Africa is facing a critical moment in its HIV response, with recent funding disruptions threatening to slow or reverse hard-won gains across the continent. For years, sub-Saharan Africa has led the global decline in new infections, but UNAIDS says prevention programmes, community services and support for vulnerable groups are now under serious strain.
The report shows that sub-Saharan Africa still accounts for about half of all new HIV infections worldwide, even though the region has also recorded the steepest long-term decline. Since 2010, new infections in the region have fallen by 59 percent, but UNAIDS warns that this progress is fragile if funding cuts continue.
One of the biggest concerns is prevention. HIV prevention programmes across sub-Saharan Africa were sharply reduced in 2025, with enrolment in pre-exposure prophylaxis, or PrEP, dropping by 38 percent in reporting countries. Funding for condom programming and other prevention support also fell steeply in some donor-backed programmes. UNAIDS says this is especially worrying because prevention services in Africa have long depended heavily on external assistance.
Women and girls remain among the most affected. In sub-Saharan Africa, women account for six in every 10 new HIV infections. Adolescent girls and young women aged 15 to 24 remain at particularly high risk, with infection rates three to four times higher than those of their male peers in the region. The report says this shows the epidemic remains deeply shaped by gender inequality, poverty and unequal access to services.
Children are also still being affected. UNAIDS estimates that 94,000 children acquired HIV in 2025, the vast majority in sub-Saharan Africa. Although treatment coverage has improved over time, the report says gaps in prevention of mother-to-child transmission and broader service delivery continue to put children at risk.
Community-led organisations are another major concern. UNAIDS says these groups are vital to reaching people who might otherwise be left out of the health system, including people living with HIV, key populations and young women. But many of these organisations are now facing funding shortages, even though they provide counselling, outreach, testing support and help reduce stigma in communities.
The report argues that Africa’s HIV response must now shift toward stronger domestic financing, more efficient use of resources and better integration of HIV services into national health systems. It also calls for greater protection of community-led programmes, which it says are essential for sustaining progress.
UNAIDS says ending AIDS as a public health threat by 2030 is still possible, but only if countries act quickly to protect prevention, treatment and community systems. For Africa, the message is clear: progress has been real, but without renewed investment and political commitment, the gains of the past two decades could begin to slip away.
