More than four decades after the beginning of the HIV epidemic, scientific advances have brought hope of ending AIDS. But in sub-Saharan Africa, where prevention programs still rely heavily on international support, shrinking funds and unequal access to new tools threaten to reverse decades of progress.
A fragile success story
For the first time since the early 1990s, global HIV infections and AIDS related deaths have reached their lowest levels. Yet, the progress achieved over the past decades is facing new challenges, particularly in sub-Saharan Africa, the region that remains the most affected by the epidemic.
At the opening of the 26th International AIDS Conference in Rio de Janeiro, the Joint United Nations Program on HIV/AIDS (UNAIDS) warned that the global response could lose momentum if urgent action is not taken. According to the agency, around 1.2 million people acquired HIV and 570,000 died from AIDS related illnesses in 2025.
Although these figures represent major progress compared with the deadliest years of the epidemic, UNAIDS warns that more than three million additional people could become infected by 2030 if current trends continue.
Scientific breakthroughs facing access barriers
The medical response to HIV has entered a new era. After decades of daily pills, new prevention options are emerging, including long acting injectable treatments that could provide protection against HIV for several months.
However, scientific progress alone cannot stop the epidemic if people who need these innovations cannot access them. UNAIDS Executive Director Winnie Byanyima insists that the real challenge is no longer only developing new medicines, but ensuring that they reach communities at an affordable cost.
In several African countries, efforts are being made to expand access to preventive treatments. South Africa, for example, is negotiating the price of lenacapavir, an injection administered twice a year for HIV prevention. Ethiopia and Uganda have also mobilized resources to increase access to preventive services.
But access remains limited. Only a small number of people currently benefit from these new prevention tools, while UNAIDS estimates that 20 million people worldwide would need access to antiretroviral based prevention to significantly reduce new infections.
Africa threatened by the funding crisis
The greatest concern for sub-Saharan Africa is the decline in international financing. In 2025, global development assistance recorded its sharpest fall, while international funding dedicated to HIV dropped from 8.8 billion dollars in 2024 to 7.3 billion dollars in 2025.
For many African countries, the consequences could be severe. International partners have historically financed a large part of HIV prevention activities, especially in low income countries where domestic resources remain limited.
This financial pressure is already affecting programs on the ground. In some countries, funding for condoms has fallen by more than 90 percent. Community based HIV services have also declined significantly, reducing access to prevention, testing and support programs for vulnerable populations.
Human rights remain central to the response
Beyond financial challenges, UNAIDS is also concerned about the growing
criminalization of communities most exposed to HIV. The agency warns that restrictive laws targeting certain populations can discourage people from seeking testing, prevention services and treatment
According to Winnie Byanyima, ending AIDS will not be possible without protecting human rights and reducing stigma against people living with HIV.
For Africa, the coming years will therefore be decisive. The continent has benefited from major scientific advances and stronger health systems, but these achievements remain fragile. Without sustainable financing and equitable access to new prevention tools, the progress made against HIV could be threatened.
The world now has the scientific capacity to end AIDS as a public health threat. The challenge is ensuring that these solutions reach the people who need them most.
