A critical combination of dwindling financial support and a rise in repressive legislation globally is significantly increasing the likelihood of a new HIV epidemic, according to a stark warning from UNAids, the international agency dedicated to tackling Aids. Winnie Byanyima, head of UNAids, highlighted that this represents the most substantial disruption to the global HIV response since its inception, posing a severe threat to years of hard-won progress.
Despite annual new HIV infections and Aids-related deaths reaching record lows, a new UN report underscores the serious risk of a resurgence unless there is renewed global commitment and action. Last year, 570,000 Aids-related deaths were recorded, alongside 1.2 million new HIV infections. However, an unprecedented 23% fall in aid spending has led to a sharp decline in HIV testing in 2025 within countries most affected by the virus. One programme alone saw testing drop by 22% year-on-year, a figure Byanyima described as “huge,” meaning more people remain unaware of their status, potentially leading to further transmission and increased fatalities due to delayed treatment.
Prevention services, including condom distribution and pre-exposure prophylaxis (PrEP) medication, have also been severely impacted by these aid cuts. Byanyima noted that these services were already underfunded, receiving only 11% of HIV spending in low and middle-income countries in 2024, and now face complete disappearance of funding. While some domestic funding has emerged, it often prioritises treatment over prevention, leading to predictions of rising new infections and deaths in the coming years.
Adding to these challenges, the report identifies a continuing increase in countries enacting new or more restrictive laws against same-sex relations. Such legislation risks undoing decades of progress by alienating the very individuals who most urgently require HIV services. Byanyima also pointed to the detrimental effect of laws designed to restrict civic space, citing Uganda's 'sovereignty bill' as an example, which limits external funding and operational capacity for civil society groups. Community-led organisations, crucial for delivering HIV services to vulnerable populations, are consequently disappearing, with one survey revealing an 85% reduction in services for men who have sex with men and an 82% reduction for sex workers across 79 organisations in 47 countries.
Despite these significant threats, Byanyima acknowledged opportunities, such as new prevention methods including the twice-yearly injectable drug lenacapavir. However, she stressed that these innovations would need to be scaled up dramatically to effectively ‘bend the curve’ of the epidemic. The agency itself faces an uncertain future, having been impacted by previous funding cuts from the Trump administration, with the UN Secretary-General proposing its 'sunset' by the end of this year. Byanyima indicated that proposals for a smaller, more dispersed programme would be presented to the UNAids board in October, aiming to retain a central hub for global leadership.