Global alarm as UN proposes shutting UNAids by end of 2026

The future of the global HIV response has been thrown into question after the UN secretary-general proposed to "sunset UNAids by the end of 2026" — a move that has alarmed public health officials and NGO leaders who depend on the agency’s leadership. Among them is Ganna Dovbakh, executive director of the Eurasian Harm Reduction Association, who works across eastern Europe and central Asia (EECA), regions where HIV infections are rising again.

In the EECA region, new HIV infections have grown by 48 per cent and AIDS-related deaths by 32 per cent over the past decade, mainly among marginalised groups such as sex workers, men who have sex with men, and people who inject drugs.

Dovbakh said UNAids has been vital in helping governments secure antiretroviral medicines, advocate for vulnerable people and maintain HIV as a policy priority in countries where civil freedoms are limited. “With the sunset of UNAids, there is a big risk that the country will ignore the needs of people living with HIV and affected populations,” she said.

The suggestion that UNAids could close four years earlier than expected has caused deep concern across its governing board. The plan comes amid falling foreign aid for low-income nations, weakening the global fight against HIV.

At the World Health Summit in Berlin last week, UNAids executive director Winnie Byanyima warned: “That rapid decline [in funding] is costing lives, let’s be clear about that.”

Meanwhile, Angeli Achrekar, UNAids’ deputy executive director, described the UN80 reform proposal as 'a big shock'.

Firing the employees

The agency is already cutting staff numbers from 600 to 300 to reduce costs. Achrekar said UNAids has been crucial this year in helping countries manage the abrupt withdrawal of donor support and track the effects on vulnerable populations.

“Abruptly sunsetting UNAids is a nail in the coffin of the HIV response,” Achrekar was quoted.

“With funding cuts from the US (United States) and other major donors, the Aids response could spiral again,” she added.

UNAids’ ability to collect and analyse global HIV data is seen as irreplaceable. Its monitoring shows Africa remains the epicentre of the epidemic, home to 67 per cent of the 40.8 million people living with HIV worldwide. Although the risk of infection in sub-Saharan Africa has fallen by 60 per cent since 1995, rates remain high among adolescent girls and young women.

“Many governments and scientists across Africa use the UNAids data to understand where more efforts need to be put in place,” said Kenneth Ngure, president-elect of the International Aids Society. “UNAids holds the mirror to the epidemic for everyone to see and act.”

Without that data, experts fear progress will stall. Nomathemba Chandiwana, of the Desmond Tutu Health Foundation in South Africa, warns that HIV could lose visibility within broader health priorities. “In the Western Cape, for example, we don’t have a dedicated HIV prevention unit like other provinces,” she said. “And because of that, HIV prevention is not as good in the Western Cape. You can’t focus on HIV in particular if it’s just part of a wider bucket.”

Dovbakh worried that closing UNAids would also make it harder to reach criminalised groups such as gay men and people who inject drugs, whose needs are already politically sensitive.

“The HIV epidemic will go under the surface,” said Dovbakh. “Some countries could completely cut their HIV response within one to two years, we won’t know what is happening, and then in five years’ time, we will start to see wider breakouts [among the general public] with HIV cases being detected in children, women and medical facilities.”

Meanwhile, Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, said the proposal comes at a time of major scientific breakthroughs, including long-acting injectable drugs like lenacapavir. “We have these amazing opportunities, and we should be focusing more on that than what organisations are going to be around in the next couple of years,” said Warren.

Ngure added that rolling out lenacapavir equitably will require UNAids’ data and advocacy.“Lenacapa vir rollout will need to be guided by the status of the epidemic, with areas most badly affected by HIV being prioritised,” he said. “It will also need global advocacy for funding. Without UNAids, the rollout will be heavily dented.”

Chandiwana warned that folding UNAids into other UN bodies could undermine decades of progress. “If you put it all into one big organisation, you’ll find that it actually dilutes what can be done,” she said.

“We still have a long way to go with HIV, and at a time when the World Health Organization is also being defunded, if you defund UNAids, you’re doing a lot more harm than good.”

With agency inputs