Sharp reductions in international funding have triggered a major decline in HIV prevention services worldwide, with nearly 40 percent fewer people receiving preventive medication in 2025 compared to the previous year, the United Nations AIDS agency has warned.
According to early data presented by UNAIDS on Friday, access to pre-exposure prophylaxis (PrEP), a key drug used to prevent HIV infection, fell by 38 percent across 62 countries. The number of people receiving the treatment dropped from 3.3 million in 2024 to 2.1 million in 2025 a decline of about 1.2 million people.
The reductions were recorded in countries including Nigeria, Cameroon and Uganda, highlighting the broad geographic impact of shrinking donor support for HIV prevention programmes.
Funding for condoms, another essential preventive tool, also collapsed in some settings, falling by more than 90 percent in certain countries, according to the report.
UNAIDS Executive Director Winnie Byanyima said the global HIV response was facing one of its most severe disruptions since the beginning of the epidemic in the 1980s.
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“We are undergoing perhaps the most serious disruption of HIV services since the HIV response started,” she said. “We can’t sit here thinking that the impact isn’t so dramatic.”
The agency warned that reduced prevention coverage, combined with growing resistance to services targeting key populations — including LGBTQ communities — could reverse recent gains in controlling the epidemic and lead to increased infections and deaths in the coming years.
Despite the setback in prevention, the report showed that new HIV infections declined slightly in 2025, falling by around 100,000 cases to 1.2 million globally. However, UNAIDS cautioned that a 22 percent drop in HIV testing in some high-burden countries meant the true picture may be incomplete.
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At the same time, access to treatment continued to improve, albeit at a slower pace than in previous years. The number of people receiving antiretroviral therapy rose by 2.7 percent to 32.1 million by the end of 2025.
While this increase is lower than the historical annual average of around 4 percent, UNAIDS said it demonstrated resilience among governments and community groups that have worked to maintain treatment coverage despite shrinking external funding.
The agency noted that domestic financing for HIV responses has increased in several countries for the first time since the COVID-19 pandemic, partially offsetting the decline in international assistance.
However, it warned that many community-based organisations — which play a critical role in reaching vulnerable populations — are shutting down due to funding shortages, weakening the overall prevention and outreach network.
The decline in HIV prevention funding comes as global health agencies face broader financial pressures, with donor governments scaling back aid budgets amid competing domestic priorities and economic constraints.
UNAIDS released the data ahead of a high-level United Nations meeting on HIV/AIDS scheduled for later this month in New York, where member states are expected to assess progress toward ending the epidemic as a public health threat by 2030.
The agency itself is also under scrutiny after a UN proposal suggested it could be closed in 2026 as part of wider reforms to address funding shortfalls within the UN system.
Byanyima said discussions were ongoing about the future structure of the organisation but stressed that the UN would continue to play a central role in the global HIV response.
“What I’m certain about is that the United Nations will not drop its leadership role in the global response,” she said.
Public health experts have warned that sustained reductions in prevention funding could undermine decades of progress against HIV, particularly in sub-Saharan Africa, where the burden of the epidemic remains highest.
