As science soars with game-changing HIV tools, a funding crisis threatens to ground progress
“We come together at a pivotal time for the HIV response, one defined by both incredible scientific possibilities and deeply troubling political realities,” said Dr. Beatriz Grinsztejn, the President of the International AIDS Society (IAS), and co-chair of the conference.
The IAS 2025 conference, held both virtually and in Kigali, Rwanda, marked a pivotal moment for the global HIV response, bringing together scientists, policymakers, activists, and communities to confront a dual reality of unprecedented scientific progress in HIV prevention, treatment, and care, and mounting political and financial challenges. In the wake of changes in U.S. budget priorities, global HIV responses are facing rising pressure from unprecedented cuts in funding.
A key focus of the conference is how to fast-track equitable access to long-acting HIV prevention and treatment solutions in the face of these financial challenges.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) recently reported that funding cuts caused by abrupt, massive cuts from international donors put countless lives at risk. According to the report, if the world does not act, there will be six million new HIV infections and four million additional AIDS-related deaths by 2029.
Dr. Grinsztejn said that the current state of the global HIV response is paradoxical, despite unprecedented scientific progress and the availability of tools and innovations to end AIDS as a public health threat, threatening progress.
The evidence of progress is clear. She said that the power of prevention science with long-acting prep is game-changing and offers a pathway towards changing the trajectory of the epidemic in tangible ways. The pipeline of even simpler and smarter ART regimens is making the management of HIV more people-centered. New mRNA-based strategies are showing promise in reactivating dormant viruses, an exciting step in cure research. The science of community-led monitoring has become crisper, serving as an early warning system to improve decision-making, said Dr. Grinsztejn.
She praised the unwavering efforts of leading African researchers in the search for an effective HIV vaccine, even as the global HIV movement faces renewed pressure from budget cuts, declining political will, and deepening inequality, and said their response, long-rooted in activism, science, and community, is once again under serious strain.
“Science remains the backbone of our response.”
“It always has been, and it must continue to guide our response. It was science that gave us highly antiretroviral therapy, PrEP, PEP, and U equals U. It is science that must continue to drive innovation, from long-acting injectables to vaccines and a potential cure,” she said. “To do this, the independence and integrity of health institutions and universities, of researchers and medical experts, must continue to drive us towards evidence-based solutions.”
In a call for accountability, Dr. Grinsztejn criticized the lack of transparency around the pricing of a new HIV prevention drug made available through the Global Fund, arguing that this lack of openness undermines equity for middle-income countries.
“Not to disclose the price at which the drug will be procured diminishes the negotiating power of countries outside of the Global Fund… This must change,” she said.
Dr. Jeanine Condo, co-chair of the conference, said the global HIV response stands at a critical juncture, marked by both crisis and opportunity, adding that hosting the conference in Africa is not merely symbolic but essential to the continent’s role in addressing the epidemic.
Africa remains one of the regions most affected by funding cuts and political uncertainty, Dr. Condo said. At the same time, she said that the continent’s leadership, resilience, and scientific excellence are at the heart of the HIV response. She said the conference celebrates African progress and recognizes the vital contributions of the continent’s scientists, healthcare workers, and communities who continue to drive innovation and hope.
“We cannot and will not allow the current crisis to erase over 40 years of hard-won progress in HIV response… We must work together to move from donor dependency to true national, regional, and global ownership,” said Dr. Condo.
“Many African countries are already stepping up, increasing domestic financing, and building more sustainable systems. But this cannot be done alone.
“We have seen the launch of the Kigali Call to Action signed by you, by scientists, policymakers, and activists as a rallying cry across continents to protect progress in the response to HIV. We must work together to move from donor dependency to true national, regional, and global ownership.”
She said many countries are burdened by historic public debts, which strain already limited resources for health and HIV services. She called for renewed national and global commitments to create the conditions where communities can lead and called for the need for global solidarity to sustain the HIV response.
“Together, we are stronger, and together, we will rise to meet the challenges,” said Dr. Condo.
“We have the tools to turn the corner on HIV.”
In his address to IAS 2025, Dr. Tedros Adhanom Ghebreyesus, the Director General of the World Health Organization, said that the sudden withdrawal of funding for HIV programs is causing huge disruptions in access to life-saving services in many countries.
Dr. Tedros raised alarm over the abrupt cuts in HIV funding, warning that they are disrupting critical services and threatening decades of progress in treatment and prevention. “For over two decades, sustained investments have led to groundbreaking advances in treatment, prevention, and care for millions of people,” he said. “We cannot let that progress slip away.”
He called for governments, scientists, civil society, and affected communities to stand together to uphold those gains and shape a new sustainable path rooted in shared responsibility and equity.
“We have the tools to turn the corner on HIV…,” he said. “WHO is proud to be releasing our new guidelines on the first injectable prophylaxis, Lenacapavir PrEP, along with injectable antiretrovirals for treatment. But these powerful medicines are only useful if we can get them to the people who need them.”
“It’s critical to ensure that services and systems are maintained to deliver these game-changing innovations and other critical medicines,” he said. “But in every crisis lies opportunity. Many health ministers and leaders have told me that they see this crisis as an opportunity to leave behind the era of aid dependency and move toward sustainable self-reliance by mobilizing domestic resources.”
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Dr. Tedros said that the WHO is supporting them in doing that and sustaining critical services, including for HIV.
As a signatory to the Kigali Call to Action, he called for renewed leadership commitment… support global HIV research, prioritize HIV prevention, protect human rights, and reject the politicization of science and scientific institutions.
The Kigali Call to Action is a global appeal issued during the 13th International AIDS Society (IAS) Conference on HIV Science, held in Kigali, Rwanda. This call is a direct response to the urgent threat posed by significant international funding cuts, particularly the suspension of U.S. government support through the President’s Emergency Plan for AIDS Relief (PEPFAR), which has been a cornerstone of HIV prevention and treatment in Africa and other regions for decades. The Kigali Call to Action urges governments, development partners, and the global community to protect and sustain the progress made in the fight against HIV, warning that without immediate action, years of hard-won gains could be lost and HIV infections and deaths could rise dramatically.
Without this action, modelling studies predict thousands of additional HIV infections and deaths, particularly in sub-Saharan Africa, reversing progress toward global targets to end AIDS as a public health threat by 2030.
“WHO remains steadfast in our commitment to achieving the end of AIDS in our lifetime… not as a luxury for some, but a right for all,” said the WHO Director-General.
