In the wake of deep cuts in foreign assistance made by President Donald Trump’s administration, at least 25 countries expect to increase their domestic budgets for efforts to treat and prevent HIV infection and AIDS, according to a new report from the United Nations. Separately, the government of South Africa, the country with the world’s highest number of HIV infections, last week announced a concrete plan to help fill the funding gap. But a close look at that plan suggests the country will still have to massively scale back its response to its epidemic—a harbinger of what many other countries will likely face.
“I just can’t see how they’re going to make it up,” says Jennifer Kates, director of the Global Health & HIV Policy Program at the nonprofit KFF and co-author of a separate HIV funding report issued on 10 July. Kates notes that some of the countries affected are also scrambling to compensate for the loss of other forms of humanitarian assistance. This funding “crisis” could reverse “decades of progress,” warns the Joint United Nations Programme on HIV/AIDS (UNAIDS), which like KFF released its report on 10 July, on the eve of an international AIDS conference in Kigali, Rwanda. The U.N. report foresees “increased mortality, a surge of new HIV infections, and the development of [drug] resistance to the most commonly used treatment regimens.”
In 2024, the U.S. government was by far the largest donor of HIV assistance, providing $6.7 billion for testing, treatment, and prevention, the KFF report documented. But this year the Trump administration partly dismantled the world’s largest HIV support program, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Roughly 60% of PEPFAR’s $4.8 billion has been withheld, and the administration is also attempting to take back $400 million appropriated to the program earlier. Worse may be coming: Trump’s 2026 budget request seeks to cut HIV assistance by at least 40% compared with 2024, though Congress is still hashing out its spending plan.
More: https://www.science.org/content/article/countries-budget-more-hiv-aids-measures-u-s-withdraws-aid
