The study found that sudden U.S. funding cuts will result in three million AIDS deaths.

By 2030, a staggering 10.8 million new HIV infections and nearly three million deaths could occur in 2030, according to shocking new research published in the Lancet HIV Journal this week.

The study, using mathematical modeling in 26 countries, reveals that decades of progress in the global battle against HIV/AIDS may be rapidly disbanded as foreign aid budgets in major donor countries, including the United States and the United Kingdom.

“The United States has historically been the biggest contributor to global treatment and HIV prevention efforts, but the current cuts to Pepfar and USAID-supported programs have undermined access to basic HIV services, including for antiretroviral treatments, HIV prevention and testing.”

This has become increasingly unstable since January 20 with the U.S. government (nearly three-quarters of all international HIV support provided) This is because five major donor countries have jointly provided more than 90% of international HIV funding, announcing plans to reduce their contributions by an average of 24% by 2026.

For those infected with HIV in areas such as sub-Saharan Africa, these cuts can have devastating consequences. The study shows that programs targeting vulnerable groups, including drug injections, sex workers, men who have sex with men and children, may be initially and most difficult.

“In sub-Saharan Africa there may be greater impact, in which case broader prevention efforts, such as distribution of condoms and providing pre-prevention prevention (PREP – a drug that reduces the risk of HIV), are the risk of discontinuation first.”

Time is particularly disturbing, as many recipient countries have been making significant progress. From 2010 to 2023, countries with PEPFAR support fell by an average of 8.3% per year, and HIV-related deaths fell by 10.3%. If this trend continues, many countries will eliminate HIV/AIDS as a public health threat by about 2036.

Instead, researchers found that if the cuts continue as planned, new infections and deaths could return to levels not seen since the early 2000s, effectively eliminating two decades of progress.

Foreign aid programs like Pepfar do more than just provide medicine. They fund comprehensive services including HIV testing, laboratory services, healthcare staff training and health system enhancement. Many also combine HIV services with other key health programs targeting tuberculosis, maternal health and child welfare.

Even temporary funding disruptions can have long-term effects. The study estimates that if support for HIV treatment is restored after 12 to 24 months, the new infection rate can still stabilize at a similar level to 2020, suggesting that setbacks may require an additional 20 to 30 years of investment to overcome.

“Innovative, state-led financing strategies and integration of HIV services into the broader health system are urgently needed,” said study author Nick Scott, Ph.D., of the Burnet Institute. “Long-term strategic planning is needed to transition countries from international support to domestically funded programs.”

The researchers acknowledge that their estimates may actually underestimate the real impact, as disruptions to the supply chain, health care workforce and health systems could have broader health consequences beyond HIV.

The stakes won’t be higher for millions of people who live on these plans. As international attention shifts to new challenges around the world, this study quickly reminds you that giving up long-term health commitments has the potential to eliminate decades of hard progress that could end up losing millions of lives.