The global fight against HIV is at a crossroads. Innovative prevention methods, such as lenacapavir an injectable version of PrEP (pre-exposure prophylaxis), promise to dramatically reduce new HIV cases. However, these advancements are being threatened by substantial cuts in funding, particularly from the United States.
Lenacapavir, recommended by the World Health Organization (WHO) in 2026, requires only two injections annually and is 99% effective in preventing sexually transmitted HIV. This breakthrough is particularly crucial for populations facing barriers to daily medication, such as those in poverty, rural areas, or experiencing stigma. Mathematical models suggest that widespread availability of lenacapavir could prevent 41% of new HIV infections in regions like South Africa, Zimbabwe, and western Kenya.
The Impact of USAID Dissolution
The dissolution of USAID which provided 73% of donor-funded resources for HIV prevention globally, has had a profound impact on the availability of these life-saving medications. As of July 2026, investment in HIV prevention has declined dramatically, affecting not only the distribution of medications but also the ability of organizations to reach those in need.
Beatriz Grinsztejn president of the International Aids Society and an infectious disease physician, highlighted the dual challenge of achieving major advancements in prevention while facing significant funding cuts. These cuts have deeply affected the delivery of new prevention technologies and decreased the number of people engaged in care and prevention services.
Outreach Services and Harm Reduction
The funding cuts have particularly impacted peer outreach workers who are crucial for reaching high-risk populations, such as people who use drugs. A report from the International Network of People Who Use Drugs found that organizations have had to cut outreach services in response to the loss of funding. This reduction in services not only affects trust and engagement but also hinders the distribution of innovative medications like lenacapavir.
Ailish Brennan a policy analyst at Harm Reduction International emphasized the importance of outreach services in building trust and engaging high-risk populations. The closure of clinics and mobile locations due to funding cuts means that clients at risk for HIV lose their local points of contact, ultimately preventing the innovations from reaching those who need them most.
Pharmaceutical Access and Global Disparities
Even before the dissolution of USAID, many Latin American countries were excluded from agreements with US-based pharmaceutical companies to make innovative HIV prevention more affordable. Gilead Sciences provides generic versions of long-acting medications to low- and middle-income countries at a reduced cost but excludes countries like Brazil, Colombia, Mexico, Peru, and Argentina by classifying them as “upper middle-income countries.” HIV advocates dispute this classification, noting the significant role these countries played in clinical trials.
Grinsztejn expressed hope that the UNAIDS goal of eliminating AIDS as a public health threat by 2030 could be achieved with the right prevention technologies. However, she acknowledged the challenges posed by the current funding scenario, making the target seem increasingly difficult to attain.
