How the cuts have shaken HIV/Aids care to its core and will mean millions more infections ahead | Global health
In Mozambique, a young rape victim visited a health clinic but found it closed. AIDS-related deaths have increased in Zimbabwe for the first time in five years. In Ethiopia and the Democratic Republic of Congo (DRC), patients with suspected HIV could not be diagnosed due to test kit stocks being depleted.
Stories about the devastating impact of US, UK and wider European aid cuts on the fight against HIV, particularly in sub-Saharan Africa, continue to mount as 2025 draws to a close and were laid out in a series of reports published last week.
The Trump administration abruptly cut all foreign aid spending in January and has only piecemeal repaired funding since then. Other countries, including the UK, have announced their own cuts. has been estimated foreign health aid During 2025, it will be between 30% and 40% lower than in 2023.
Winnie Byanyima, executive director of USAID, said: “The complex ecosystem that sustains HIV services in dozens of low- and middle-income countries has been shaken to its foundations.”
UNAids predicts there will be 3.3 million more new HIV infections than expected by 2030 unless action is taken quickly to get services back on track. While there are signs of improvement in some countries, including new domestic financing, access is far from universal.
UN agency report It found that services trying to prevent HIV infections were particularly donor-funded and were among those most affected, with treatment of existing patients being prioritized due to limited resources. In Burundi, for example, the number of people taking HIV preventive medication dropped by 64%.
A separate series Country-level reports from British charity Frontline AidsSimilar issues are emphasized in the report covering Angola, Kenya, Malawi, Mozambique, Nigeria, Tanzania, Uganda and Zimbabwe.
It will take time to collect all the figures, but there are already signs that new HIV cases or AIDS-related deaths are rising in some places after years of decline.
Many of the gains made in the fight against HIV in recent years have been achieved by recognizing that certain groups of people, known as “key groups”, are at higher risk of infection. These include men who have sex with men, people who inject drugs, sex workers, transgender individuals and prison inmates.
In each case, services designed specifically for the needs of these groups bore fruit; For example, LGBTQ+-friendly walk-in clinics could mean access to care for people who stay away from public clinics due to HIV-related stigma.
Many of these clinics and other outreach services have closed, along with community-led organizations that were previously dependent on donor funds. A member of Uganda’s LGBTQ+ community said the loss of safe spaces has left them “isolated and vulnerable”, according to a Frontline Aids country report […] The mental strain is huge.”
Across sub-Saharan Africa, teenage girls and young women are disproportionately affected by HIV, but programs designed specifically for them are another common victim of cuts.
In Kenya, activists report that people who can do this are hiding the fact that they belong to a key population so that they can safely access care in public clinics. They fear this will mean a loss of information about where and how the virus is spreading.
John Plastow, chief executive of Frontline Aids, said: “We are already seeing progress going backwards.”
But Plastow also saw the potential for a health policy reset. “In many countries,” he said, “we are seeing early signs that governments and communities are working together to create more sustainable, homegrown HIV interventions.”
UNAids also pointed to signs of hope, with countries such as Nigeria, Uganda, Ivory Coast, South Africa and Tanzania pledging to increase domestic investment.
And innovations such as new, long-acting injectable drugs to prevent infection are “gaining momentum”, they said.
“We know what works; we have the science, the tools, and the proven strategies,” Byanyima said. “What we need now is political courage: investing in communities, prevention, innovation and protecting human rights as the path to ending AIDS.”
