HIV/AIDS Funding Crisis Risks Reversing Decades of Global Progress

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Health

About 9.2 million people across the world living with HIV were not receiving treatment in 2024, according to the UNAIDS report. At the launch of the report was Rev. Mbulelo Dyasi, Executive Director of SANARELA. Winnie Byanyima, UNAIDS Executive Director, Aaron Motsoaledi, Minister of Health of South Africa. Juwan Betty Wani, Programme Coordinator, Adolescents Girls and young women Network South Sudan. Helen Rees, Executive Director, Wits RHI. Credit: UNAIDS

About 9.2 million people across the world living with HIV were not receiving treatment in 2024, according to the UNAIDS report. At the launch of the report was Rev. Mbulelo Dyasi, Executive Director of SANARELA. Winnie Byanyima, UNAIDS Executive Director, Aaron Motsoaledi, Minister of Health of South Africa. Juwan Betty Wani, Programme Coordinator, Adolescents Girls and young women Network South Sudan. Helen Rees, Executive Director, Wits RHI. Credit: UNAIDS

UNITED NATIONS, Jul 10 2025 (IPS) – UNAIDS called the funding crisis a ticking time bomb, saying the impact of the US cuts to the President’s Emergency Plan for AIDS Relief (PEPFAR) could result in 4 million unnecessary AIDS-related deaths by 2029.


A historic withdrawal of global HIV/AIDS funding threatens to derail decades of hard-won progress in the fight against AIDS, according to UNAIDS’ annual report, entitled Aids, Crisis and the Power to Transform. This funding shortage – caused by sudden and massive cuts from international donors – is already dismantling frontline services, disrupting lifesaving treatments for millions and endangering countless lives in the world’s most vulnerable communities.

“This is not just a funding gap—it’s a ticking time bomb,” said UNAIDS Executive Director Winnie Byanyima.

Despite major strides in 2024, including a decrease in new HIV infections by 40 percent and a decrease in AIDS-related deaths by 56% since 2010, the onset of restricted international assistance, which makes up 80 percent of prevention in low- and middle-income countries, could have disastrous effects. The report, mostly researched at the end of 2024, concluded that the end of AIDS as a public health threat by 2030 was in sight.

However, in early 2025 the United States government announced “shifting foreign assistance strategies,” causing them to withdraw aid from organizations like the President’s Emergency Plan for AIDS Relief (PEPFAR), which had earlier promised 4.3 billion USD in 2025. PEPFAR is one of the primary HIV testing and treatment services in countries most affected. Such a drastic decision could have ripple effects, including pushing other major donor countries to revoke their aid. The report projected that if international funding permanently disappears, they expect an additional 6 million HIV infections and 4 million AIDS-related deaths by 2029.

At a Press Briefing, Assistant Secretary-General for UNAIDS Angeli Achrekar noted the importance of PEPFAR since its inception in 2003, calling it one of the most successful public health endeavors. She expressed hope that as the US lessens its support, other organizations and countries are able to take up the global promise of ending AIDS without eroding the gains already made.

Achrekar noted “acute shifts” in a weakening of commitment from countries less directly affected by HIV/AIDS since the US has pulled funding.

UNAIDS also reports a rising number of countries criminalizing populations most at risk of HIV – raising stigma and worsening gender-based violence and non-consensual sex, two of the highest HIV risk-enhancing behaviors. The report showed the primary groups who lacked care were child HIV infections and young women, which is likely related to government campaigns  “attacking HIV-related human rights, including for public health, with girls, women and people from key populations.”

These punitive laws include criminalization or prosecution based on general criminal laws of HIV exposure, criminalization of sex work, transgender people and same-sex sexual activity and possession of small amounts of drugs. These laws have been on the rise for the past few years, and in conjunction with limited funding, the results for HIV/AIDS-positive patients could be fatal.

Recently, scientific breakthroughs have been made regarding long-acting medicine to prevent HIV infection. Health workers have seen tremendous success, both with new technologies like annual injections and the potential for more growth in the form of monthly preventative tablets and in old prevention techniques like condom procurement and distribution and access to clean, safe needles for drug users. However, due to various global conflicts and wars, supply chains have been disrupted, often harming countries not in the thick of the altercation but reliant on products like PrEP, an HIV prevention medication.

Although many countries most afflicted with the AIDS crisis have stepped up, promising more national funding for the issue, and many community networks have doubled down on their efforts, the disruption of supply chains and the lack of international frontline health workers cannot be solved overnight. To entirely restructure how healthcare is provided takes time – something those with HIV do not always have.

Areas like sub-Saharan Africa, which in 2024 housed half of the 9.2 million people not receiving HIV treatment, have been particularly affected by the recent changes. The majority of child infections still occur there, and combinations of “debt distress, slow economic growth and underperforming tax systems” provide countries in sub-Saharan Africa with limited fiscal room to increase domestic funding for HIV.

Despite the loss of funding, significant progress has been made to protect essential HIV treatment gains. South Africa currently funds 77% of its AIDS response, and its 2025 budget review includes a 3.3% annual increase for HIV and tuberculosis programs over the next three years. As of December 2024, seven countries in sub-Saharan Africa have achieved the 95-95-95 targets established by UNAIDS: 95% of people living with HIV know their status, 95% of those are on treatment, and 95% of those on treatment are virally suppressed. UNAIDS emphasized the importance of this being scaled up to a global level.

Achrekar observed, referring to countries whose domestic funds towards AIDS have increased, that “prevention is the last thing that is prioritized, but we will never be able to turn off the tap of the new infections without focusing on prevention as well.”

She reiterated the importance of countries most affected by the HIV/AIDS crisis establishing self-sustaining health practices to ensure longevity in both prevention and treatment.

Achrekar praised the global South for their work in taking ownership of treatment while still calling upon the rest of the world to join.

She said, “The HIV response was forged in crisis, and it was built to be resilient. We need, and are calling for, global solidarity once again, to rebuild a nationally owned and led, sustainable and inclusive multi-sectoral HIV response.”

IPS UN Bureau Report

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For the Aged, Their Sunset Years Will Be Bedeviled by Lethal Heatwaves

Asia-Pacific, Civil Society, Climate Change, Development & Aid, Editors’ Choice, Environment, Featured, Global, Green Economy, Headlines, Humanitarian Emergencies, Population, Sustainable Development Goals, TerraViva FAO38, TerraViva United Nations

Climate Change

Facing frequent climate hazards, resultantly offsprings having migrated out, this South Sikkimese elder in India battles depression, anxiety and early onset of dementia. Credit: Manipadma Jena/IPS

Facing frequent climate hazards, resultantly offsprings having migrated out, this South Sikkimese elder in India battles depression, anxiety and early onset of dementia.
Credit: Manipadma Jena/IPS

NAIROBI & BHUBANESWAR, Jul 10 2025 (IPS) – The global population is aging at a time when heat exposure is rising due to climate change. Extreme heat can be deadly for older populations given their reduced ability to regulate body temperature. Already there has been an 85 percent increase since 1990 in annual heat-related deaths of adults aged above 65, driven by both warming trends and fast-growing older populations.


If this were not heartbreakingly disastrous enough, heat-related deaths in older populations are projected to increase by 370 percent annually if global temperatures rise by 2˚ Centigrade mid-century. The world is currently on track to reach 2.7°C by the end of the century, up from 1.14°C above pre-industrial levels in 2013-2022.

With 2024 the hottest year ever recorded and the past 11 years declared the 11 warmest on record since records began in 1880, the World Meteorological Organization (WMO) report warning of an 80% chance that 2025-2029 will be warmer than 2024, predicting severe climate impacts, and nearing the 1.5°C warming threshold is alarming if not surprising.

As extreme heat grips many countries and becomes ‘the new normal,’ the UN Environment Programme (UNEP) warns of heightened health risks for older persons in the Frontiers 2025 Report published today.

Older persons, especially those with chronic illnesses like diabetes, hypertension and heart ailments, limited mobility, or age-related frailty, are particularly vulnerable to severe health issues, depending on the intensity, duration, and frequency of heat spells. These could range from respiratory and cardiovascular to metabolic diseases, as well as increased mortality.

Inger Andersen, Executive Director of UNEP said solutions exist that can help protect communities and ecosystem. Courtesy: UNEP

Inger Andersen, Executive Director of UNEP said solutions exist that can help protect communities and ecosystems. Courtesy: UNEP

“Heat waves are among the most frequent and deadly impacts of climate change, along with floods and shrinking ice cover,” said Inger Andersen, Executive Director of UNEP. “We must be prepared for the risks these impacts pose, especially for society’s most vulnerable, including older persons.”

The 7th edition of the Frontiers Report, The Weight of Time – Facing a new age of challenges for people and Ecosystems, is part of UNEP’s Foresight Trajectory initiative and highlights emerging environmental issues as well as doable solutions. The first edition, in 2016, warned of the growing risk of zoonotic diseases, four years before the COVID-19 pandemic.

Those worst effected by rising temperatures: where and why

“The (third) issue is the risk to aging populations from environmental degradation. It is estimated that the global share of people over 65 years old will rise from 10 percent in 2024 to 16 percent by 2050. Most of these people will live in cities where they will be exposed to extreme heat and air pollution, and experience more frequent disasters. Older people are already more at risk. Effective adaptation strategies will need to evolve to protect these older populations,” says UNEP’s Executive Director, Inger Andersen.

Projections indicate that heatwaves will become more intense, frequent and persistent in nearly all regions. As heatwaves intensify, scientists warn of the amplified danger when extreme heat and humidity combine. Higher humidity tends to limit the human body’s ability to cool itself through the evaporation of sweat.

When temperatures rise by 1o C, estimates peg 275 million people will be exposed to humid heatwaves. The impact will shoot up to 789 million with 2o C, and with an apocalyptic 3oC rise, 1220 million people will be battling absolutely lethal humid heatwaves.

Already experiencing humid heatwaves are low-lying tropical regions of India and Pakistan, the Persian Gulf, the Arabian Gulf, the Red Sea, and eastern China.

Urban centers usually experience higher temperatures than surrounding rural areas because buildings, pavement, and other artificial surfaces trap, retain and re-radiate heat. This urban heat island effect and heat waves interact synergistically, exposing urban residents to greater heat and amplifying health risks.

Developing and low-income countries that are urbanizing at a fast pace are more at risk.

Rural-to-urban migrants often live in tin- or asbestos-roofed one-roomed houses, crowded and ill-ventilated, in informal settlements that spring up in low-value, hazardous land parcels without water supply, sanitation or electricity facilities. In recent hotter years, surveys have found the temperature inside these housing units is even higher than the ambient high heat outside on heat-wave days. Often poorer parts of cities have less green and heat up faster. Worse, night temperatures are not cooling down in cities owing to the heat-island effect.

Older adults who are uprooted from their traditional communities into cities, are socially isolated, economically disadvantaged, have cognitive, physical, or sensory impairments, and live in substandard housing with inadequate cooling systems or even basic water, are especially ill-equipped to withstand or adapt to heat extremes, say other studies.

Are only the elderly in low- and middle-income countries at heat risk? Latest reports suggest even the developed countries cannot protect their aged from growing climate heat.

A first rapid study released earlier in July by scientists at the Grantham Institute at Imperial College London and the London School of Hygiene & Tropical Medicine focused on ten days of heatwaves in 12 European cities from June 23 to July 2, 2025. The researchers estimated that climate change nearly tripled the number of heat-related deaths, with fossil fuel use having increased heatwave temperatures up to 2°C – 4°C across the cities.

Of the 2,305 estimated heat deaths in those ten days, people aged 65-plus made up 88 percent of the deaths, highlighting how those with underlying health conditions are most at risk of premature death in heatwaves.

“It is society’s most vulnerable … who suffer most in the midst of record temperatures. Europe’s dependence and soft hand on oil and gas corporations who are fueling this extreme heat is giving a death blow to our parents and grandparents,” said Ian Duff, Head of Greenpeace International’s ‘Stop Drilling Start Paying’ campaign, called on polluters to pay up.

It is not heat alone that the aged are vulnerable to

Exposure to air pollutants such as fine particulate matter, ground-level ozone, nitrogen dioxide and sulfur dioxide often triggers the onset and progression of a variety of respiratory, cardiovascular, neurological and cognitive illnesses and related deaths in older people, according to the Frontier report.

Nearly half of the 1.24 million deaths attributable to air pollution in India in 2017 were those aged 70 years or older.

Accelerating climate change that brings extreme heat, worsening air pollution, drought and dust storms, floods and melting glaciers is, in multiple ways, directly and indirectly, not only responsible for physical ailments but also for the development of dementia, late-life depression, anxiety and mental health in elders.

Building climate resilience for aging population: the time is now

“As this year’s Frontiers Report shows, solutions exist that can help protect communities and restore ecosystems long thought to have been lost,” Inger Andersen urges governments to implement adaptation strategies.

On its part, the report recommends transforming cities into age-friendly, pollution-free, resilient, accessible spaces with expansive vegetation through better urban planning.

Community-based disaster risk management and access to climate information are key approaches to help aging people adapt successfully to climate change. Investing in weather stations to monitor extreme heat is critical to protect lives.

The digital divide among older populations in cities needs to be addressed. Digital ignorance may affect their capacity to live in smart cities and be adequately informed of possible extreme events that may affect their survival. Otherwise too, day-to-day living—banking, medicine purchases, and shopping for essentials—are all going digital and, once mastered, convenient to the aged.

IPS UN Bureau Report

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