Reductions in foreign aid could mean 10 million HIV infections by 2030.

In January, the Trump administration ordered all of us to suspend a major moratorium. Funding for foreign aid.

Among other issues, this has a major impact on US funding for HIV. The US is and provides the world's largest donor to international HIV support 73% of funds in 2023.

Most of this is The US President's emergency plan for AIDS relief (PEPFAR) oversees low- and middle-income countries' programs to prevent, diagnose and treat the virus. These programs are It was destroyed significantly.

Furthermore, recent funding cuts in international HIV support have surpassed the US. Five countries that provide the largest foreign aid to HIV (US, UK, France, Germany and the Netherlands) have announced 8% to 70% reductions in 2025 and 2026 for international aid.

Together, this may mean a 24% reduction In addition to US foreign aid, in international HIV spending.

We wanted to know how these cuts would affect HIV infection and death over the next few years. in New researchthe worst-case scenario shows that more than 10 million additional infections will be seen than expected over the next five years.

What is HIV?

HIV (Human immunodeficiency virus) It is a virus that attacks the body's immune system. HIV Can be sent At birth, he is in thorough contact with blood and unprotected gender, including shared needles.

If left untreated, HIV can progress to AIDS (acquired immunodeficiency syndrome). This is a serious and fatal condition in which the immune system is damaged.

HIV was the world's most deadly infection Early 1990s. There is no cure for HIV yet, but modern treatments allow the virus to be suppressed with daily pills. People with HIV who continue to treat them can live without symptoms and are at no risk of infecting others.

Continuous global efforts to awareness, prevention, testing and treatment have diminished 39% new HIV infections per year (From 2.1 million in 2010 to 1.3 million in 2023), and 51% of deaths per year (1.3 million to 630,000).

Most of that decline occurred in sub-Saharan Africa, when the epidemic was at its worst. Today, almost two-thirds of people with HIV live there Sub-Saharan Africaand almost all live in low- and middle-income countries.

Our research

We wanted to estimate the impact of recent funding cuts from the US, UK, France, Germany and the Netherlands on HIV infection and death. To do this, we used us Mathematical Models 26 low- and middle-income countries. This model includes data on international HIV expenditures and data on HIV cases and deaths.

These 26 countries represent about half of all people living with HIV in low- and middle-income countries, and half of international HIV spending. As we worked with the National HIV/AIDS team to set up national models, our data sources reflect the best local knowledge available. We then estimated the findings from the 26 countries we modeled in all low- and middle-income countries.

For each country, we first predicted the number of new HIV infections and deaths that would occur if HIV spending remained the same.

Second, we modeled the expected reduction scenario based on a 24% reduction in international HIV funding in each country.

Finally, in addition to other expected cuts, we modeled the scenario for the possibility of immediate cancellation of PepFAR.

With a 24% reduction and the abolition of PEPFAR, it estimated there were 4.43 million to 1.75 million HIV infections between 2025 and 2030, and between 770,000 and 2.93 million HIV-related deaths. Most of these are due to reduced treatments. Children can have up to 882,400 infections and 119,000 deaths.

In a more optimistic scenario where PEPFAR continues, we estimated there will be 70,000-1.73 million additional new HIV infections and 5,000-61,000 additional deaths between 2025 and 2030, as 24% are still being cut from international HIV funding.

The broad range of our estimates reflects low and middle-income countries, in the best cases, committed to far more domestic funding for HIV. Or reflects the health system dysfunction and persistent gap in financing for worst-case HIV treatment.

Some funds for HIV treatment may be saved by taking that money from HIV prevention efforts, but this will have other consequences.

The scope also reflects the limitations of available data and uncertainties within the analysis. However, most of our assumptions have been cautious, so these results may underestimate the true impact of reducing funding for HIV programs worldwide.

Send progress backwards

If funding cuts continue, the world could see a higher annual rate of new HIV infections by 2030 than the peak of the 1995 pandemic (up to 3.4 million)3.3 million).

Sub-Saharan Africa experiences much greater impact due to the high proportion of HIV treatments that rely on international funding.

In other regions, estimate Vulnerable groups They may experience a 1.3-6 times more new HIV infections than the general population, including those who inject drugs, sex workers, men who have sex with men, and people of trans and gender diverse.

Received by Asia Pacific USD 591 million It is the second highest in HIV international funding in 2023, after sub-Saharan Africa. So This area HIV could rise significantly as a result of the expected funding cuts.

Especially more than that 10% of new HIV infections It is estimated that among people born in Australia, it was acquired overseas. The more HIV there are in the region, the more HIV there is, the more HIV there is in Australia.

However, concerns are the biggest for countries affected by HIV and AIDS, many of which are most affected by international funding cuts.

Rowan Martin-Hughes is a senior researcher at the Burnet Institute.

Debra Ten Brink is Senior Research Director at the Burnet Institute.

Nick Scott is Head of Modeling and Biostatistics at the Burnett Institute.

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