Aid cuts hit disease prevention harder than treatment, Global Fund says

Global funding cuts have fallen more heavily on efforts to prevent AIDS, malaria and tuberculosis than on services treating patients already infected, according to the head of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Peter Sands said affected countries and the fund worked to avert the worst scenarios forecast after the United States and other wealthy nations sharply reduced aid spending. Even so, many countries had to scale back prevention programmes to shield core treatment services.

"Obviously, in terms of the momentum towards ending these diseases as public health threats, if you back off on prevention, you slow your progress," Sands said, speaking ahead of the release of the fund's annual report on Wednesday. The report covers its work in more than 100 countries.

Treatment largely holds up

The report found that treatment programmes mostly withstood the funding cuts. The number of people receiving antiretroviral therapy for HIV rose by 1.3 million to 26.9 million in 2025, while 7.4 million people were treated for tuberculosis, broadly unchanged from the previous year. Distribution of insecticide-treated bed nets for malaria prevention increased to 196 million from 162 million.

But the picture varied by country. Tuberculosis programmes faced disruptions to case-finding and diagnosis, while malaria responses dealt with medicine shortages and delays to prevention campaigns.

Prevention setback

For HIV prevention, 300,000 fewer people got access to pre-exposure prophylaxis, down to 1.1 million in 2025 compared with 2024, putting them at risk of infection.

Sands said it was too early to assess the effect of the cuts on infection and death rates because that data would not be available for several months.

"I wouldn't want people concluding that therefore it was all okay and we could survive with less money," he said. "The fact that prevention programs across all three diseases have been cut - that will have consequences."