The head of United Nations Aids has warned that recent cuts to US funding could result in 2,000 additional HIV infections daily and over six million deaths within the next four years. These cuts pose a serious setback in the global fight against HIV, which had previously seen annual deaths drop from over two million in 2004 to 600,000 in 2023. Winnie Byanyima, UNAids Executive Director, expressed concern that the US government's suspension of foreign aid, which includes HIV programme funding, is already having severe consequences. She urged Washington to reconsider the cuts, emphasizing that women and girls are particularly vulnerable. The funding pause was announced by US President Donald Trump on his first day in office this January, as part of a broader review of government spending. Since then, most USAID programmes have been halted.
Many HIV treatment and prevention initiatives funded by the US have received orders to cease operations. This has led to the closure of mother-and-baby clinics in Africa and critical shortages of life-saving antiretroviral (ARV) medications.
Byanyima expressed fears that the situation could mirror the 1990s when limited access to HIV treatment in poorer countries resulted in surging infection rates and deaths.
The US has long been the largest contributor to global HIV treatment and prevention efforts. While Byanyima acknowledged Washington’s past generosity, she cautioned that the abrupt withdrawal of support is causing devastating effects.
Despite urgent appeals, there has been no indication that the US government plans to reverse its decision.
Funding challenges are not limited to the US, European donors are also planning reductions, and UNAids has yet to secure alternative funding to fill the gap.
In Geneva, Byanyima shared the story of Juliana, a Kenyan woman living with HIV. Juliana had worked with a US-funded programme that supported mothers in accessing treatment to protect their babies from HIV. With the programme suspended, Juliana not only lost her job but also worried about losing her own treatment while still breastfeeding her youngest child.
The World Health Organization (WHO) previously warned that eight countries, Nigeria, Kenya, Lesotho, South Sudan, Burkina Faso, Mali, Haiti, and Ukraine, risk running out of HIV medications due to the funding freeze. WHO Director-General Tedros Adhanom Ghebreyesus cautioned that this disruption could reverse two decades of progress in fighting HIV.
In South Africa, the Treatment Action Campaign (TAC) warned that the country could once again face major obstacles in providing HIV treatment services. TAC Chair Sibongile Tshabalala stressed that "we can't afford to die" and called for urgent action to prevent a return to past struggles.
Byanyima proposed a potential solution to the Trump administration, marketing Lenacapavir, a new long-acting ARV injection developed by US pharmaceutical company Gilead. UNAids estimates that 10 million people could benefit from this treatment. Byanyima emphasized that such a deal would not only save lives but also generate significant economic benefits for the US through profits and job creation.
UNAids is one of several UN agencies facing funding challenges. The UN Refugee Agency may lose 6,000 jobs, Unicef has warned of setbacks in reducing child mortality, and the World Food Programme has had to reduce rations in famine-stricken areas.
