UN warns of catastrophic impact as Trump administration halts $4 billion in HIV/AIDS support

A devastating funding crisis has gripped the global fight against HIV/AIDS, threatening to reverse decades of progress and potentially cost millions of lives. The United Nations AIDS program (UNAIDS) issued a stark warning this week that the sudden withdrawal of US funding could trigger over four million additional AIDS-related deaths by 2029.

The crisis began in January when President Donald Trump ordered the suspension of all foreign aid programs, effectively cutting off the $4 billion that the United States had pledged for global HIV response through the President's Emergency Plan for AIDS Relief (PEPFAR). This massive funding gap has created what UNAIDS Executive Director Winnie Byanyima calls "a ticking time bomb."

The consequences of this funding shortfall are already being felt worldwide. Health facilities have shuttered overnight, thousands of healthcare workers have been sent home, and critical prevention programs have ground to a halt. The disruption has been particularly severe in sub-Saharan Africa, where countries like Nigeria were 99.9% dependent on PEPFAR funding for HIV prevention medicines.

"We have seen services vanish overnight," Byanyima emphasised. "Health workers have been sent home. And people, especially children and key populations, are being pushed out of care."

The timing couldn't be worse. Before the funding crisis, the global community had made remarkable progress, reducing new HIV infections by 40% and AIDS-related deaths by 56% since 2010. However, this progress now hangs in the balance.

According to the latest UNAIDS report, approximately 9.2 million people living with HIV were unable to access life-saving treatment in 2024, including 620,000 children aged 0-14. The lack of treatment resulted in 75,000 AIDS-related deaths among children alone.

UNAIDS modelling suggests that if the US funding disappears permanently, the world could see an additional six million HIV infections and four million AIDS-related deaths by 2029. Such figures would make the UN's goal of ending AIDS as a public health threat by 2030 virtually impossible.

India, home to 2.56 million people living with HIV, faces particular challenges. While the country has made significant strides in reducing HIV prevalence from 0.55% in 2000 to 0.2% in 2023, experts worry about a potential resurgence. The country recorded 64,000 new infections and 32,000 AIDS-related deaths in 2024, with concerning trends among young people.

Dr. I.S. Gilada, president emeritus of the AIDS Society of India, warns of rising infections similar to other sexually transmitted diseases, emphasising the need for increased testing and screening programs.

It is the time of scientific breakthrough as well as the time of a funding crisis that brings unprecedented hope. Recently developed prevention tools such as long-acting PrEP, among them the medicine Lenacapavir, demonstrated close to 100 percent efficacy rate in clinical trials. However, the advances might not be accessible to anyone who needs them most, as funding issues and lack of access to are an obstacles.

Although a few nations have reported having raised their domestic HIV spending, analysts claim that this cannot be substituted by the extent of international funding that is needed by the highly dependent states. Crisis is leading to the request for the solidarity and new funding systems to avoid the huge regressive effect of decades of accomplishments.

With this new and unprecedented challenge, the health community has been ringing a clear alarm as time is running out and action is needed to stop millions of preventable AIDS deaths and to save years of progress in the global AIDS epidemic.