On March 24, 2025, Winnie Byanyima, the executive director of the Joint United Nations Program on HIV/AIDS (Onusida), delivered a stark warning regarding the future of global health if U.S. funding for AIDS programs ceases. Byanyima emphasized that without the restoration of American support, deaths from HIV/AIDS could surge dramatically, potentially increasing tenfold compared to current figures. This warning comes amidst a backdrop of ongoing discussions about U.S. aid and the fight against AIDS in developing nations.
Byanyima stated that in 2023, the world recorded approximately 600,000 AIDS-related deaths. A grim prediction was offered: if U.S. assistance is not resumed after a temporary pause, around six million people could die from AIDS-related complications over the next four years. Furthermore, the annual rate of new infections, currently at 1.3 million, is projected to skyrocket to 8.7 million globally.
The current funding freeze, initiated by the U.S. government on January 20, 2025, is part of a larger reevaluation of overseas assistance. Byanyima expressed concern that the suspension of support might mark a critical turning point in the battle against AIDS, particularly in vulnerable populations. Daily new infections, standing at about 2,000, could jump to 3,500 if these challenges are not addressed.
“There will be a significant resurgence of the pandemic, not only in low-income countries in Africa where it is primarily concentrated, but also among specific populations in Latin America and Eastern Europe,” Byanyima warned. As the United States contributes nearly 50% of Onusida’s funding, its withdrawal could lead to devastating consequences across 67 countries where the agency operates.
Byanyima pointed out, “If U.S. assistance for AIDS is not restored after this pause or is not replaced by other funding sources, there will be 6.3 million AIDS-related deaths.” This figure starkly contrasts with the 600,000 noted in 2023. The agency has thus far received no commitments from other governments to fill the looming financial gap.
The director lamented that the robust progress made in combating HIV/AIDS over the last 25 years could be rapidly undone. “We are talking about losing the advancements made over the last quarter-century; this could set us back considerably,” Byanyima explained.
Statistics reveal that previously functioning clinics are now experiencing closures or staff reductions, drastically impacting services for patients needing antiretroviral medications. “Many treatment centers that provided essential services to patients are no longer reopening, fearing they might not align with the new guidelines,” Byanyima added.
As the fight intensifies in East and Southern Africa, which together bear 53% of the global HIV burden, Byanyima cautioned that closing essential treatment centers could be catastrophic, especially as girls and young women account for over 60% of new infections among youth on the continent.
In addition to the impacts on HIV/AIDS programs, Byanyima highlighted that various other U.N. agencies heavily reliant on U.S. funding are facing severe disruptions as a result of the funding freeze. Aid programs are under threat, exacerbating chronic issues across the globe. She pointed to the alarming statement made by the United Nations Refugee Agency earlier in March, which indicated that conflicts in the eastern Democratic Republic of Congo have left thousands without vital assistance.
“The sudden withdrawal of U.S. life-saving aid is devastating for many countries, especially in Africa, but also in Asia and Latin America,” Byanyima stressed, emphasizing the urgency of reevaluating these funding decisions to ensure the health and safety of the most vulnerable populations.
As the international community awaits the outcome of the U.S. government's review of its international assistance policies, the stakes could not be higher. Byanyima called on President Trump, appealing for a “revolution of prevention” and advocating for the further distribution of drugs like injectable treatments that require fewer doses for effective prevention.
“It's about ensuring an American company can produce and license generics in all regions to manufacture millions of doses and extend this injectable treatment to those who truly need it,” she concluded. The message is clear: the future of millions remains uncertain, hinging on decisions that the United States will make in the coming weeks regarding its funding commitments.
