The stopping of American aid is “a time bomb” which risks destroying more than twenty years of progress in the fight against the AIDS pandemic, warned UNAID in a report on Thursday in South Africa.
About 31.6 million people benefited from antiretroviral therapy in 2024 and deaths related to the virus decreased by more than half compared to 2010, to 630,000 per year, indicates the United Nations agency responsible for the fight against AIDS.
However, contamination may start upwards due to budget cuts in prevention and treatment programs.
Historically the largest humanitarian donor, the United States brutally reduced its international aid in February after the arrival of Donald Trump in the White House.
“We are proud of our results but worried about this sudden interruption, which is erasing the progress made,” the UNAIDA executive director, Ugandan byANYIMA, told AFP before the presentation of the report to Johannesburg.
South Africa is one of the countries that have paid the heaviest tribute to AIDS, with a life expectancy that has fallen at 52 years in 2006, before going back, and more than one in ten people living with the virus (12.7 %), or 8 million people, according to government figures for 2024.
“We have gone from a situation where people died every day to a point where (AIDS) is really like a chronic disease,” said Ms. Byanyima.
So “the question of whether the investment was worth it, and it continues to be worth it. It saves lives, ”she says.
However, with the judgment of the American emergency plan to combat AIDS (PEPFAR), UNAIDS has made its calculations: this would cause more than six million new contaminations and 4.2 million additional deaths in four years.
This would bring the pandemic to the levels of the early 2000s.
“It is not just a lack of money, it is a time bomb,” said in a press release Ms. Byanyima, whose country has more AIDS orphans than South Africa (890,000 against 630,000 in 2024, UNAIDA figures).
More than 60 % of women’s associations against AIDS contacted have already lost funds or suspended services, according to the report. In Nigeria, for example, the number of people under preventive prophylactic treatment dropped by 85 % over the first months of 2025.
“The way in which the world has managed to unite (against AIDS) is one of the most important pages of progress in global public health,” said Ms. Byanyima.
“But this fantastic story is strongly undermined” by the “cruel” and “unprecedented” decision of Mr. Trump, she says. “The priorities can change but we do not just withdraw like that a vital support from populations.”
Crucial medical research has already been stopped, including in South Africa, a high prevalence country of AIDS and the cutting edge of research.
The global struggle against AIDS, supported by field activism, remains “resilient by nature”, wants to hope for the leader.
And in 25 countries with low or medium income out of 60 studied by UNAIDS, governments were able to partially compensate for the shortfall.
“We must go towards funded responses nationally and specific to each country,” says Ms. Byanyima, calling for debt reductions and a reform of international financial institutions in order to “generate a budgetary room for maneuver so that developing countries can finance their own response”.
By Julie Bourdin, AFP
