At the end of July, thousands of scientists, advocates and policymakers gathered at Aids 2026, the 26th International Aids Conference in Rio de Janeiro, to advance the global HIV response. But during one high-profile session, a jarring moment threatened to derail our focus: a slide presented by a senior US state department official displayed a map of Africa with country names glaringly scrambled and mislabelled.
While the mistake apparently occurred due to an over-reliance on AI tools, it carried a painful symbolic weight for many of us. It reinforced a longstanding frustration: that too many political leaders treat Africa as a monolithic abstraction rather than a continent of 54 distinct sovereign nations.
A cartographic blunder is embarrassing, but far greater harm comes when that same lack of thought and care influences budget decisions. Today, global political resolve to address HIV continues to waver and the funding that has kept millions of people alive has plunged.
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A report from UNAids and KFF, a health non-profit, released at Aids 2026 revealed that donor government funding for the global HIV response fell 25% in 2025 from the previous year, putting decades of hard-won progress at risk. And this shift was entirely due to a steep decline in US support.
Due in part to these cuts, many African countries are already stepping up their own HIV investments. But hard-hit countries have extremely limited resources, often because they remain crippled by debt. And no single country can replace the sheer scale of international financing and partnerships that have sustained the global HIV response for decades.
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The most important of those partnerships is Pepfar, the President’s Emergency Plan for Aids Relief, which has saved more than 26 million lives since 2003 and changed the trajectory of the HIV pandemic. During President Trump’s first term, the programme continued to expand and contributed to substantial progress towards global HIV targets. Since the start of his second administration, however, Pepfar has undergone significant disruptions.
Two studies presented at Aids 2026 shed light on the real-world consequences of these disruptions. In the first, amfAR, the Aids research foundation, surveyed Pepfar implementing partners in 46 countries. More than half reported that they had at least one terminated award, and these terminations led to more than 1,700 closed HIV service sites. Disturbingly, partners were most likely to have permanently stopped providing services for the very groups most vulnerable to HIV.
The second study drew on a rapid analysis of newly released Pepfar data. It showed that, globally, more than 77,000 fewer children living with HIV received Pepfar-supported treatment in the fiscal year 2025 than in 2024, a decline of 14%. South Africa alone recorded a 45% drop, with more than 30,000 fewer children receiving treatment support from the programme.
The maths of the HIV pandemic is unforgiving. If we retreat now, new HIV acquisitions will spike, more lives will be lost and the ultimate cost will increase massively.
Sustaining donor funding for the HIV response is a shared global security imperative and a moral responsibility. We cannot end HIV as a threat to public health and individual wellbeing if donor countries treat Africans as disposable.
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It is time for political leaders to look at Africa clearly: as an essential partner deserving of mutual respect, serious engagement and sustained support. Getting our geography right is the bare minimum. Getting our priorities right will save millions of lives.
