KFF-UNAIDS report shows sharp drop in funding for the HIV response | AIDS 2026

The United States and other developed countries slashed their funding in support of HIV treatment and prevention efforts in low- and middle-income countries by 25% from 2024 to 2025, according to a report from KFF and the Joint United Nations Programme on HIV and AIDS (UNAIDS) released today on the first day of the AIDS 2026 meeting in Rio de Janeiro, Brazil.

Disbursements in 2025 from donor countries totaled $6.2 billion, a decrease of $2.1 billion from the $8.3 billion paid out in 2024, according to the report.

The U.S. accounts for approximately 75% of the donated funds, and cutbacks in its HIV disbursement account for most of the overall declines, according to the KFF-UNAIDS report. In 2024, the U.S. disbursements for the global HIV response totaled $6.7 billion compared with $4.6 billion in 2025, which matched the overall decline of donor government funding of $2.1 billion. That decline works out to a 31% decrease from 2024 to 2025.

But the governments of other countries have also pulled back on how much they give toward the HIV response. When countries other than the U.S. are lumped together, the funding from 2024 to 2025 is flat at $1.6 billion, according to the report, but from 2011 to 2025, it fell by 50% from $3.2 billion. There’s some year-to-year variability, but Australia, France, Germany, Ireland, the Netherlands, and Norway all donated considerably less toward the HIV response in 2025 than they did in 2011.

The report notes that Congress has continued to appropriate funds at a relatively even level, but Trump administration actions that changed foreign policy halted or slowed how much money was actually paid out. In early 2025, the administration dismantled the United States Agency for International Development (USAID) and froze foreign aid. Funds for the main AIDS program, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), were granted a waiver but reoriented toward treatment. USAID implemented many of the programs that PEPFAR funded, so its dissolution affected the flow of HIV funds.

The KFF report notes that because Congress has appropriated funding, “additional funding remains in the U.S. pipeline and could be spent in the future.” But it says that the administration’s America First Global Health Strategy, issued in September 2025, calls for reduced funding in the future. The America First report lauds the accomplishments of global health funding but says it has become “inefficient and wasteful” and calls for a shift to bilateral agreements with governments.

The KFF-UNAIDS report says that bilateral funding by the U.S. decreased by 28% from 2024 to 2025, from $5.4 billion to $3.9 billion.

The report says that U.S. contributions to multilateral organizations, such as UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria, fell by 47%, from $1.3 billion in 2024 to $672 million. The Trump administration eliminated U.S. support of UNAIDS altogether, which in 2024 amounted to $50 million.

The release of the KFF-UNAIDS report was timed to happen at the beginning of a press conference kicking off the AIDS 2026 meeting in Rio, which is expected to have an attendance of approximately 7,000 researchers, policymakers and advocates. Winnie Byanyima, executive director UNAIDS, referenced an emerging theme of the meeting: the tension between notable scientific progress and innnovation amid cutbacks in funding that creates access to the innovations and reversals in human rights.

“Innovation without access is not innovation. It is injustice,” said Byanyima

UNAIDS issued its own report today, titled “United to End AIDS,” that used statistics to outline the progress that has been made in curbing HIV transmission and deaths from AIDS while also sounding the alarm about that progress faltering. The UNAIDS says, for example, that domestic and international funding for HIV prevention programs in sub-Saharan Africa was substantially reduced in 2025 and that there were major declines in pre-exposure prophylaxis (PrEP) in Cameroon, Nigeria and Zambia between 2024 and 2025. South Africa, which the report says has the largest number of people receiving PrEP, saw an 8% decline from 2024 to 2025.

At the press conference, Byanyima said the UNAIDS report documents the “deeply troubling trend around the world." Human rights are moving backwards.” She said 66 countries criminalize same-sex relations, 168 criminalize aspects of sex work, 152 criminalize drug use and 14 criminalize transgender people.

“HIV spreads when rights are denied,” Byanyima said. “Human rights are not separate from the HIV response. Human rights are the HIV response. Human rights are HIV treatment. Human rights save lives.