people living with HIV still did not have access to life-saving treatments, contributing to 75,000 AIDS-related deaths among children in 2024.

“This is not just a funding gap – it’s a ticking time bomb,” said Winnie Byanyima, UNAIDS Executive Director, as many AIDS-relief programmes are being defunded, pushing people out of critically needed care.

If US-supported HIV treatment and prevention services collapse entirely, UNAIDS estimated that an additional six million new HIV infections, and four million additional AIDS-related deaths could occur between 2025 and 2029.

Call for solidarity

Despite the grim landscape, “there is still time to transform this crisis into an opportunity,” said Ms. Byanyima, as countries and communities are stepping up to protect treatment gains.

As of December 2024, seven countries in sub-Saharan Africa had achieved the 95-95-95 targets: 95 per cent of people living with HIV know their status, 95 per cent of those are on treatment, and 95 per cent of those on treatment are virally suppressed.

While such successes must be maintained and further scaled up, the global HIV response cannot rely on domestic resources alone.

“In a time of crisis, the world must choose transformation over retreat,” said Ms. Byanyima.

“Together, we can still end AIDS as a public health threat by 2030 – if we act with urgency, unity and unwavering commitment,” she added.