Arun Seang* works six days a week in a garment factory in Phnom Penh. In the past when he needed time off to go to the HIV clinic he came up with excuses. Now there’s no need. The National Clinic for AIDS, Dermatology and STDs (NCHADS) is open every day, including weekends.

The scheduling suggestion came from a community-led monitoring exercise and community feedback. It was initially implemented as part of an Australia-supported project managed by UNAIDS. When the experiment ended, the clinic maintained a seven-day week due to its popularity.

This is one of several approaches taken to make HIV prevention and treatment services in Cambodia more user-friendly. “The staff are really nice,” Mr Seang said following his Sunday afternoon treatment consultation. “They are welcoming and also, they maintain confidentiality. I feel very safe coming here.”

Integrated community support

Cultivating a sense of trust in the delivery of HIV care has been key to Cambodia’s progress toward ending AIDS. The country is one of the front-runners to reach the 95-95-95 global targets. Currently 92% of people living with HIV are aware of their status. Almost all diagnosed people are on HIV treatment and more than 98% of those on treatment have a suppressed viral load.

These results were unimaginable when Sovann Reatrey learned she was HIV-positive, 26 years ago. “In the early days it was completely different,” she said. “Before there was a lot of stigma and discrimination. Many healthcare providers gossiped about people in the clinic and kept their distance. Now there is a welcoming environment, good communication and close physical interaction.”

At NCHADS she helps achieve this. As an Antiretroviral Users Association (AUA) counsellor her work is fully integrated into the clinic’s operations rather than an add-on. Mrs Reatrey consults with patients when they are first diagnosed and throughout their treatment journey.

“It starts as a friendly discussion. I disclose my status and tell them ‘I am also living with HIV’. Some don’t believe me. They say, ‘you look very healthy, but you are like me?’ I reassure them that it’s true. This builds trust and a relationship so they can discuss their concerns openly,” she explained. “The interaction is not as client and healthcare provider, but rather as a friend and neighbour.”

Nhem Salat, another community worker, enrolls people for HIV treatment. “I smile and encourage them to raise any issues they have when they go to see the doctor,” said Mrs Salat. “It’s all about making them feel comfortable.”

One-stop services

The waiting room isn’t hemmed in by walls. Sunlight and breeze rush through. Rows of colorful flags hang from the ceiling. The space is decidedly—perhaps deliberately—open and bright.

Huge posters invoke celebrity and safety. Singer Nicky Nicky, influencers Yaro and Sinora Roath and drag queen performer Rebecca Chan promote HIV prevention and options including condoms, PrEP (medicine to prevent HIV) and self-testing.

In addition to its standard PrEP service, this month the clinic adds long-acting cabotegravir (CAB-LA), an injectable HIV prevention option that lasts for two months, and the Dapivirine Ring (DVR), a vaginal ring which slowly releases antiretroviral medicine to prevent HIV infection.

Multiple posters invite clients to get tested. Sexually transmitted infection screenings and treatments are available. Non-communicable disease services are provided. Mental health screenings are offered to everyone. Next on NCHADS’s to-do list: more work to make the service offering youth-friendly.

By design, the space is everything for everyone.

“This clinic is a one-stop shop so people can access whatever services they need. People living with HIV don’t want to move around to different places to get healthcare,” explained the clinic’s Deputy Manager, Dr Nhem Chantha.

In his examining room, Dr Chantha, explained to Mr Seang that his viral load will be checked annually. “The U=U (undetectable equals untransmittable) message has been integrated into counseling to all clients. We have a Telegram group, and we also share information on social media platforms. This makes the clients understand the benefit of having an undetectable viral load by taking their treatment so they cannot transmit HIV. Because of this, they are very happy and really adhere to the treatment.”

UNAIDS Country Director for Cambodia, Lao PDR and Malaysia, Patricia Ongpin, noted that the emphasis on community-led care and service integration ensures impact and sustainability. “Partners in government and community are working together to find solutions that get the most out of every interaction and investment,” she said. “When services are friendly and convenient, people will use them. Then we will further reduce new HIV infections and deaths.”

*(name changed to protect privacy)

GENEVA, 19 May 2025— As funding cuts threaten to cause an additional 6 million new HIV infections and 4 million preventable AIDS-related deaths, UNAIDS is calling on governments and partners attending the 78th World Health Assembly (WHA) to recommit to ending AIDS by 2030.

UNAIDS estimates that an additional 2300 people are contracting HIV every day. Without immediate action to dismantle barriers to healthcare, strengthen community-led responses, and unlock sustainable financing, a catastrophic loss of life and millions more new HIV infections could reverse decades of progress.

“I remember the darkest days of AIDS – the millions of lives lost, and the existential threat to global health security. We must not go back,” said UNAIDS Executive Director Winnie Byanyima. “Amid disruption, the international community needs to come together to protect the gains made in the response to HIV and see this battle through to the end.”

A HIV prevention revolution

Long-acting injectable antiretroviral medicines such as lenacapavir – twice-yearly shots that are almost 100% effective in preventing new HIV infections – offer a chance to put the world back on track.

“We have an opportunity today of new, long-acting HIV prevention tools that could fundamentally reshape the HIV response and put us on course to end AIDS by 2030”, said Ms Byanyima. “We need a moonshot approach to mobilize a HIV prevention revolution – to scale-up these potentially revolutionary medicines and make them available and affordable to everyone who needs them.”

UNAIDS, the Global HIV Prevention Coalition, government ministers, community representatives, civil society and the pharmaceutical sector will discuss how to remove barriers to accessing lenacapavir, including pricing, intellectual property issues and regulatory hurdles at a special event on the sidelines of the WHA.

Preparing for future pandemic threats

During #WHA78, member states will adopt a Pandemic Agreement, after three years of negotiations reached a consensus last month. “UNAIDS watched in horror as the world repeated many of the mistakes of the AIDS pandemic with COVID-19. With the Pandemic Agreement, governments have a chance to say, ‘never again.’

“I congratulate South Africa and France as Co-Chairs; Australia, Brazil, Egypt and Thailand as Vice-Chairs — each representing their region — and WHO Director-General Dr Tedros Adhanom Ghebreyesus for this landmark achievement. It is proof that, even in times of crisis, multilateralism and global cooperation can deliver for humanity."

At #WHA78, UNAIDS will underline the importance of implementing the Agreement, embedding equitable, inclusive and rights-based approach, advancing access to medical innovations, centring community systems, and protecting human rights.

Communities at the heart of global health

The recent cuts in external funding for global health and development have devastated community-led organizations that deliver HIV services to people highly vulnerable to HIV. Many have had to close their doors or severely reduce their activities as international funding suddenly stopped.

UNAIDS, Coalition Plus, Frontline AIDS and UNAIDS are co-organizing an event at #WHA78, in collaboration with WHO, focusing on the urgent need to sustain and scale up community-led health systems amidst mounting global crises and shrinking international aid.

Africa’s pathway to sustainable health systems

UNAIDS has been working with governments to develop detailed transition plans towards greater domestic ownership of their HIV responses. Domestic resources already account for more than 60% of the HIV response. In the face of massive cuts to international funding, Global South leaders are stepping up and accelerating efforts, but many countries are still facing huge challenges to increase domestic HIV funding when budgets are being drained by unsustainable debt repayments.

UNAIDS will talk about the urgent need for international financial reform to enable sustainable health financing for Africa in an event co-organized with Nigeria’s Ministry of Health and Social Welfare and the Global Fund to Fight AIDS, Tuberculosis and Malaria, and other partners.

UNAIDS KEY EVENTS AT #WHA78

At the 78th World Health Assembly UNAIDS is calling for urgent action to avoid millions of avoidable HIV infections and AIDS-related deaths.

As the world faces an unprecedented international funding crisis affecting global health security, UNAIDS is calling on governments and partners attending the 78th World Health Assembly (WHA) to urgently recommit to ending AIDS by 2030. UNAIDS is warning that without immediate action to dismantle barriers to healthcare, strengthen community-led responses, and unlock sustainable financing, decades of progress could be reversed and millions of lives put at risk. 

The theme of the 78th World Health Assembly is One World For Health.

During the week, UNAIDS will be advocating for continued global solidarity and sustained political and financial commitment for the global HIV response as part of broader efforts to achieve the Sustainable Development Goals. This includes the need to scale up HIV services, including access to long acting injectables for HIV prevention which are almost 100% effective at preventing infections and could help countries move towards a sustainable HIV response.

UNAIDS will also be pushing for equitable, inclusive and rights-based approaches to pandemic preparedness and response, supported by lessons learned from the gains made against HIV. This means ensuring equal access to medical innovations and the centrality of community systems, data equity, access to innovations and the protection of human rights.

UNAIDS KEY EVENTS AT #WHA78

Wednesday 21 May - 08:30 – 10:00 CET

Ending inequalities in pandemic responses - The pandemic agreement and beyond  

The Pandemic Agreement is a significant step forward in pandemic prevention, preparedness and response, based on the principles of equity and the full respect for the dignity, human rights and fundamental freedoms of all persons. The panel will discuss how to ensure that those principles are adhered to as the Agreement is put into practice.

Panel members:

• Precious Matsoso, Co-Chair of the Intergovernmental Negotiating Body for the Pandemic Agreement
• Nísia Trindade, former Minister of Health, Brazil
• Winnie Byanyima, UNAIDS Executive Director

Venue: Kofi Annan room - UNAIDS/WHO D Building
*WHA delegates can use their WHA accreditation badge to enter the UNAIDS building. Other attendees must register in advance here

To follow online click here

Wednesday 21 May - 18:30 – 21:00 CET

“A new era of HIV prevention; Accelerating access to long-acting prevention options through sustainable prevention systems and financing”  

This High-Level Dialogue organized by the Global HIV Prevention Coalition and co-hosted by UNAIDS in collaboration with UNFPA, WHO and UNDP, the Federal Republic of Brazil and Kingdom of the Netherlands aims to galvanize political leadership, financing, and coordinated action to drive a transformational HIV prevention push. The meeting will serve as a platform for Ministers of Health, global health partners, pharmaceutical companies, and civil society to explore opportunities to expand access to new long-acting prevention technologies as a powerful addition to existing effective options. 

Join UNAIDS leadership, representatives of UN partners and global health stakeholders as they discuss these issues with Ministers of Health, community representatives and leaders of pharmaceutical companies developing long-acting prevention options.

Venue: Kofi Annan room - UNAIDS/WHO D Building
Watch the livestream here

Thursday 22 May - 08:30 – 10:30 CET

The future of domestic health financing is now: Africa’s pathway for sustainable health systems   

The panel discussion will explore how best to achieve financial sustainability of the health sector from different perspectives. Topics would include raising more money through innovative means, improving efficiency, strengthening planning and coordination, public-private partnerships as well as discussing the roles of different actors, including donor partners, and the institutional reforms necessary for success.

Co-organised by the Ministry of Health & Social Welfare of Nigeria, the Global Fund, WHO, UNAIDS and other partners

Venue: Ballroom AE, INTERCONTINENTAL GENEVE

Thursday 22 May - 18:30 – 20:30 CET

Communities at the heart of global health and health security: Why sustained funding for community-led health systems matters now more than ever.

Co-organised by UNAIDS, Coalition PLUS, Frontline AIDS and WHO, this event will bring together Ministers of Health, civil society leaders, donors, and global health institutions to explore sustainable solutions to safeguard and scale up community-led health systems amid global crises and decreasing aid.

Venue: Kofi Annan room - UNAIDS/WHO D Building 

To attend in person, please register here
To attend online, please register here

The government of Côte d’Ivoire is transforming access to health services, including HIV services, in its commitment to achieve Universal Health Coverage (UHC).

The government has made UHC registration mandatory and nearly 60% of the population is already enrolled, demonstrating the country’s political will to build a resilient and equitable health system.

A central priority of the Government’s UHC agenda—supported by the World Bank, the Global Fund and UNAIDS—is to ensure that all people living with HIV, estimated at over 400 000 people, are fully enrolled in the national health insurance scheme. Special attention is being given to identifying modalities through which the poorest and most vulnerable people living with HIV will benefit from free coverage under UHC.

In 2022, UNAIDS conducted an evaluation of Côte d’Ivoire’s social protection system through the lens of the HIV response. This work informed the 2024–2028 National Social Protection Strategy, which now explicitly recognizes people living with HIV as a priority vulnerable group.

“This is an urgent plea—I want all people living with HIV to have free access to the UHC card because many people simply cannot afford to contribute. I’m calling on the government to cover their premiums,” said Tinhidé Adéline, Community Counsellor.

Efforts are underway to integrate HIV-related services and products into the UHC benefits package. Over the past three years UNAIDS, in partnership with the Network of Organizations of People Living with HIV (RIP+), has mobilized communities and advocated with national authorities to ensure people living with HIV are enrolled in UHC, ensuring that stigma and exclusion do not stand in the way of health and dignity.

“UHC is a real opportunity for people living with HIV because being HIV-positive is often a barrier to accessing health insurance,” says Filbert Guéhi, Chair of the Board, RIP+.

UNAIDS, in collaboration with WHO, is also assisting RIP+ in developing a budgeted community-based strategy to sensitize and register people living with HIV in UHC to guarantee that services reach those most in need. This community-driven approach to UHC enrollment for people living with HIV represents a major step forward in ensuring equitable access to health care for vulnerable populations.

Advocacy continues to establish a sustainable national mechanism to automatically enroll the most vulnerable people living with HIV in the non-contributory Health Insurance Scheme. A two-year pilot initiative on this is currently being supported by The Global Fund and The World Bank. This is a vital step toward ensuring no one is left behind, and toward harnessing UHC as a powerful lever in the fight to end AIDS by 2030.

Ensuring full inclusion of people living with HIV in the roll out of UHC was a commitment made by the government at the annual session of the National AIDS Council in 2023 chaired by the Vice-President of Côte d’Ivoire Tiémoko Koné and in presence of the First Lady Madame Dominique Ouattara. This initiative is a cornerstone of the Government’s long-term strategy to transition towards a sustainable, nationally owned HIV response to end AIDS as a public health threat by 2030.

GENEVA, 16 May 2025–Ahead of International day against Homophobia, Biphobia and Transphobia (IDAHOBIT), May 17, UNAIDS stands in solidarity with LGBTQI+ communities.

Despite gains in the HIV response, LGBTQI+ communities continue to be left behind. While new HIV infections have dropped 35% among adults globally since 2010, they have risen by 11% among gay men and by 3% among trans people. Stigma, discrimination and criminalization, as well as restrictions on the ability for community organizations to form and operate act as barriers to accessing essential healthcare.

“We pay tribute to our colleagues who are part of the LGBTQI+ community,” said Winnie Byanyima, UNAIDS Executive Director. “We celebrate your courage, your authenticity, and your resilience even in the face of adversity for the community. We must continue supporting and promoting partnerships of LGBTQI+ movements with people living with HIV, women and girls and other key populations. In unity, communities can find the power to disrupt injustice and drive the changes that are required to end AIDS.”

Organizations led by gay men and other men who have sex with men have increasingly come under threat due to new or strengthened repressive laws, harmful policing practices, violence and a shrinking civic space. Research has found that HIV prevalence among gay men and other men who have sex with men is ten times higher in countries where there are legal barriers to civil society groups operating.

Recent cuts in aid funding have also had a devastating impact on community-led organizations, undermining their ability to provide healthcare, peer-led outreach and defending their rights.

"Threats to the lives and dignity of LGBTI people are escalating worldwide and cuts to foreign and development aid, as well as rollbacks in diversity, equity and inclusion policies, are only making it worse — especially for our communities,” said Julia Ehrt, ILGA World Executive Director. “Every day, we see projects and organizations to advance safety, well-being, and dignity being shut down.”

The 2025 IDAHOBIT theme “The Power of Communities” celebrates the power of collective action, highlighting that communities have been the driving force for progress not just for LGBTQI+ people, but for everyone. In the HIV response, community organizations play a critical role in the HIV response because they are trusted by their peers, able to reach the most marginalized people and groups and can deliver services based on people’s needs.

They also provide critical data to improve policies and advocate politically for access to services and to end stigma and discrimination.

UNAIDS fears that the growing pressure and attacks on communities combined with huge financial cuts from international donors will have catastrophic consequences on the HIV response. The loss of peer-led services will lead to higher levels of stigma and discrimination, creating even more barriers to life-saving prevention, testing and treatment.

Activism and the work of communities have driven the HIV response for decades. UNAIDS affirms that access to health is a right for all. A community-led HIV response is essential to end AIDS as a public health threat by 2030.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

PHNOM PENH, 16 May 2025—UNAIDS Executive Director, Winnie Byanyima, saw firsthand Cambodia’s strong progress towards ending AIDS as a public health threat during her 12-16 May mission. Among other achievements, the country treats 100% of people who are aware of their HIV status. Key approaches include national roll-out of modern HIV prevention and treatment tools, community-led service delivery and social protection. During the visit she discussed the sustainability of the response with the Royal Government and partners. 

“Cambodia’s HIV response demonstrates that ending AIDS is possible for low- and middle-income countries when we combine political will, community leadership and international support,” Ms Byanyima said.

Cambodia is on track to achieve the 95-95-95 Global AIDS Strategy targets. Currently 92% of people living with HIV are aware of their status. Almost all diagnosed people are on treatment, while more than 98% of those on treatment have achieved a suppressed viral load. Since 2010, new infections have decreased by 45%. This is higher than the overall global results and more than three times faster than the average Asia-Pacific rate of decline. 

The country employs a multisectoral approach that includes social assistance and free healthcare access for people living with HIV and key populations. It has also prioritized peer- and community-led voluntary counselling and testing, adherence support and prevention services. To achieve and sustain epidemic control there must be continued investments, including increased domestic financial ownership of the response.

H.E. Prime Minister Samdech Thipadei Hun Manet thanked the United Nations for its support of Cambodia’s socio-economic development and expressed appreciation for UNAIDS’ active role in strengthening its HIV response. 

“When we talk about building human capital, we must pay attention to the health of the people,” he said.

Prime Minister Hun Manet stressed the importance of deepening this cooperation and partnership while announcing a new financial contribution to UNAIDS. 

“This contribution is symbolic of the importance Cambodia places on UNAIDS, the HIV response, and the multilateral system,” Ms Byanyima said. “It sends a signal to donors and to other Association of Southeast Asian Nations countries about the importance of continued investment in ending pandemics.”

In a meeting with the UNAIDS Executive Director, community representatives called for continued funding for people-centered strategies, as well as support to end stigma and discrimination. 

Ms Byanyima’s mission included a visit to the National Clinic for AIDS, Dermatology and Sexually Transmitted Diseases in Phnom Penh. The clinic is a model for service integration and community-led care. Open seven days a week, it provides peer-led counseling, testing and treatment for HIV and sexually transmitted infections, non-communicable disease services, mental health screening and multiple pre-exposure prophylaxis (PrEP) options. PrEP is the use of antiretroviral therapy by HIV-negative people to avoid contracting the virus if exposed.

In Siem Reap, Ms Byanyima joined the Health Action Coordinating Committee and Joint Forum of Networks of People Living with HIV and Key Populations awareness raising campaign on U=U (undetectable equals untransmittable). U=U refers to the scientific fact that people living with HIV who have an undetectable viral load through successful treatment have zero chance of passing the virus to a sexual partner. Cambodia has embraced this concept to not only increase treatment adherence but also stop stigma and discrimination against people living with HIV.

“HIV cannot harm us if we take our ARV medication correctly, regularly, and consistently,” said Sorn Vichheka, Coordinator of the Cambodian Community of Women Living with HIV at the U=U event. “When our viral load is undetectable, we cannot transmit the virus to our partners. This means we can live freely—we can dream, work, love, have families, and even have children, just like anyone else.”

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Em Ra disappears into the house twice, slipping past the shrine of flowers and incense by the front door. First, she brings out an old HIV magazine. She flips to a page of a small child, sitting on the back seat of a bike, looking straight into the camera. Next, she emerges with two framed photographs from a recent university graduation.  

The girl and the graduate are her daughter, Sorn Vichheka, twenty years apart. In 2005, the year the bicycle picture was taken, Vichheka started taking medicines. At first, she didn’t know why. When she was 12, she learned that she was born with HIV.   

“I am not sure when I accepted myself fully,” she says from her verandah in Meanchey, a commune to the south of Cambodia’s capital, Phnom Penh. “It was gradual.”  

She looks out into a yard patrolled by chickens and surrounded by towering coconut trees. Under a shed in a nearby yard a baby sleeps in a hammock swung quickly back and forth by a string tied to its mother’s wrist. Vichheka’s sibling, who is HIV-negative, plays with the neighbours’ kids. They climb trees, dismounting onto the sides of concrete rainwater cisterns. 

She traces her evolution from child to advocate. As a girl her mother was already involved in the HIV movement. Today Ra remains a community action worker with the Antiretroviral Users Association (AUA), helping other people at their treatment site. But as a teen, Vichheka was afraid of being found out. 

“I started working for a company and did not disclose my status. At the same time, I was studying at the university. I was struggling with work and my studies, so I did not take my medicine regularly. Every time I went to the clinic co-workers would ask questions. They were curious to know what kind of health issue I had. I was very scared that people would know my HIV status,” she remembers. 

Stressed, she ended up resigning from the job and dropping out of school. She soon began volunteering with an HIV organization. There, peers explained the concept of U=U (undetectable equals untransmittable) more clearly. She grasped that HIV treatment could not only keep her  alive but make it impossible for her to pass the virus to others. 

She also understood more clearly the issues women living with HIV were facing. Half of the people living with HIV in Cambodia are women. Five percent of women report recent intimate partner violence. Many are petrified about disclosing their status. Then there is the balancing act of self-care, family responsibility and economic survival. 

“Some are housewives and need to take care of children so sometimes they don’t care much about their own health. Sometimes, because of the living conditions, they need to go to work to make an income to support the family. With this, they might miss some clinic appointments,” she explains.  

Vichheka says that government social protection programmes offering free healthcare, nutrition support and cash transfers for women living with HIV have been vital. Community-led care is also required. 

During the COVID-19 lockdowns when treatment access was interrupted, she joined the AUA. She participated in the community delivery of antiretrovirals for two years. After the project ended, she continued to volunteer. Between 2023 and 2024 Vichheka was driven, balancing volunteer work, daytime employment at an accounting company and evening study.  

In 2023, the Cambodian Community of Women Living with HIV (CCW) — an organization that had been founded in 2008 but lost its financing in 2017—  was revived thanks to small seed funding from UNAIDS for a U=U project.  

That year, the Cambodian Network of People Living with HIV (CPN+) and International Community of Women Living with HIV Asia Pacific (ICWAP) mentored CCW to engage in a UNAIDS-funded Global Fund Grant Cycle 7 project. They successfully mobilized funding for 2025-2026. Vichheka was among three Cambodian participants in ICWAP’s Feminist School Leadership Training.  

For the first time in over five years, CCW had a seat at the table. Vichheka was chosen by the members to be its coordinator.  

“We set up a peer support group of women living with HIV who come together, share experiences and motivate one other. CCW also provides psychosocial support and connects women with job opportunities. The Global Fund investment will expand this work while conducting leadership training to build capacity among sub-national coordinators,” Vichheka explains.  

Her leadership journey is a win against the odds. For her family it is also a full circle moment. 

“I am really proud to have such a kind mother, taking care of me since an early age, knowing that I was born with HIV. She protected me all the time from outside society and kept me motivated,” she says.   

Eswatini, a country once described as the epicentre of the HIV epidemic with nearly 1 in 3 adults living with HIV in 2015 [adult HIV prevalence in 2015 was 31%]. But Eswatini managed to turn around its HIV epidemic, reducing new HIV infections from a peak of 21 000 per year in 2000 to 4 000 in 2023, a remarkable result, achieved with the support of US funding. 

However, the sudden US funding cuts threaten to undo years of progress. We sat down with Nuha Ceesay, UNAIDS Country Director in Eswatini, to discuss the current situation, the impact on HIV services, and the way forward.

Q: How are US funding cuts impacting Eswatini’s HIV response? 

Eswatini’s HIV response has been a success story, by transforming a crisis that once saw extremely high HIV prevalence rates, into a model of resilience and opportunity. But the recent US funding cuts, representing about half of the country’s HIV response budget, have left the people living with and affected by HIV in despair, the government was not notified and left unprepared, and the people working to end AIDS are in total shock. There is real concern that new HIV infections and AIDS-related deaths will rise, reversing years of hard-won progress. The cuts threaten not just HIV treatment and prevention, but also the broader health system improvements, data collection, jobs and empowerment of people living with HIV. 

Q: What disruptions are being seen on the ground? 

The effects are immediate and widespread. HIV testing services, the gateway to treatment, are now limited. With fewer people being tested, many may unknowingly be infected with HIV, missing the chance for early treatment and increasing the risk of further transmission. This could push annual new infections, which are currently around 4 000, even higher, and add pressure to already strained treatment resources. Stockouts of antiretroviral, lab test kits, and condoms are expected within months, and health worker layoffs are affecting service delivery and quality data collection. Primary prevention services, such as medicine to prevent HIV (PrEP), education campaigns, and voluntary medical male circumcision for HIV prevention (which is around 60% effective in preventing HIV) have also been scaled back or suspended. 

We are also seeing a stop of the DREAMS programme which is a major setback for adolescent girls and young women, who are disproportionately affected by HIV in Eswatini. DREAMS provided prevention education, skills, and socio-economic support to young women. Its termination leaves them more vulnerable to infection and strips away resources that have been central to empowering this high-risk group. HIV prevalence among young women and girls aged between 15 and 24 years was 70% higher than among young men in Eswatini in 2023. 

Read more about the impact on UNAIDS website 

Q: How is UNAIDS responding to these challenges? 

UNAIDS is working closely with the government and partners to continue the work of developing and implementing the HIV Sustainability Roadmap. This will help Eswatini’s HIV response to gradually shift from being reliant on international aid to increasing its domestic funding which will lead to the government taking full ownership of its HIV response. The first phase of this roadmap has already been launched, focusing on building resilience and long-term solutions. 

UNAIDS has also worked closely with the Ministry of Health and partners to map the impact of the funding cuts, identify service gaps, and strategize on mitigating disruptions. Collaboration with the Ministry of Health, UN partners, and civil society remains central, but the transition to sustainability is a complex and gradual process. 

Q: What’s your message to the international community? 

The successes that we celebrate in the HIV response are built on mutual accountability and global solidarity. That’s what enabled countries like Eswatini to shift the narrative-from a crisis by leading a response that brought down new HIV infection to 4 000 compared to when new infections were as high as 21 000. 

It is therefore devastating to see all the hard-won gains being reversed at this stage. This is the moment we need to come together in solidarity and in partnership to accelerate our collective efforts. 

Ending the epidemic is like a marathon. We have run the race many miles, but the end is what matters. If we cannot reach that finish line, it means we have not completed, and we cannot afford that. 

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads the global effort to end AIDS as a public health threat by 2030 as part of the Sustainable Development Goals. 

Following the US stop work order in January, UNAIDS is working closely with governments and partners in affected countries to ensure that all people living with or affected by HIV continue to access life-saving services. 

For the latest updates, please visit unaids.org 

Q&A with UNAIDS Country Director in Burundi 

International aid is shrinking, and countries are increasingly burdened by the need to prioritize debt repayment over essential services, including healthcare. This shift has left vulnerable populations more exposed, with the abrupt funding cuts by the United States throwing the HIV response in many countries into chaos. Burundi, unfortunately, is no exception. Across the country, HIV services have faced severe disruptions. Clinics are reducing their services, staff are being laid off, and thousands of people living with HIV are at risk of losing access to critical treatment. 

In this interview, Marie Margarete Molnar, UNAIDS Country Director in Burundi, explains how communities are being affected, how the health system is coping, and what must happen next. 

Q: Can you describe the current funding landscape for Burundi’s HIV response? 

Burundi’s HIV response relies heavily on international aid - 95% of its funding comes from donors, with the US government contributing 51% through PEPFAR. This support sustained 10 major projects covering HIV prevention, treatment, and care for both the general population and vulnerable populations. PEPFAR also provided support to community-led monitoring projects and critical data system information. 

Q: How have the recent US funding cuts affected these programmes? 

Out of the 10 PEPFAR-funded projects, three were not eligible for the US waiver and had to stop operating. Some of the remaining seven, although eligible, could not resume their activities due to delays and financial uncertainty. As a result and based on an assessment conducted during the first month of the pause, at least 10 000 people living with HIV—who were among the 79 000 currently under treatment—have been directly affected. These individuals risk losing consistent access to medication and support services. In addition, 167 health professionals have lost their positions. These include doctors, nurses, psychologists, lab technicians, and community health workers—many of whom were directly providing HIV services. Financially, the immediate PEPFAR cut represents approximately US$ 6.5 million from the annual PEPFAR envelope of US$ 25 million for HIV in Burundi. 

Q: What does this mean in practical terms for people on the ground?

Burundi had almost reached the 2025 ambitious targets: 95% of people living with HIV who know their HIV status, of whom 95% are on treatment and of the people on treatment 95% are virally suppressed. This was the result of strong collaboration between the government, civil society organizations and partners. The country was even recognized with an award. But now the third 95, on viral suppression, is declining because some people can no longer access viral load testing or follow-up services. If the situation continues, there is a high risk of an increase in new infections and a weakening of the entire HIV response system. 

Q: What steps have the government and partners taken so far to respond to the crisis? 

The government and partners acted quickly. UNAIDS conducted consultations during the first two weeks of February with key stakeholders. These consultations identified the scale of the impact and led to a series of recommendations that were shared with the Government and partners. The Ministry of Health together with UNAIDS and WHO held a two-day workshop with the PEPFAR implementing partners and civil society to understand how the cuts affected budgets, staffing, services, and beneficiaries and to brainstorm on rapid mitigation measures. As instances, it was recommended carrying out field missions to visit treatment sites and assess how services were coping without US support, forming a crisis response group and developing a national contingency plan. The government also began to identify treatment sites facing ARV shortages and organized a drug quantification workshop after PEPFAR-supported partners could no longer lead it. 

Finalizing the HIV Sustainability Roadmap has also become a top priority. The roadmap is intended to guide how Burundi can finance and manage its HIV response without relying so heavily on external donors. We also discussed modeling different scenarios, from best case to worst case, based on whether funding returns or disappears entirely. These models would help us plan, reprioritize, and adapt strategies accordingly. We are also using the UNAIDS Rapid AIDS Financing Tool (RAFT) to get detailed data on how the funding cut is affecting commodities and staffing across the country. 

Q: Is the government prepared to increase its contribution to its national HIV efforts? 

It’s trying. Previously, funding for antiretroviral treatment was split between 76% from the Global Fund, 15% from the government, and 9% from PEPFAR. The government has now committed to covering partially that missing 9%. That shows political will. But it’s not just about medicine. It’s about health workers, community programmes and lab capacity. Burundi will need to restructure its approach by, for instance, integrating HIV into broader health and social protection systems, and significantly increase domestic health funding to reduce dependency, but this is difficult given the country's economic constraints. 

Q: What’s your message to the international community? 

Burundi is a fragile country facing multiple crises—economic instability, fuel shortages, emerging epidemics, and an influx of refugees from neighboring Democratic Republic of Congo. Despite these challenges, the country has made significant progress towards ending HIV, thanks to sustained investment in health including the HIV response. The risk now is losing these gains. Continued support from international partners is essential, not just for health but for the country’s overall development. At the same time, the Burundian government must increase its commitment to health funding. Only through global solidarity and strong political will can Burundi hope to end HIV by 2030. 

The global community must understand that this is more than a budget line. It’s about lives, stability and global health security. 

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads the global effort to end AIDS as a public health threat by 2030 as part of the Sustainable Development Goals. 

Following the US stop work order in January, UNAIDS is working closely with governments and partners in affected countries to ensure that all people living with or affected by HIV continue to access life-saving services. For the latest updates, please visit unaids.org