Funding cuts, discrimination and unequal access to treatment and prevention are threatening progress towards ending AIDS as a public health threat by 2030, UNAIDS has warned ahead of World AIDS Day on December 1.
In its message under the theme “Ending AIDS starts with access”, the Joint United Nations Programme on HIV/AIDS said medical advances would not achieve their potential unless people could obtain services affordably, confidentially and without discrimination.
“The gap is no longer what medicine can do. It is who is able, allowed and supported to reach it,” the agency said.
An estimated 340,000 people were living with HIV in the Caribbean in 2025, when the region recorded 13,000 new infections and 4,800 AIDS-related deaths, according to the statement.
Although new infections in the Caribbean fell by 30 per cent and AIDS-related deaths by 65 per cent between 2010 and 2025, significant gaps remain. Only about one in four children living with HIV in the region had a suppressed viral load, the agency said.
Globally, 32.1 million people were receiving treatment, but nearly nine million people living with HIV still lacked access. During 2025, an estimated 1.2 million people acquired HIV and 570,000 died of AIDS-related causes.
UNAIDS said external HIV financing fell by 18 per cent in 2025, the largest decline in almost two decades. Prevention programmes and community-led organisations serving marginalised populations were among the first affected.
A 2026 survey of 79 community-led organisations in 47 countries found a 50 per cent decline in the delivery of pre-exposure prophylaxis, or PrEP, which is medication used to prevent HIV acquisition. Services for gay men and other men who have sex with men fell by 85 per cent, while those for sex workers declined by 82 per cent, the agency reported.
The warning follows earlier concerns about disruptions to Caribbean HIV services. Stabroek News reported on November 29, 2025, that a UNAIDS and Pan Caribbean Partnership Against HIV and AIDS survey found that 80 per cent of HIV service organisations in the region were experiencing serious disruptions following United States funding cuts.
In that report, Health Minister Dr Frank Anthony said the Guyana government financed the key components of the national programme, including HIV testing, antiretroviral medicines and viral-load testing. He nevertheless acknowledged gaps in getting people diagnosed and into treatment.
More recently, research in Guyana has illustrated the distinction between providing tests and ensuring patients receive care.
The study of 112 adults with advanced HIV at seven healthcare facilities found that 24, or 21.4 per cent, had at least one opportunistic infection. Approximately one-third of those affected had no obvious symptoms.
Although all participants underwent testing to assess immune function, only 69.3 per cent initiated antiretroviral therapy and 38.3 per cent received tuberculosis preventive treatment. The findings, presented by Dr Tariq Jagnarine at the 19th Guyana Medical Research Conference, supported stronger screening, reliable medicine supplies and improved treatment and follow-up arrangements. The study’s limitations included its relatively small sample.
UNAIDS also highlighted the promise of lenacapavir, a long-acting HIV prevention medicine administered twice yearly. It is not a vaccine.
According to the agency, more than 50,000 people in nine sub-Saharan African countries had received it by the end of June 2026. Its price for lower-income countries is expected to fall to US$40 per person annually from 2027, but prices for middle- and upper-income countries remain unclear.
The agency said countries needed funded implementation plans to ensure the medicine reached those who needed it, alongside other prevention options.
Stigma and punitive laws remained additional barriers. UNAIDS said a quarter of people living with HIV who sought non-HIV healthcare across 25 countries reported experiencing stigma or discrimination, while 12 per cent were denied care.
The agency called for protection of rights, sustained support for community organisations and implementation of the Political Declaration on HIV and AIDS adopted by United Nations member states in June.
The declaration includes targets of 40 million people receiving treatment by 2030, with 38 million achieving viral suppression, and 20 million using antiretroviral-based prevention. It also calls for annual HIV funding of US$21.9 billion by 2030, compared with US$17.6 billion available in 2025.
UNAIDS said meeting the commitments could avert 3.2 million new infections and 1.3 million AIDS-related deaths by 2030.
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