UN says millions will die by 2029 is HIV funding programs aren't replaced
But in the last six months, the sudden withdrawal of U.S. money has caused a 'systemic shock,' U.N. officials warned, adding that if the funding isn't replaced, it could lead to more than 4 million AIDS-related deaths and 6 million more HIV infections by 2029.
8 A worker in a lab loads HIV/malaria test cassettes into a machine.
REUTERS
8 Winnie Byanyima speaking at the UNAIDS Global AIDS Update 2025.
AP
'The current wave of funding losses has already destabilized supply chains, led to the closure of health facilities, left thousands of health clinics without staff, set back prevention programs, disrupted HIV testing efforts and forced many community organizations to reduce or halt their HIV activities,' UNAIDS said in a report released Thursday.
UNAIDS also said that it feared other major donors might also scale back their support, reversing decades of progress against AIDS worldwide — and that the strong multilateral cooperation is in jeopardy because of wars, geopolitical shifts and climate change.
The $4 billion that the United States pledged for the global HIV response for 2025 disappeared virtually overnight in January when U.S. President Donald Trump ordered that all foreign aid be suspended and later moved to shutter the U.S. AID agency.
Andrew Hill, an HIV expert at the University of Liverpool who is not connected to the United Nations, said that while Trump is entitled to spend U.S. money as he sees fit, 'any responsible government would have given advance warning so countries could plan,' instead of stranding patients in Africa when clinics were closed overnight.
8 A patient shows a Vulante tablet.
AFP via Getty Images
8 South Africa's Minister of Health Aaron Motsoaledi speaking at a UNAIDS report release.
AP
The U.S. President's Emergency Plan for AIDS Relief, or PEPFAR, was launched in 2003 by U.S. President George W. Bush, the biggest-ever commitment by any country focused on a single disease.
UNAIDS called the program a 'lifeline' for countries with high HIV rates, and said that it supported testing for 84.1 million people, treatment for 20.6 million, among other initiatives. According to data from Nigeria, PEPFAR also funded 99.9% of the country's budget for medicines taken to prevent HIV.
8 Mosele Mothibi, 40, an unemployed textile factory worker, holds her ARV tablets.
Getty Images
8 Colorized electron microscope image of a T cell under attack by HIV.
AP
In 2024, there were about 630,000 AIDS-related deaths worldwide, per a UNAIDS estimate — the figure has remained about the same since 2022 after peaking at about 2 million deaths in 2004.
Even before the U.S. funding cuts, progress against curbing HIV was uneven. UNAIDS said that half of all new infections are in sub-Saharan Africa.
Tom Ellman, of the charity Doctors Without Borders, said that while some poorer countries were now moving to fund more of their own HIV programs, it would be impossible to fill the gap left by the U.S.
'There's nothing we can do that will protect these countries from the sudden, vicious withdrawal of support from the U.S.,' said Ellman, director of Doctors Without Borders' South Africa Medical Unit.
Experts also fear another loss: data. The U.S. paid for most HIV surveillance in African countries, including hospital, patient and electronic records, all of which has now abruptly ceased, according to Dr. Chris Beyrer, director of the Global Health Institute at Duke University.
8 South Africa's Minister of Health Aaron Motsoaledi, right, speaks as Winnie Byanyima, Executive Director of UNAIDS and Under-Secretary-General of the United Nations watches on during the UNAIDS report release at Bertha Gxowa Hospital in Germiston, South Africa.
AP
8 Workers in a Nigerian factory package HIV test kits.
REUTERS
'Without reliable data about how HIV is spreading, it will be incredibly hard to stop it,' he said.
The uncertainty comes as a twice-yearly injectable could end HIV, as studies published last year showed that the drug from pharmaceutical maker Gilead was 100% effective in preventing the virus.
At a launch event Thursday, South Africa's health minister Aaron Motsoaledi said the country would 'move mountains and rivers to make sure every adolescent girl who needs it will get it,' saying that the continent's past dependence upon US aid was 'scary.'
Last month, the U.S. Food and Drug Administration approved the drug, called Yeztugo, a move that should have been a 'threshold moment' for stopping the AIDS epidemic, said Peter Maybarduk of the advocacy group Public Citizen.
But activists like Maybarduk said Gilead's pricing will put it out of reach of many countries that need it. Gilead has agreed to sell generic versions of the drug in 120 poor countries with high HIV rates but has excluded nearly all of Latin America, where rates are far lower but increasing.
'We could be ending AIDS,' Maybarduk said. 'Instead, the U.S. is abandoning the fight.'
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She noted that during the urgency of the COVID-19 pandemic, South Africa played a crucial role by testing the Johnson & Johnson and Novavax vaccines, and South African scientists' genomic surveillance led to the identification of an important variant . Labs empty and thousands are laid off A team of researchers at the University of the Witwatersrand has been part of the unit developing the HIV vaccines for the trials. Inside the Wits laboratory, technician Nozipho Mlotshwa was among the young people in white gowns working on samples, but she may soon be out of a job. Her position is grant-funded. She uses her salary to support her family and fund her studies in a country where youth unemployment hovers around 46%. 'It's very sad and devastating, honestly,' she said of the U.S. cuts and overall uncertainty. 'We'll also miss out collaborating with other scientists across the continent.' Professor Abdullah Ely leads the team of researchers. He said the work had promising results indicating that the vaccines were producing an immune response. But now that momentum, he said, has 'all kind of had to come to a halt.' The BRILLIANT program is scrambling to find money to save the project. The purchase of key equipment has stopped. South Africa's health department says about 100 researchers for that program and others related to HIV have been laid off. Funding for postdoctoral students involved in experiments for the projects is at risk. South Africa's government has estimated that universities and science councils could lose about $107 million in U.S. research funding over the next five years due to the aid cuts, which affect not only work on HIV but also tuberculosis — another disease with a high number of cases in the country. Less money, and less data on what's affected South Africa's government has said it will be very difficult to find funding to replace the U.S. support. And now the number of HIV infections will grow. Medication is more difficult to obtain. At least 8,000 health workers in South Africa's HIV program have already been laid off, the government has said. Also gone are the data collectors who tracked patients and their care, as well as HIV counselors who could reach vulnerable patients in rural communities. For researchers, Universities South Africa, an umbrella body, has applied to the national treasury for over $110 million for projects at some of the largest schools. During a visit to South Africa in June, UNAIDS executive director Winnie Byanyima was well aware of the stakes, and the lives at risk, as research and health care struggle in South Africa and across Africa at large. Other countries that were highly dependent on U.S. funding including Zambia, Nigeria, Burundi and Ivory Coast are already increasing their own resources, she said. 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an hour ago
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an hour ago
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