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The world risks a resurgence of the HIV epidemic as global funding for the response declined sharply last year, the United Nations agency fighting AIDS warned on Monday.

Funding fell by 18% to $7.3 billion in 2025, the lowest level in nearly two decades, according to a UNAIDS report released at the start of an International AIDS conference in Brazil.

The decline threatens decades of progress that have reduced new HIV infections and AIDS-related deaths to their lowest levels in more than 30 years, the report said.

“The international community has entered a period of profound political and financial upheaval that threatens decades of hard-won gains against HIV,” UNAIDS said. “Without renewed commitment and action, the world risks a resurgence of the HIV epidemic.”

The report said the current state of the HIV response remains fragile unless global solidarity is restored and inequalities are addressed.

The global goal of ending AIDS as a public health threat by 2030 is also off track, UNAIDS said, citing reduced funding and other crises, including Ebola, as factors slowing progress. Around 1.2 million people contracted HIV last year.

Foreign Funding Cuts Hit Prevention Programs

The United States previously accounted for 75% of international HIV funding before President Donald Trump returned to the White House in January 2025. That month, Trump ordered a temporary halt to all HIV-related funding before restoring life-saving HIV programs days later, although most prevention efforts were curtailed.

Cuts in foreign funding were partly offset by increases in domestic spending, limiting the overall decline in HIV resources to 6% last year, according to UNAIDS.

However, many governments were unable to replace lost international support. Some of the largest reductions in prevention spending occurred in sub-Saharan Africa, a region that accounts for about half of new global HIV infections.

National data from Cameroon, Nigeria, and Zambia showed that the number of people receiving pre-exposure prophylaxis, or PrEP, fell by more than 50%.

“HIV funding disruptions severely impacted HIV prevention, testing and key components of treatment programs, such as the range of community-led services that reach the people most affected by HIV,” the report said.