The world could face a resurgence of the HIV epidemic after international funding fell sharply in 2025, threatening decades of progress in prevention and treatment, UNAIDS warned on Monday.
In a new report released at the start of an international AIDS conference in Brazil, the UN agency said global HIV funding had entered a period of severe political and financial uncertainty.
International support fell by 18% last year to $7.3 billion, the lowest level recorded in nearly two decades, according to the report.
UNAIDS warned that the decline could reverse gains that have pushed new HIV infections and AIDS-related deaths to their lowest levels in more than 30 years.
“The international community has entered a period of profound political and financial upheaval that threatens decades of hard-won gains against HIV,” the agency said.
It added that without renewed political commitment and financial support, the world risked a renewed spread of the virus.
The United States had previously provided around 75% of international HIV funding. After returning to the White House in January 2025, President Donald Trump temporarily suspended HIV-related foreign assistance.
Funding for life-saving treatment programmes was restored several days later, but many prevention initiatives remained restricted.
UNAIDS said the global target of ending AIDS as a public health threat by 2030 was now off track, with reduced funding and competing health emergencies, including Ebola outbreaks, placing further pressure on already fragile systems.
Around 1.2 million people contracted HIV in 2025, according to the report.
Higher domestic spending by some governments helped partly offset the fall in foreign assistance, limiting the overall decline in global HIV resources to 6%.
However, many lower-income countries were unable to replace the lost funding.
Some of the sharpest reductions in prevention spending were recorded in sub-Saharan Africa, which accounts for roughly half of all new HIV infections worldwide.
National figures from Cameroon, Nigeria and Zambia showed that the number of people receiving pre-exposure prophylaxis, commonly known as PrEP, fell by more than 50%.
UNAIDS said the funding disruption had severely affected HIV testing, prevention services, treatment support and community-led programmes serving populations most vulnerable to infection.
The agency called for international solidarity to be restored and for inequalities in access to HIV services to be addressed before recent gains are lost.