Global efforts to prevent HIV lost ground last year as funding disruptions forced countries to scale back services, even as health systems managed to put more people living with the virus on lifesaving treatment.
About 1.1 million people received pre-exposure prophylaxis, or PrEP, last year in countries where the Global Fund invests, down 21% from 2024, according to the organisation’s annual results report. HIV prevention services were scaled back or suspended in many countries as reductions in domestic and international funding squeezed health programs.
The reversal comes as the world is trying to drive down the roughly 1.3 million new HIV infections that still occur annually. PrEP medicines protect HIV-negative people before exposure to the virus and are particularly important for people at elevated risk. Expanding their use is considered critical to curbing new infections rather than relying on treatment after people acquire HIV.
The prevention setback contrasted with continued progress in treating people already living with the virus. Some 26.9 million people were receiving antiretroviral therapy in Global Fund-supported countries in 2025, up from 25.6 million a year earlier.
About 87% of people living with HIV knew their status, while 74% had achieved viral suppression.
The pressures extended beyond HIV. Tuberculosis programs faced disruptions to case finding, diagnosis and treatment, while malaria programs experienced medicine shortages and delays to prevention campaigns.
Still, countries treated 7.4 million people for TB and distributed 196 million insecticide-treated mosquito nets.
New technology could help rebuild HIV prevention.
The Global Fund began delivering Gilead Sciences twice-yearly lenacapavir injection to early-adopter countries at the end of 2025 and is accelerating its rollout this year.
Generic versions of lenacapavir are expected to become available from 2027, potentially putting the long-acting prevention drug within reach of millions more people.
“If we can ensure these interventions get to the key and vulnerable populations most at risk, and the barriers to access, such as stigma and discrimination, don’t impede that,” Peter Sands, executive director of the Global Fund, told reporters, “then we have the opportunity to dramatically reduce new HIV infections.”
