The 26th International AIDS Conference in Rio de Janeiro in 2026 brought together around 7,000 delegates, marking one of the smallest gatherings since the biennial conference’s inception in 1985. The event was overshadowed by an unprecedented funding crisis, with discussions in the passageways focusing more on layoffs than on viral load reductions.
In 2026, the United States government, the world’s largest HIV donor, made sharp cuts to HIV funding in developing countries, including South Africa. This resulted in the closure of 1,714 HIV clinics and drop-in centers in 46 countries and the loss of more than 16,000 full-time staff. The US government’s Aids program, Pepfar, cut its support by a quarter, with more cuts on the horizon. Other wealthy countries have also reduced or flatlined their contributions, pushing donor funding for HIV to levels not seen since before 2008.
The Cruel Irony of Scientific Breakthroughs
Just as funding was disappearing, science delivered a remarkable breakthrough: lenacapavir (LEN), an injection given twice a year that significantly reduces the likelihood of contracting HIV. However, this breakthrough is only effective if people can access it. LEN requires funding to produce, purchase, and distribute, raising the critical question: does the world still have the political will to end AIDS?
The Changing Face of the HIV/AIDS Movement
The conference signaled the end of an era where AIDS occupied a unique place in global health. The fight over the discovery of HIV reached the highest levels of government, with US President Ronald Reagan and French Prime Minister Jacques Chirac signing an agreement in 1987 to settle a dispute between American and French scientists. This level of scientific and political attention is rare for any disease.
The HIV/AIDS movement has attracted extraordinary international funding, with the creation of two huge funding mechanisms: Pepfar and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. This funding has fueled fast-moving science, built influential activist movements, and delivered lifesaving treatment to poor countries. However, the world has changed, and the old funding model is not coming back.
The Future of AIDS Conferences
The financial reality will almost certainly change the number, size, and shape of AIDS conferences. These gatherings have served an important purpose, from announcing scientific breakthroughs to developing regional HIV plans. However, with the rise of webinars, livestreams, and social media, the need for large in-person conferences is being questioned.
Despite these changes, AIDS conferences remain places where scientists, public health officials, activists, and HIV organizations exchange ideas and build alliances. The question is whether we still need as many conferences in their current form. Integration of HIV with other health services has become a buzzword, but there is a danger in confusing integration with simply shutting down specialized services.
A New Generation, a Different Movement
An unavoidable generational handover is underway. The activists who shaped HIV programs and helped through the darkest years of the epidemic still command respect. However, young activists live in a different world with new worries competing with HIV for their attention. The HIV movement must find ways to fit into their reality, utilizing platforms like TikTok, gaming, and WhatsApp.
The HIV movement faces a critical juncture. It must adapt to new funding realities, leverage scientific breakthroughs, and engage a new generation. The future of the movement will be shaped by its ability to integrate without losing the effectiveness of its specialized structures and conferences.
