UNAIDS Executive Director Winnie Byanyima has expressed alarm over a crisis in the global HIV response, urging the international community to rally behind a renewed effort to prevent millions of new infections and deaths.
In a statement accompanying the latest UNAIDS report, Byanyima revealed that by the end of 2024, remarkable gains had been made in the fight against HIV.
“This report shows that at the end of 2024, just before a sudden collapse in funding triggered a crisis in the global AIDS response, the remarkable efforts of communities and governments had brought down the numbers of new HIV infections by 40% and of AIDS-related deaths by 56% since 2010,” she said.
However, she cautioned that significant gaps remain.
“It also shows that huge gaps in HIV prevention remained, with 1.3 million new infections in 2024—almost unchanged from the year before,” she said.
Byanyima highlighted the promise of medical innovation as a potential game-changer.
“We started 2025 excited about a transformative opportunity to tackle HIV with lenacapavir, a new long-acting medicine that can prevent HIV infection with twice-a-year injections. This is just one of a suite of new long-acting medicines. Within the next few years, annual injections and monthly tablets to prevent HIV could be a reality.”
She added that such developments could herald an “HIV prevention revolution” but only if access is widened.
“We could be on the verge of an HIV prevention revolution that reduces new infections towards epidemic control if the world comes together again to overcome monopolies, drive down prices, and ensure everyone who could benefit has access to these new, highly effective prevention tools.”
Troublingly, a major disruption occurred in early 2025 following the withdrawal of the single largest donor to the global HIV response.
“The sudden withdrawal of the single biggest contributor to the global HIV response disrupted treatment and prevention programmes around the world in early 2025,” she said, noting that international aid accounts for 80% of prevention programs in low- and middle-income countries.
According to UNAIDS modeling, if this funding loss becomes permanent, the consequences could be devastating:
“There could be an additional 6 million HIV infections and an additional 4 million AIDS-related deaths by 2029.”
Adding to the concern, Byanyima noted a reversal in global human rights progress, “The number of countries criminalizing the populations most at risk of HIV has risen for the first time since UNAIDS began reporting.”
Despite the funding crisis and shrinking civic space, communities have stepped up.
“When formal systems broke down in Ethiopia, young volunteers formed WhatsApp groups to check on their peers, mothers banded together to support children’s treatment, and youth collectives used community radio to share health information.”
Byanyima acknowledged that while the traditional model of global HIV financing may be nearing its end, a new framework is emerging.
“The consensus behind the old model of financing the HIV response may be coming to an end, but the international community is forging a new, more sustainable path.”
At a major international conference in Seville, countries agreed to explore progressive reforms to boost domestic investment.
“Nations embraced calls for debt relief, international tax cooperation and reform of international financial institutions—the first steps towards a new economic settlement that can give countries the fiscal space needed to invest in the global HIV response.”
She praised progress in domestic HIV financing, noting that 25 out of 60 low- and middle-income countries have already found ways to increase their investment into 2026.
“This is the future of the HIV response—nationally owned and led, sustainable, inclusive and multisectoral.”
Still, she warned that global support remains essential, “This transformation cannot happen overnight. Global solidarity and renewed commitment from funding partners will be needed as countries plan and lead sustainable transitions towards self-financing.”
Ending AIDS, she emphasized, is within reach, “The HIV response has already saved 26.9 million lives. With an HIV prevention revolution, we could end AIDS as a public health threat, saving many more lives.”
And the shift could bring significant economic benefits, “It could be better value for money too: UNAIDS estimates that if the world embraces new technologies, efficiencies and approaches, the annual cost of the HIV response could fall by around US$ 7 billion.”
Byanyima noted that the AIDS response may be in crisis, but there is power to transform. Communities, governments and the United Nations are rising to the challenge.
