International donor funding for HIV programmes in low and middle-income countries fell by US$2.1 billion in 2025. This represents the steepest annual decline since global HIV financing began. The 25% reduction brought donor government disbursements to US$6.2 billion, down from US$8.3 billion in 2024, reaching the lowest level since 2007.
This significant drop raises serious concerns about the continuity of vital HIV prevention and treatment services worldwide. The decline is largely attributed to reduced disbursements from the United States, which is the world’s largest HIV donor. This funding crisis has already disrupted community-led HIV prevention, testing, treatment, and support services in many nations.
Ghana, like many other African nations, has made strides in its fight against HIV/AIDS, but still relies on international support for a portion of its programmes. A reduction in global funding could strain Ghana's healthcare system, potentially impacting the availability of antiretroviral therapy and prevention initiatives. The country's AIDS Commission reported a decline in new HIV infections and AIDS deaths in 2025, a trend that could reverse if funding shortfalls persist. This situation underscores the need for increased domestic investment in health, a recurring theme in Ghana's economic discourse.
The findings are detailed in the joint report, "United to End AIDS," by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and KFF, an independent health policy research organisation. The report was launched at the 26th International AIDS Conference in Rio de Janeiro, Brazil. Ms. Winnie Byanyima, Executive Director of UNAIDS, stated that the global HIV response has entered an immediate funding crisis. She warned, "Never has donor funding fallen so far, so fast."
Countries that depend heavily on external financing, sometimes for nearly 60% of their HIV programmes, are already scaling back prevention programmes. They are also reducing community services and limiting access to lifesaving treatment. This could lead to a resurgence in new infections and increased AIDS-related deaths, reversing years of progress. Decision-makers and global health organisations will closely monitor the impact of these cuts on national HIV responses and the broader public health landscape.
Despite the funding decline, the report highlighted significant progress in controlling the epidemic. New HIV infections fell by 42% between 2010 and 2025, decreasing from 2.1 million to 1.2 million. AIDS-related deaths also declined by 57% to 570,000 during the same period. More than 32 million people were receiving antiretroviral therapy in 2025, marking the highest number recorded. Additionally, 87% of pregnant women living with HIV received treatment to prevent mother-to-child transmission.
The report, however, cautioned that the world remains off course to end AIDS as a public health threat by 2030. It estimated that 2025 recorded one million more new HIV infections and 400,000 more AIDS-related deaths than would have occurred if countries had remained on track to achieve global targets. Ms. Byanyima emphasised that recent advances in long-acting HIV prevention medicines make ending AIDS scientifically achievable. She stressed that equitable access is essential, stating, "innovation without access is not innovation; it is injustice."
Ms. Erika Castellanos, Executive Director of the Global Action for Trans Equality (GATE) and a transgender woman living with HIV, noted that political decisions have become a major obstacle. She observed, "Science did not fail. Politics did." Dr. Joe Phaahla, South Africa’s Deputy Minister of Health, urged donor governments and development partners to support a gradual transition as countries increase domestic financing for HIV programmes. The report urged countries to increase domestic investment, strengthen national ownership of HIV programmes, and integrate HIV services into broader health systems.