AIDS 2026, the 26th International AIDS Conference is underway in Rio de Janeiro and it has begun with a stark warning about how funding US funding cuts have had a major impact on the global response and how international goals are not being met.
Funding for the global HIV response plunged in 2025 – entirely due to a steep decline in US support – putting decades of progress at risk, according to reports from UNAIDS and KFF released at the opening of the conference. The event brings together approximately 7,000 scientists, policy makers, healthcare providers, funders and people living with and affected by HIV from around the world.
At a press briefing ahead of the opening session, global health leaders called on donor governments to sustain robust support for the HIV response, and on low- and middle-income countries to continue stepping up their own investments where possible.
“We come to Rio de Janeiro at a moment of real danger for the HIV response,” Beatriz Grinsztejn, IAS President and AIDS 2026 International Co-Chair, said. “Never has donor funding fallen so far, so fast, and those most vulnerable are already paying the price. Donor countries are choosing to walk away while many high-burden countries remain shackled by debt they cannot escape. We must rethink outdated models, rebuild what has been broken, and rise to ensure the response gets the resources it needs.”
The first report, from KFF and UNAIDS, found that the 25% decline in donor government funding marks the largest single-year drop since international funding scale-up began, driven by funding delays and project cancellations tied to changes in the US global health response last year.
The second report, from UNAIDS, published alongside the analysis, found that domestic HIV financing increased by 4% in 2025, accounting for nearly 60% of total HIV funding, as countries worked to offset declines in international support. More than 55 countries have committed to increasing domestic HIV investments in 2026.
The report also found that in 2025, there were 1.2 million new HIV acquisitions and 570,000 AIDS-related deaths as the world fell short of its global AIDS targets. New HIV acquisitions are rising in many countries, including Brazil, Pakistan, the Philippines and Madagascar. At the same time, countries such as Kenya, Lesotho, Rwanda, Zimbabwe and Eswatini continue to make progress towards the 2030 targets despite an increasingly difficult funding environment.
Taken together, the two reports show a global HIV response under more severe strain than at any point since the funding scale-up began in 2002.
“The era of relying on international aid is over,” Winnie Byanyima, Executive Director of UNAIDS, said. “Countries cannot wait, and they cannot go backwards. The world must urgently fix the broken global financial system and accelerate debt restructuring so governments can invest in what matters most: the health, education and futures of their people.”
A chorus of leading health experts called on governments around the globe to ensure sufficient funding is maintained.
“Fund this response like lives depend on it, because they do,” Erika Castellanos, Executive Director of Global Action for Trans Equality (GATE), said. “People living with HIV are not a line item in a budget. We are the ones holding this response together while decisions are made far from their consequences. Let us be in the room when those decisions are made, not informed of them afterwards.”
“African countries must continue to strengthen domestic investment and make HIV a national priority,” Mathume Joseph “Joe” Phaahla, South Africa’s Deputy Minister of Health, said. “At the same time, no country can replace the scale of international partnership that has driven the global HIV response for decades. Ending the HIV pandemic will require stronger domestic financing, sustained international support and shared responsibility.”
“The world has made extraordinary progress against HIV,” Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), said. “New acquisitions and AIDS-related deaths are at their lowest levels in more than three decades. Millions more people are receiving life-saving treatment, and ending AIDS as a public health threat by 2030 remains within reach. But that progress is fragile. We have the tools, the knowledge and the evidence to save lives and prevent new acquisitions. The challenge now is to sustain the commitment, investment and solidarity needed to reach every person who needs prevention, testing, treatment and care, and to finish the job.”
Jarbas Barbosa, Director of the Pan American Health Organization (PAHO) and WHO Regional Director for the Americas, said: “We know how to end HIV as a public health threat. The science, the tools and the evidence are already in our hands. The challenge now is ensuring that every person who needs prevention, testing, treatment and care can access them at a time when progress is threatened. We must strengthen political commitment, invest in resilient health systems, and work together with communities and partners. Through the Alliance for the Elimination of HIV in the Americas and the Path to HIV Elimination, PAHO is supporting countries to accelerate action and ensure that no one is left behind.”
“It is an honour to welcome the world to Brazil for the first International AIDS Conference ever in South America,” Alexandre Padilha, Brazilian Minister of Health, said. “For decades, Brazil has made bold political choices. As one of the first countries to provide free HIV treatment to all who needed it, we have demonstrated that a public health response grounded in science, universal access and human rights can save lives. Now, we must work together to ensure that innovation and equitable access reach every community. Innovation without access is not an innovation. It is an injustice.”
