A sharp decline in access to HIV prevention services across Nigeria and 61 other countries has raised concerns about a potential resurgence of new infections, as global aid cuts continue to undermine efforts to combat the virus, according to new data released by the Joint United Nations Programme on HIV/AIDS (UNAIDS).
Figures presented by UNAIDS on Friday showed that nearly 40% fewer people received pre-exposure prophylaxis (PrEP) — a medication that helps prevent HIV infection — last year compared with two years earlier.
The decline amounted to about 1.2 million people, with the number of individuals accessing PrEP falling from 3.3 million to 2.1 million across countries including Nigeria, Cameroon and Uganda.
The agency also reported severe reductions in funding for other prevention measures, with support for condom distribution dropping by more than 90% in some countries.
“We are undergoing perhaps the most serious disruption of HIV services since the HIV response started,” UNAIDS Executive Director Winnie Byanyima said.
“We can’t sit here thinking that the impact isn’t so dramatic,” she added.
Byanyima warned that shrinking donor support, combined with growing restrictions and discrimination affecting key populations, including LGBTQ communities, could reverse years of progress in the global HIV response.
She said the reduction in prevention services is likely to contribute to higher numbers of HIV infections and AIDS-related deaths in the coming years unless urgent action is taken.
Although UNAIDS data showed new HIV infections fell slightly last year, dropping by around 100,000 to 1.2 million cases globally, the agency cautioned that the picture may be incomplete.
HIV testing rates declined by 22% in some of the countries most affected by the epidemic, making it difficult to fully assess the scale of new infections.
Despite the challenges facing prevention programmes, the report noted that treatment coverage continued to expand.
An estimated 32.1 million people were receiving antiretroviral therapy by the end of last year, representing a 2.7% increase compared with the previous year.
While that growth was lower than the annual average increase of about 4% recorded in recent years, UNAIDS said it demonstrated the efforts of governments and communities to maintain treatment services despite financial pressures.
The agency said many countries had increased domestic spending on HIV programmes for the first time since the COVID-19 pandemic, helping to prevent a more severe disruption to treatment access.
However, UNAIDS warned that prevention programmes have been less resilient, with many community-based organisations — often regarded as the backbone of HIV response efforts — facing closure as international funding declines.
The data was released ahead of a high-level United Nations meeting on HIV/AIDS scheduled to take place in New York later this month, where UNAIDS is expected to call for renewed global commitment to the fight against the disease.
The agency is also confronting uncertainty over its future after the UN proposed winding it down in 2026 as part of broader efforts to address financial constraints within the organisation.
Byanyima said reforms were underway and a final report on the agency’s future would be presented in October.
“What I’m certain about is that the United Nations will not drop its leadership role in the global response,” she said.
