Key highlights:

• UNAIDS warns that HIV infections could surge over six times by 2029 if U.S. support ceases.
• Current funding from the United States accounts for about 90% of some African nations' HIV programs.
• The recent announcement of a freeze on U.S. foreign assistance raises concerns over critical health impacts in affected countries.

The head of UNAIDS, Winnie Byanyima, has issued a dire warning regarding the potential escalation of new HIV infections if the United States withdraws its support for global AIDS initiatives. Byanyima emphasized that the number of new cases could increase more than sixfold by 2029 if U.S. funding is cut, highlighting the critical importance of American contributions to the fight against the epidemic.

Recent trends have shown a decline in HIV infections, with 1.3 million new cases reported in 2023—a 60% drop since the virus peaked in 1995. However, the looming threat of a funding freeze, implemented following President Trump’s announcement of a 90-day suspension of foreign assistance, has stirred alarm within the global health community.

Byanyima explained that projections suggest by 2029, the tally of newly infected individuals could soar to 8.7 million, with deaths from AIDS-related issues rising dramatically to 6.3 million, resulting in 3.4 million children left orphaned. She stated, “People are going to die because lifesaving tools have been taken away from them,” while further stressing that the funding gap is already causing widespread disruption in essential healthcare services across several nations in Africa.

According to estimates, external funding—primarily from the U.S.—is crucial for the operational budgets of HIV programs in various countries, covering nearly 90% of their financial needs. Already, significant layoffs of health workers have occurred, including in Kenya where 550 HIV-related jobs were lost. Byanyima noted that without U.S. support, many global health initiatives, including the lifesaving antiretroviral treatments, would face unprecedented challenges.

A new prevention tool, lenacapavir, developed by the American company Gilead, represents hope in combating HIV but relies on sustained funding for widespread implementation. Byanyima stressed the urgency of a collaborative effort, appealing for a reassessment of U.S. foreign aid allocations. She noted that foreign assistance makes up less than 1% of the overall U.S. budget and called for a more measured approach that aligns global health commitments with national interests.

Byanyima is set to engage with European leaders in a bid to secure alternative funding sources, expressing concern that without immediate action, the health systems that have made significant strides in combating HIV will face severe setbacks. “I have not yet heard of any European country committing to step in, but I know they are listening and trying to see where they can come in because they care about rights and humanity,” she concluded, emphasizing the collective responsibility in the fight against HIV.

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