HIV Crisis Looms, Warns Lancet Study — Why Foreign Aid Cuts Could Bring A Deadly Comeback

A new study published in The Lancet HIV warns that proposed cuts to foreign aid by major donor countries could wipe out decades of progress in fighting HIV/AIDS. The research estimates that funding reductions could cause millions of new HIV infections and deaths by 2030, especially in low-and-middle-income countries (LMICs).

According to the study, between 4.4 and 10.8 million additional new HIV infections and 770,000 to 2.9 million HIV-related deaths in children and adults could occur globally between 2025 and 2030 if funding cuts proposed by the top five donor countries, including the USA and the UK, are not mitigated. 

What’s Happening And Why It Matters

Right now, millions of people worldwide rely on international funding for HIV treatment, testing, and prevention programmes. But some of the biggest donors— the United States, United Kingdom, France, Germany, and the Netherlands — are slashing foreign aid budgets. This means fewer free condoms, HIV tests, life-saving medicines, and health programmes for the most vulnerable communities.

The study warns that sub-Saharan Africa will be hit hardest, but the crisis could spread globally. Among the most at-risk groups are people who inject drugs, sex workers, men who have sex with men, and children. And while this might seem like a distant issue, India isn’t immune either — the country has the third-highest number of HIV cases in the world. With global funding drying up, India’s own prevention programs and progress could take a hit.

The Big Numbers: Why We Should Worry

If foreign aid cuts go ahead as planned, here’s what could happen by 2030:

  • 4.4 million to 10.8 million new HIV infections globally.
  • 770,000 to 2.9 million HIV-related deaths.
  • A 1.3 to 6 times surge in new infections among high-risk groups.

"The United States has historically been the largest contributor to global efforts to treat and prevent HIV, but the current cuts to PEPFAR and USAID-supported programs have already disrupted access to essential HIV services, including antiretroviral therapy and HIV prevention,” said Dr. Debra ten Brink of the Burnet Institute in Australia.

Why Is The Money Drying Up?

One of the biggest casualties in these cuts is PEPFAR (The U.S. President’s Emergency Plan for AIDS Relief), which has been the backbone of global HIV funding for decades. But in January 2025, the US government paused all foreign aid funding for a 90-day review, causing a chain reaction of disruptions in HIV programs worldwide. Political shifts, economic slowdowns, and changing priorities mean that many Western nations are pulling back on foreign aid — and programmes in Africa, Asia, and other LMICs are feeling the heat.

How It Could Set Us Back 20 Years

The study, led by researchers at the Burnet Institute, used a mathematical model across 26 countries to predict the worst-case scenario. If funding cuts continue:

  • Prevention programmes like condom distribution and PrEP (a medication that prevents HIV) could disappear.
  • Mother-to-child transmission efforts could collapse, leading to more HIV-positive babies.
  • Even if funding is restored after 1-2 years, reversing the damage could take 20-30 years.

“There could be an even greater impact in sub-Saharan Africa, where broader prevention efforts, such as distributing condoms and offering pre-exposure prophylaxis (PrEP), are at first risk to be discontinued,” said Dr. Rowan Martin-Hughes of the Burnet Institute.

Why India And Some Other Countries Should Care

Many countries, including India, have made significant strides in reducing HIV cases. But without global funding, sustaining progress will be a challenge. While India has its own HIV programs, they also receive international support. If aid vanishes, it could strain India’s healthcare system and make prevention and treatment harder for millions.

“There is an urgent need for innovative, country-led financing strategies and an integration of HIV services into broader health systems,” said Dr Nick Scott of the Burnet Institute. But transitioning from international aid to self-funded programs takes time — something we may not have if funding is cut abruptly.

International aid has historically played a significant role in supporting India's HIV/AIDS prevention and control programmes. Organisations such as the Global Fund have allocated substantial resources to India; and so have initiatives like the Bill & Melinda Gates Foundation, etc. bolstering the nation’s prevention efforts. Additionally, India has been progressively increasing its domestic funding and transitioning into a role as both an aid recipient and donor in the global health.

According to the Global Fund organisation’s website, “India joined the Global Fund as a donor in 2006, and has contributed a total US$84.5 million to date. The country pledged US$25 million for the Global Fund’s Seventh Replenishment, covering 2023-2025.” This global flow of international aid works to keep the gears of prevention and rehabilitation moving.

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