By: Al Ballesteros
Photo by: Sergiy Gaydaenko | Dreamstime.com
The World Health Organization (WHO) established World AIDS Day to raise awareness about HIV/AIDS. Today, organizations, including the WHO, the United Nations programme on HIV/AIDS (UNAIDS), and the United States Centers for Disease Control and Prevention (CDC), coordinate efforts to mark the day and combat the epidemic.
“Overcoming disruption, transforming the AIDS response” is the theme of this year’s World AIDS Day. That’s a big ask. Funding cuts here domestically challenge us. And, our support for International AIDS work has been greatly reduced.
If you have been paying attention to our federal policy changes with respect to international programs and those within the United States, this theme seems fitting. Essentially, the US has cut back on funds to poorer countries fighting HIV and there is concern that this will lead to falling backwards in the battle against the pandemic.
The statistics are 40.8 million around the world live with HIV disease. The numbers do continue to grow. There are rich countries and developing countries and poor countries. It’s safe to say, the poorer or developing countries have more challenges with controlling the disease and less resources will make the problem worse.
The United States is making significant cuts to its global HIV funding, with proposed cuts of up to 40% in the 2026 budget request compared to 2024 levels, and roughly 60% of the $4.8 billion allocated for bilateral PEPFAR programs at risk of being withheld.
These cuts have led to a drastic decrease in overall global health development assistance (DAH), with the U.S. contribution dropping significantly and disproportionately affecting low-income countries that depend on this aid.
Since nearly the beginning of the epidemic, the United States has been the world leader in work to stop the spread of disease and improve life expectancy. This has been done through support of HIV testing and prevention work and getting effective medications to those in need. Due to the policy changes in Washington, the support the US provides is being lessened. The International AIDS conference is scheduled in Brazil for next summer. I wonder what kind of a reception will the United States delegation get from the rest of the world.
The US is also cutting back on HIV care and prevention funding. Most of the proposed cuts will happen in the 2026 budget year which recently started. As background information, about 1.2 million people are living with HIV and as many as 31,800 become infected with the virus annually. The funding delays earlier this year led to program cut backs and some destabilization of the system. Proposals would cut domestic programs in: HIV prevention: Some proposals have eliminated all funding for HIV prevention and surveillance at the CDC, including funds for Ending The HIV Epidemic the (EHE) initiative. Ryan White programs, which provide a safety net for people with the disease face significant cuts that will affect clinics that provide care and treatment, and may eliminate funding for specific programs such as the AIDS Education and Training Centers and the Minority AIDS Initiative and funds for dental care.
(NIH): The NIH has faced cuts to HIV/AIDS research, including the elimination of funding for the Consortia for HIV/AIDS Vaccine Development.
Will the Safety net be there for the future?
“Overcoming disruption, transforming the AIDS response” our communities are being asked to focus on raising awareness, combating the stigma associated with HIV, and highlighting the resilience of communities and healthcare systems in addressing the AIDS pandemic, particularly in the face of funding challenges.
We are being asked to recognize the impact of funding cuts on the global response to AIDS. We should all care how this disease is spreading around the world.
Resilience and innovation will need to be explored and also the need for community leadership, political commitment, and human-rights-centered approaches to end AIDS.
Events that aim to reduce stigma and discrimination against people living with HIV are also important to host.
“Overcoming disruption, transforming the AIDS response,” must focus on innovation, addressing inequality, and increasing community and political leadership. Strategies may include implementing new technologies like long-acting injections, removing legal and social barriers, empowering communities to lead local responses, and securing renewed global solidarity and political commitment to ensure sustainable, nationally-owned, and inclusive programs.
Other Strategies for achieving the 2025 theme:
• Integrate HIV services within primary healthcare, including strong community-based programs.
• Scale up new, life-saving technologies such as long-acting anti-retrovirals for both prevention and treatment.
• Strengthen the management of drug resistance and advanced HIV disease.
• Address inequality: Focus on ending the inequalities that drive the epidemic, such as stigma and discrimination; Protect the rights of key populations and vulnerable groups, including women, girls, and LGBTQ+ people, who face disproportionate barriers. We have to ensure access to essential services like housing, nutrition, and utilities that support people in care and help them achieve an undetectable viral load.
• Empower communities and leaders to lead the response, as they are the foundation of the HIV response. Foster renewed global solidarity and commitment from the international community. We must elect political leadership to advance policies that address structural inequalities and protect vulnerable populations.
• Secure funding and resources and address the financing gap by ensuring the international community supports poor countries to bridge funding shortfalls.