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New tools for prevention and investment in services essential to the fight against AIDS
On World AIDS Day, the World Health Organization (WHO) is calling on governments and partners to rapidly expand access to new WHO-approved tools, including lenacapavir (LEN), to reduce infections and prevent disruptions to essential health services caused by cuts in foreign aid.
Despite dramatic setbacks in funding, the global HIV response gained significant momentum in 2025 with the introduction and WHO approval for twice-yearly injection of lenacapavir for HIV prevention. LEN, a highly effective, long-acting alternative to oral pills and other options, is a transformative intervention for people who face challenges with regular adherence and stigma in accessing health care. WHO announced in July this year new guidelines recommending the use of lencapavir as an additional option of pre-exposure prophylaxis (PrEP) for HIV prevention.
Sharp and sudden cuts in international funding this year have led to disruptions in HIV prevention, treatment and testing services, with key community-led programmes, including pre-exposure prophylaxis (PrEP) and harm reduction initiatives for injecting drug users, scaled back or closed entirely in some countries.
“We are facing significant challenges, with cuts in international funding and delays in prevention,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “At the same time, we have significant opportunities, with exciting new tools with the potential to change the trajectory of the HIV epidemic. Expanding access to these tools for people at risk of HIV everywhere must be the number one priority for all governments and partners.”
Denotation World AIDS Day under the topic “Overcoming Disruption, Transforming the AIDS Response”WHO calls for a two-fold approach – solidarity and investment in innovation to protect and empower communities most at risk.
After decades of progress, the response to HIV is at a crossroads. In 2024:
- HIV prevention efforts have stagnated, with 1.3 million new infections, disproportionately affecting key and vulnerable populations;
- Data from UNAIDS found that almost half (49%) of new HIV infections occurred among key populations – including sex workers, men who have sex with men, transgender women and people who inject drugs – and their sex partners;
- while sex workers and transgender women face a 17 times higher risk of acquiring HIV, men who have sex with men face an 18 times higher risk, and people who inject drugs – a 34 times higher risk;
- underlying drivers include stigma, discrimination, and the legal, social, and structural barriers these groups face in accessing HIV care; and
- globally, an estimated 40.8 million people were living with HIV and 630,000 people died from HIV-related causes.
While the full extent of the impact of cuts in foreign aid is still being assessed, access to PrEP is believed to have fallen dramatically. The AIDS Vaccine Advocacy Coalition estimates that as of October 2025, 2.5 million people who used PrEP in 2024 had lost access to their medication in 2025 solely due to cuts in donor funding. Such disruptions could have far-reaching consequences for the global response to HIV, jeopardizing efforts to end AIDS by 2030.
Momentum for innovation
“We are entering a new era of powerful innovations in HIV prevention and treatment,” said Dr Tereza Kasaeva, Director of the WHO Division of HIV, TB, Hepatitis and STIs. “By pairing this progress with decisive action, supporting communities and removing structural barriers, we can ensure that key and vulnerable populations have full access to life-saving services.”
WHO prequalified LEN for HIV prevention on October 6, 2025, followed by national regulatory approvals that will increase access in South Africa (October 27), Zimbabwe (November 27) and Zambia (November 4). The WHO Collaborative Registration Procedure (CRP) supported these approvals. WHO is also working closely with partners such as CIFF, the Gates Foundation, the Global Fund to Fight AIDS, Tuberculosis and Malaria and Unitaid to enable affordable access to LEN in countries. Ensuring that long-acting HIV drugs for prevention and treatment reach priority populations must be a global priority.
Integration of HIV services into primary health care
WHO emphasizes that ending the AIDS epidemic depends on a fully integrated evidence-based and rights-based approach guided by the umbrella of primary health care. WHO will continue to work with partners and leaders to put those most affected at the center of the HIV response. Despite funding setbacks, resilience and community leadership offer a clear path forward. By strengthening health systems, increasing domestic investment and protecting human rights, countries can preserve gains and ensure that no one is left behind.
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