Funding for the global HIV response plunged in 2025, entirely due to a steep decline in U.S. support, according to reports from KFF and the Joint United Nations Programme on HIV/AIDS (UNAIDS). 

Taken together, the reports, released at the International AIDS Conference, show decades of progress to combat HIV is at risk. The current HIV response is fragile, and the world is not on track to achieve the 2030 goal of ending AIDS as a public health threat. 

Funding from donor countries to combat HIV in low- and middle-income countries fell by $2.1 billion in 2025, driven primarily by reductions in disbursements from the United States, according to the KFF report.  

A separate UNAIDS report showed that those reductions, combined with cuts to HIV prevention and community services, are likely to lead to a resurgence of the epidemic.  

Total payouts dropped to $6.2 billion in 2025, a 25 percent drop from $8.3 billion in 2024, marking the largest single-year decline since donor funding scale-up began. It represents the lowest funding level since 2007, according to the KFF report.  

The decrease in U.S. contributions was due entirely to the Trump administration’s decision to pull back from open-ended funding for foreign assistance programs under its America First Global Health Strategy, which calls for significant scale-down in U.S. funding for countries in the future, including an estimated $7.3 billion decline over the next five years. 

Other changes made by the administration include freezing and ultimately canceling global HIV projects, and eliminating the U.S. Agency for International Development. The U.S. also eliminated its support to UNAIDS in 2025. 

Despite the cuts, the U.S. remains the top donor to the global HIV effort — which the administration’s strategy seeks to change. Officials have said they broadly want other countries to contribute more.  

The U.S. provided $4.6 billion in 2025, accounting for 74 percent of total donor government funding in 2025, according to the report. The second-largest donor was France, which contributed just $280 million. 

Other donor countries’ HIV funding remained flat in 2025 compared to 2024. Longer-term, their contributions have been declining steadily, dropping nearly 50 percent since 2011. 

“The era of relying on international aid is over,” Winnie Byanyima, executive director of UNAIDS, said in a statement. “Countries cannot wait and they cannot go backwards. The world must urgently fix the broken financial system and accelerate debt restructuring so that governments can invest in what matters most—the health, education and futures of their people.” 

Jennifer Kates, director of the Global and Public Health Policy Program at KFF and one of the authors of the KFF report, said the U.S. contributions were never meant to continue in perpetuity. But the changes were so abrupt that it created a “shock.”  

Kates said there’s no indication that other countries have plans to fill the gap created by the U.S. stepping back. 

At the same time, Congress has continued to appropriate funding for HIV at steady levels, meaning that additional funding remains in the U.S. pipeline and could be spent in the future — but it’s not clear the administration will spend those funds.