HIV funding falls short of targets: What’s at stake

Global pledges leave gaps in treatment and prevention, threatening progress for millions in Africa

- MELANIE BISNAUTH

THE US government paused all foreign assistance in January 2025. This abrupt decision affected the delivery of lifesaving HIV medicines and the provision of HIV prevention services to millions of people.

A UNAIDS report estimates there could be an additional 6 million new HIV infections and 4 million AIDS-related deaths by 2029 if the world does not act.

In November 2025, a global health initiative, The Global Fund, raised $11.34 billion (R221.13bn) for HIV/ Aids, tuberculosis and malaria.

This article discusses how far this latest funding could go and how African nations can tackle the dwindling funding for HIV/Aids control.

What is the funding status for HIV/Aids?

Raising $11.34bn is significant but it falls short of the $18bn target. The Global Fund is trying to raise $18bn for its work from 2027 to 2029. The Global Fund is a worldwide partnership to end the epidemic of HIV/Aids, tuberculosis and malaria and ensure a healthier, safer and more equitable future for all. It is only a partial response to the global funding gaps.

The US pledged $4.6bn to the Global Fund during the fund's summit in November 2025, on the side of the G20 meeting in South Africa. It was a reduction from its previous pledge of $6bn to support prevention, treatment, care and related services for the three diseases. But it is also an indication that the US has not abandoned all multilateral global health efforts. It remains the largest single contribution to the Global Fund 2027 to 2029 cycle. The shortfall may strain existing programmes and delay expansion of lifesaving interventions for HIV/Aids, tuberculosis and malaria.

HIV remains a major global public health issue, having claimed an estimated 44.1 million lives to date. An estimated 40.8 million people were living with HIV at the end of 2024, 65% of whom are in the WHO African region. Job losses could create inefficiencies or service reductions.