Severe reductions in international health aid are threatening to reverse decades of progress in the global fight against HIV and Aids, with new analysis warning the cuts could lead to 3.3 million additional new infections by 2030.
A System Shaken to Its Core
As 2025 draws to a close, a series of stark reports detail the mounting human impact of funding cuts by the United States, Britain, and other European donors. The complex ecosystem supporting HIV services in low and middle-income nations has been "shaken to its core," according to Winnie Byanyima, Executive Director of UNAids.
External health assistance for 2025 is estimated to be between 30% and 40% lower than it was in 2023. This follows the Trump administration's abrupt halt to all overseas aid spending in January, with only partial restorations since. Other nations, including the UK, have implemented their own reductions.
Lives Disrupted and Progress Reversed
The consequences are being felt acutely across sub-Saharan Africa. In Zimbabwe, Aids-related deaths have risen for the first time in five years. In Mozambique, a teenage rape victim found a crucial health clinic closed. In Ethiopia and the Democratic Republic of the Congo, patients went undiagnosed as stocks of HIV test kits ran out.
Services aimed at preventing new HIV infections, which are often heavily reliant on donor funding, have been among the hardest hit. With limited resources, existing patients are being prioritised for treatment over prevention. In Burundi, for example, the number of people receiving preventive HIV medicines plummeted by 64%.
Country-level reports from the British charity Frontline Aids, covering nations including Angola, Kenya, Malawi, and Uganda, highlight similar distressing trends. After years of decline, there are now early signs that new HIV cases and Aids-related deaths are beginning to rise again in some regions.
Key Populations Left Isolated and Exposed
Many of the recent gains against HIV were achieved by targeting services to groups at higher risk, known as "key populations." These include men who have sex with men, people who inject drugs, sex workers, and transgender individuals. Tailored services, like LGBTQ+ friendly walk-in clinics, provided vital, stigma-free access to care.
Now, many of these community-led organisations and outreach services have closed after losing donor funding. A member of the LGBTQ+ community in Uganda described the loss of safe spaces, saying it left them feeling "isolated and exposed […] the mental strain is overwhelming." In Kenya, activists report some individuals are hiding their status as a member of a key population to access public clinics safely, risking a loss of crucial data on how the virus spreads.
Programmes designed for teenage girls and young women, who are disproportionately affected by HIV in sub-Saharan Africa, have also been common casualties of the funding axe.
Signs of Hope and a Call for Courage
Despite the bleak outlook, there are flickers of resilience and change. John Plastow of Frontline Aids noted the potential for a reset, stating, "In several countries, we are seeing the first signs of governments and communities working together to build more sustainable, homegrown HIV responses."
UNAids points to nations including Nigeria, Uganda, South Africa, and Tanzania, which have pledged to increase domestic investment. Innovations like new long-acting injectable drugs to prevent infection are also gaining momentum.
Winnie Byanyima issued a clear call to action: "We know what works – we have the science, tools and proven strategies. What we need now is political courage: investing in communities, in prevention, in innovation and in protecting human rights as the path to end Aids." The window to avert the predicted surge in infections is narrowing, placing the onus on global leaders to restore and sustain the funding required to finish the fight.
