Protesters gather at the opening ceremony of the 26th International AIDS Conference in Rio de Janeiro, Brazil, on Monday. Pablo Porciúncula/AFP via Getty Images hide title toggle title Pablo Porciúncula/AFP via Getty Images “Rethink. Rebuild. Rise up.” That’s the theme of this year’s international AIDS conference, which began this week in Rio de Janeiro. “Rethink”
Protesters gather at the opening ceremony of the 26th International AIDS Conference in Rio de Janeiro, Brazil, on Monday.
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“Rethink. Rebuild. Rise up.”
That’s the theme of this year’s international AIDS conference, which began this week in Rio de Janeiro.
“Rethink” may be an understatement.
This year, there are encouraging signs regarding the ongoing epidemic: although 1.2 million people contracted the virus in 2025, the number of AIDS-related deaths was 547,000, the lowest number in 30 years.
However, the fate of the global campaign to end AIDS as a public health threat by 2030 is now in doubt, as the Trump administration’s aid cuts have taken a tremendous toll.
“The question is no longer whether [we] “We can end AIDS, the question is whether we choose to end AIDS,” said Winnie Byanyima, executive director of the UNAIDS agency., he said at a news conference on Monday. “When prevention disappears, infections increase. When treatment is stopped, people die.”
“The HIV pandemic is not over,” he said. “Without urgent action, it could resurface.”
Even the future of his agency, which is leading the global effort to defeat the disease, is uncertain. The UN secretary general proposed closing the organization before the end of the year as part of an effort to shrink the UN system. After the rejection, a final decision has not yet been made.
In this uncertain context, the around 6,000 HIV researchers, practitioners and activists present at the conference are rethinking: how to address disruptions and funding cuts by the United States, the largest funder of global HIV/AIDS programming, whose support from $6.7 billion was reduced to $4.6 billion last year? How do they respond to new research that points to deep disparities in who has access to care and ensure that new medications for people living with HIV, which have shown great promise in trials, reach everyone who needs them?
“The past year has been a year of mixed feelings,” Dr. Kenneth Ngure, a public health expert and president-elect of the International AIDS Society, told NPR. “We have had very good scientific progress with new products, but funding cuts have also set us back.”
A focus on PEPFAR
During the five-day conference, attention will focus on the impact of cuts to the President’s Emergency Plan for AIDS Relief (PEPFAR), the acclaimed program launched by President George W. Bush.
The Trump administration cut 30% of PEPFAR’s $4.7 million funding last year. Congress attempted to restore funding to previous levels, but the State Department, which runs PEPFAR, only reported spending 70% of the available funds.
A closed clinic in Kitwe, Zambia, that had been funded by the US foreign aid agency USAID. The clinic provided free HIV medications and treatment to the community until it was suddenly closed in January 2025, after the Trump administration halted the vast majority of US foreign assistance in light of its America First agenda.
Ben de la Cruz/NPR
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Ben de la Cruz/NPR
After this year’s ups and downs, another funding milestone is looming: the Trump administration has announced that it will permanently end funding for PEPFAR in early 2027.
As the conference begins, new surveys of PEPFAR grantees are being shared, indicating the impact of these cuts and delays.
The nonprofit amfAR, dedicated to AIDS research, education and prevention, will present the results of its survey of PEPFAR funding recipients conducted between November 2025 and April 2026.
Among the findings:
Most organizations reported reducing their services in response to cuts and restrictions on the use of their funds.
A total of 1,714 clinics, drop-in centers and other providers closed.
Community programs were hit harder than those provided by large international aid groups.
Prevention programs targeting men who have sex with men, transgender people, sex workers, and people who inject drugs were greatly affected.
“The PEPFAR that survived is not necessarily the PEPFAR that existed before,” says Elise Lankiewicz, policy associate at amfAR.
When asked to respond to these findings, the State Department sent a statement to NPR saying it could not verify amfAR’s report but called its methodology “flawed.”
The statement further noted that the Trump administration has “strengthened PEPFAR through clear strategic direction.”
Also on the agenda: New treatments
The week’s conference will also include presentations on successes, including trials of two HIV drugs: a twice-yearly injection and a weekly pill.
Over the course of a year, trials showed that lenacapavir injections had “superior efficacy” in preventing HIV transmission compared to daily oral medications, the researchers wrote. Weekly pills were also shown to be as effective as a daily dose and had relatively few side effects.
These options make it easier for people living with HIV to keep their viral load suppressed to an undetectable level, protecting their health and preventing them from transmitting HIV to their partners. The medications can also be used preventively for people at high risk for HIV.
However, funding cuts could keep this drug out of reach for many people living with HIV, says Dr. Kenneth Ngure of the International AIDS Society.
“We’re not really sure if these products will be scalable and reach the people who need them most,” he says.
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