World AIDS Day was commemorated by the U.S. government on the first day of December every year since 1988 to honor those who have lost their lives to the disease, until this year. The White House made the decision this year not to commemorate World AIDS Day for the first time since the tradition was established, with promotion through official communication channels being prohibited for federal employees. This decision aligns with what UNAIDS has described as the most significant setback to the global HIV response in decades.

The organization attributes this decline to the 2025 funding crisis, driven by the White House’s cancellation of foreign aid for HIV/AIDS research and prevention, as well as the depletion of the President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR is the U.S. government’s global HIV program established under President George W. Bush. The Guardian reports that PEPFAR is estimated to have prevented 25 million early HIV/AIDS-related deaths.

Nearly a year after the onset of the crisis, HIV/AIDS poses a greater threat to the global population than it has in recent years. The impact on HIV/AIDS in developing countries is especially severe, as they tend to rely most heavily on these resources.

A 75% Halt in Global HIV Funding

According to the UNAIDS’ 2025 World AIDS Day report, the U.S., the world’s largest economy, was the largest donor to the HIV/AIDS response, providing 75% of all international funding. This was until funding was halted earlier in the year, with other members of the international community, particularly European countries, caving to pressure from the White House to divert funding from foreign aid toward national defense spending, as reported by Reuters.

The report revealed that by the end of 2024, before the funding crisis began, the world was closer than ever to achieving SDG 3’s goal of eradicating AIDS worldwide by 2030. Of the 40.8 million people living with HIV, 31.6 million were receiving lifesaving treatment. Between 2010 and 2024, HIV prevention and treatment services contributed to a 40% decline in new infections and a 54% drop in AIDS-related deaths.

These improvements coincided with increases in funding during the same period, rising 28% domestically and 12% internationally. The 2025 UNAIDS Global AIDS Update reported that sub-Saharan Africa achieved a remarkable 56% decline in new HIV infections between 2010 and 2024. The report also highlighted that five countries, most of them in sub-Saharan Africa, are on track to reduce new infections by 90% by 2030 compared to 2010 levels.

HIV/AIDS in Developing Countries

According to the 2025 UNAIDS Global AIDS Update, by the end of 2024, external funding supported nearly 80% of HIV prevention programs in sub-Saharan Africa, 66% in the Caribbean and 60% in the Middle East and North Africa—making these regions particularly vulnerable amid the funding crisis. The report also noted that the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) had identified more than 60 countries at risk of losing assistance or having their grants reduced, including some that had recently been reclassified as upper-middle-income.

The 2025 UNAIDS World AIDS Day report notes that antiretroviral therapy programs are largely financed domestically outside of sub-Saharan Africa. However, they are particularly vulnerable to donor reductions in western and central Africa, where donors provide 90% of treatment-related funding—53% of which comes from the Global Fund. Some examples of how countries in these regions have been affected include:

• The HIV prevention program in Eswatini lost 20% of its funding between 2024 and 2025, despite a 23% HIV prevalence among people aged 15 to 49.
• The number of people using PrEP (prevention medication) fell by 64% in Burundi, 38% in Uganda and 21% in Vietnam.

What Needs To Change

Despite the challenges facing the global HIV response, UNAIDS executive Winnie Byanyima believes that AIDS can still be eliminated as a public health threat by 2030 through “urgency, unity and unwavering commitment.” The most impactful and simultaneously most challenging path forward is for the international community to help close the funding gap for HIV prevention. According to the 2025 UNAIDS Global AIDS Update, achieving global targets in low- and middle-income countries would require an annual investment of $21.9 billion.

The report also highlights a financial incentive for action, noting that “if the world embraces new technologies, efficiencies and approaches, the annual cost of the HIV response could fall by around $7 billion.” Furthermore, the report notes that community-led organizations have been central to the HIV response for more than 40 years, providing information and support, driving advocacy and conducting critical research. Their impact has been significant enough that multiple countries now permit them to deliver treatment services and receive funding from the Global Fund for community-led and civil society initiatives.

Additionally, the World Health Organization supports expanding access to lenacapavir, a six-monthly injection and a recent advancement in prevention medication, offering hope, despite ongoing funding challenges, in the fight against HIV/AIDS in Developing Countries.

– Luca Hanlon

Luca Hanlon is based in Brooklyn, NY, USA. and focuses on Good News, Politics for The Borgen Project.

Photo: Unsplash