A chilling prediction from UNAids chief Winnie Byanyima warns that US funding reductions will trigger an estimated 2,000 new HIV infections daily and over six million additional deaths within the next four years, potentially reversing decades of progress in combating the disease.
This stark assessment comes as the global fight against HIV has achieved remarkable strides, reducing annual deaths from over two million in 2004 to approximately 600,000 in 2023.
However, the US government’s decision to pause foreign aid, including crucial HIV program funding, has already created devastating consequences, according to Ms. Byanyima.
“The sudden withdrawal of lifesaving support [was] having a devastating impact,” Ms. Byanyima stated, urging the US to swiftly reverse the funding cuts, emphasizing the disproportionate impact on women and girls. The pause, initially intended for 90 days as part of a government spending review, has since resulted in the termination of numerous US Agency for International Development (USAID) programs.
Consequences include the issuance of stop-work orders to many US-financed HIV treatment and prevention programs, leading to the closure of vital mother and baby clinics in Africa and severe shortages of life-saving antiretroviral (ARV) medications.
Ms. Byanyima expressed concerns about a potential return to the 1990s, when ARV access was limited in poorer countries, and infection and death rates surged.
The US has long been the largest single contributor to global HIV treatment and prevention efforts. While acknowledging the US’s past generosity, Ms. Byanyima underscored the catastrophic impact of the “sudden withdrawal” of crucial resources, even as she acknowledged it was “reasonable” for the United States “to want to reduce its funding – over time”.
Despite appeals, there has been no indication of a policy shift in Washington. Furthermore, amidst parallel funding cuts from traditional European donors, UNAids sees no indication of other nations compensating for the US funding deficit.
Illustrating the impact, Ms. Byanyima shared the story of Juliana, a Kenyan woman living with HIV who lost her US-funded job supporting new mothers in accessing treatment. “She also feared losing the treatment she needed,” while breastfeeding, after her place of work was closed.
The World Health Organization (WHO) previously highlighted eight countries—Nigeria, Kenya, Lesotho, South Sudan, Burkina Faso, Mali, Haiti, and Ukraine—facing potential ARV shortages.
WHO chief Tedros Adhanom Ghebreyesus warned that disruption to HIV programs “could undo 20 years of progress.” Echoing this sentiment, South Africa’s Treatment Action Campaign (TAC) chair, Sibongile Tshabalala, cautioned that the country “can’t afford to go back to those years where we were suffering with access to services, especially for people living with HIV treatment.”
Ms. Byanyima also presented a potential solution, suggesting the US administration leverage the situation to market the US-developed ARV, Lenacapavir, to millions of people. This six-monthly injection, produced by Gilead, has the potential to benefit an estimated 10 million individuals, with resulting profits and job creation benefiting the United States.
UNAids, alongside other UN agencies like the UN Refugee Agency, Unicef, and the World Food Programme, are grappling with funding reductions, threatening essential programs and services globally.
