The Global HIV Prevention Coalition urges the United States Government to continue its global leadership role
For the past two decades the United States Government has been an exemplary and steadfast leader in HIV prevention, providing two-thirds of international financing for HIV prevention in low- and middle-income countries. However, a 90-day pause in United States foreign development assistance issued by the United States Government on 20 January 2025 has thrown progress in global HIV prevention into turmoil.
The high-quality HIV prevention and treatment programmes supported by the U.S. Government over the past 20 years, including during the first Trump administration, have been highly effective. In 2024, the United States Government provided over 83.8 million people with critical HIV testing services in 55 low- and middle-income countries, reached 2.3 million adolescent girls and young women with HIV prevention services, and enrolled 2.5 million people on pre-exposure prophylaxis (PrEP, medicine to prevent HIV infections). | If the United States Government does not continue funding for the global HIV response and no alternative funding is secured, UNAIDS estimates that there would be an additional 350,000 new HIV infections in children, an additional 8.7 million new HIV adult infections, 6.3 million AIDS-related deaths, and 3.4 million additional AIDS orphans by end of 2029. |
HIV prevention is one of the life-saving programs which has been most affected by the pause in funding from the United States Government. Dozens of countries are reporting disruptions of services such as PrEP delivery and community outreach, which is essential for HIV prevention because a large proportion of people at risk for HIV infection cannot be reached through government clinics.
Just at a moment when new American-developed scientific innovations for long-acting prevention could speed up the decline in new HIV infections, the U.S. suspension of HIV prevention is a huge setback to the global HIV response which could derail international efforts to end AIDS by 2030.
A new, injectable medicine, lenacapavir, developed by Gilead, a U. S. pharmaceutical company, has proven to be more than 95% effective in preventing HIV when administered twice a year. If lenacapavir is made available, affordable and accessible to people most at risk for HIV, it would be a game-changing intervention and prevent a substantial number of new HIV infections in the U.S. and globally.
The Global HIV Prevention Coalition urges the United States Government to seize this pivotal moment and help make this groundbreaking medicine available and accessible to everyone in need of HIV prevention.
Access to long-acting prevention options will require a rapid and bold collaboration between the US Government, the Global Fund to Fight AIDS, Tuberculosis and Malaria, pharmaceutical industry, UN agencies, countries, partners, and communities around the world to ensure these options are accessible and affordable with speed and scale for people in greatest need.
2025 will decide if these new, highly effective HIV technologies will remain small-scale science undertakings with limited impact, or whether the field will realize a global vision and market with ambitious targets for these products, so that they become real choices for people and accelerate the reduction of new HIV infections.
There has already been a concerning 30% reduction in donor supported condom procurement over the past decade, contributing to a rise in other sexually transmitted infections. This is a strong reminder that progress in the global HIV response cannot be taken for granted, even for a low-cost product like condoms.
With 1.3 million new HIV infections in 2023 - three times more than the global 2025 target of fewer than 370 000 - this is not the moment to reduce funding for HIV prevention. It is a choice between using new opportunities to progress towards ending AIDS as a threat to public health by 2030 or open the floodgates for a rising HIV epidemic to the next generation.
The Global HIV Prevention Coalition urges the United States Government to continue its exceptional leadership in HIV prevention and seize new technological opportunities to end AIDS by 2030. The Coalition also calls on other donors and private sector partners to step up their efforts in supporting HIV prevention for young people, women, men, key populations and other communities most affected by HIV.
About the GPC
In 2017, a global coalition of United Nations Member States, donors, civil society organizations, and implementers was established to support global efforts to accelerate HIV prevention. Membership includes 38 of the highest HIV-burden countries, UNAIDS Cosponsors, donors, civil society, and private sector organizations. The overarching goal of the Global HIV Prevention Coalition is to strengthen and sustain a political commitment to primary prevention by setting a common agenda among key country policy-makers, funders, and programme implementers.