US Funding Withdrawal Risks Millions HIV Deaths, Infections by 2029

Significant progress in the global fight against HIV/AIDS, including a 30-year low in AIDS-related deaths, is now at risk due to the abrupt cessation of U.S. foreign aid directed by President Donald Trump. The withdrawal of approximately $4 billion in funding has led to closures of healthcare facilities, interruptions in HIV testing, and disruptions in supply chains, potentially resulting in more than 4 million AIDS-related deaths and 6 million new HIV infections by 2029, according to the United Nations and UNAIDS reports. In Nigeria, which has relied heavily on external funding such as PEPFAR, these funding cuts have strained HIV response efforts, causing reductions in community testing and service interruptions, although the Nigerian government is attempting to mitigate impacts by increasing local financing and establishing an AIDS Trust Fund. The National Agency for the Control of AIDS (NACA) in Nigeria is calling for sustainable, homegrown strategies and coordinated multisectoral approaches to maintain and advance the HIV response amid declining global donor support. Despite these challenges, advances such as FDA approval for twice-yearly HIV prevention injections offer hope, but the overall weakening infrastructure threatens the ability of individuals and communities to prioritize self-care and maintain progress made over decades. Stakeholders emphasize the urgency of refocusing efforts on national sustainability and strengthening health systems to avoid reversing the gains achieved in combating HIV/AIDS.