THE SUDDEN REVERSAL of United States (‘US’) funding for the global fight against HIV shocked the world in January 2025. The immediate rise in deaths and new HIV infections in Africa has been devastating, and modeling studies predict a durable impact. These cuts abandoned evidence-based practices, further stigmatized key populations, and endangered decades of progress built on a human rights approach to HIV care and prevention.
In this analysis, we will review the human toll of cuts to the President’s Emergency Plan for AIDS Relief (‘PEPFAR’) and United States Agency for International Development (‘USAID’) through the lens of HIV in Africa and consider the implications for the future of the pandemic globally and in the US.
HIV in 2026
The HIV pandemic evolved from a global catastrophe to an inspirational triumph of the power of activism, collective action, public health, and science. Among the remarkable global achievements to date are 31 million people with HIV (PWH) receiving treatment, a 57 percent decline in new infections, a decline in annual deaths from 2.5 million to 600,000, and serious planning to end the epidemic in some regions. An integral part of this evolution was a human rights-based approach that offered the best framework for understanding the disease and for effective, evidence-based prevention, treatment, and public policy.
Despite substantial progress, the HIV pandemic remains volatile and uncontrolled in 2026. Momentum towards 95 percent coverage of People living with HIV (‘PLWH’) with antiretroviral therapy (‘ART’) has stalled, with 25 percent still untreated, and HIV incidence remains high. Every day, 1500 girls and young women in Africa, 1500 members of key populations, and 330 children acquire HIV worldwide, resulting in 1.3 million new infections in 2024. HIV incidence rates continue to rise in Eastern Europe, Central Asia, South America, and in conflict regions, and outbreaks continue in key populations in all countries.
