Sub-Saharan Africa’s fight against HIV/AIDS is facing a renewed crisis as cuts in US, British, and European aid leave health services struggling, with experts warning of millions of additional infections by 2030.

In Mozambique, a teenage rape victim seeking care at a health clinic found it shuttered. In Zimbabwe, AIDS-related deaths rose for the first time in five years. In Ethiopia and the Democratic Republic of the Congo, patients with suspected HIV went undiagnosed due to stockouts of test kits.

These stories, documented in a series of reports released over the past week, highlight the devastating impact of aid reductions on HIV prevention, testing, and treatment services across the continent.

“The complex ecosystem that sustains HIV services in dozens of low- and middle-income countries was shaken to its core,” Winnie Byanyima, executive director of UNAIDS, said of the crisis

Millions at risk

UNAIDS warns that without immediate intervention, the cuts could result in 3.3 million more new HIV infections by 2030 than previously expected. While some countries have introduced domestic funding to compensate, access to care remains far from universal.

Preventive programs, which rely heavily on donor funding, have been hit hardest. In Burundi, for example, the number of people receiving preventive HIV medications fell by 64%. Country-level reports from the British charity Frontline Aids, covering Angola, Kenya, Malawi, Mozambique, Nigeria, Tanzania, Uganda, and Zimbabwe, reveal similar setbacks.

Read more: HIV testing drops in South Africa amid US aid cuts: Reuters

Vulnerable groups disproportionately affected

Progress in HIV prevention has long focused on “key populations” at higher risk of infection, including people who inject drugs, sex workers, and prison inmates.

Now, many of these clinics that treat vulnerable groups and community-led organizations have closed.

Teenage girls and young women, who are disproportionately affected by HIV in Sub-Saharan Africa, have also been heavily impacted, with programs designed specifically for them among the common casualties of aid reductions. In Kenya, some key population members reportedly hide their identity to access care safely, threatening the accuracy of public health data on infection trends.

Signs of resilience, hope

Despite the setbacks, some observers see potential for reform. John Plastow, executive director at Frontline Aids, noted that governments and communities are beginning to “build more sustainable, homegrown HIV responses.”

UNAIDS highlighted several countries, including Nigeria, Uganda, Cote d’Ivoire, South Africa, and Tanzania, that have pledged to increase domestic investment in HIV services. Innovations, such as long-acting injectable drugs for prevention, are also “gaining momentum.”

“We know what works, we have the science, tools, and proven strategies,” Byanyima said. “What we need now is political courage: investing in communities, in prevention, in innovation, and in protecting human rights as the path to end Aids.”

Aid cuts, policy context

The crisis has been fueled in part by the Trump administration’s abrupt cut to all overseas aid in January 2025, with only partial restorations since. The UK and other European donors have also reduced funding, leaving external health assistance over 2025 between 30% and 40% lower than in 2023.

Experts warn that without renewed international and domestic commitment, the hard-won progress against HIV in sub-Saharan Africa risks reversing, potentially setting back the fight against Aids by years.

Read more: Trump's aid freeze threatens millions as HIV/AIDS programs collapse