The number of people taking a vital anti-HIV drug has fallen by almost two-fifths in just one year in the aftermath of swinging aid cuts, the United Nations has warned.

Between 2024 and 2025, the use of PrEP – a daily medicine that stops people contracting HIV – fell by an average of 38 per cent across 62 countries, according to initial data from UNAIDS published on Friday.

In many places hit hard by the disease, this reduction is far higher – Nigeria, Cameroon, Uganda and Kenya have all reported drops of more than 50 per cent. 

Dr Mary Mahy, the director for Data Impact at UNAIDS, told the Telegraph it was the first time in the history of the HIV/Aids response that prevention efforts have gone backwards. 

“PrEP took a long time to roll out – it was available in 2012, but it took countries time to figure out how to move forward with it or generate the demand,” she said. “But since then, it’s only been an uphill drive… never in the whole HIV epidemic have we seen [rates] coming down with prevention efforts.” 

The annual UNAIDS report, published ahead of a UN General Assembly meeting on HIV and Aids later this month, said the early data demonstrates that slashed international aid budgets are threatening decades of progress in the fight against the deadly disease. 

It is now 18 months since President Donald Trump’s new administration – with the help of Elon Musk’s Department of Government Efficiency (Doge) – began to dismantle the world’s largest aid agency, USAID, and introduced sweeping aid cuts. 

Other countries have since followed suit, including France, Germany and the UK – where ​​Labour has overseen a real-term aid budget reduction of 40 per cent. While many said the sector needed reform, the speed, severity and haphazardness of the cuts have left humanitarian organisations reeling.

“This is the most serious disruption in the HIV response since the world came together to fight this disease,” Winnie Byanyima, the executive director of UNAIDS, told AFP. 

She said progress against HIV had already started to slow, but “is now in peril because of sudden cuts”. Although 50 countries have committed to increase their national HIV funding, Dr Byanima added that “the new domestic resources coming in won’t replace what is going away”. 

Reductions in the use of PrEP (or pre-exposure prophylaxis) is a blow. Used by at-risk groups to prevent potential infections and has been one of the most significant developments in the fight against HIV – in 2023, a UK study involving more than 24,000 people found it reduces the chance of contracting the disease. 

But it is not the only prevention tool hit by aid cuts: HIV testing has declined by 22 per cent in countries with US funding through the PEPFAR programme, while funding allocated for condom programmes has fallen by 93 per cent.

Overall, this is yet to translate into a surge of new infections. The initial UNAIDS data, which will be followed by a further country-by-country analysis in July, found that there were 570,000 Aids-related deaths and 1.2m new cases last year. This remains a significant improvement since 2010, when there were 1.4m deaths and 2.2m new infections. 

But Dr Mahy said any jump in new cases would likely take longer to emerge, given the nature of the disease. While early symptoms typically emerge within a few weeks or months of contracting HIV, the more serious and obvious signs of an infection can take years to develop. 

She added that many of the people working on data and surveillance also lost their jobs because of aid cuts, which is complicating efforts to understand the impact of reduced funding across the world. 

Outreach work to ensure people can access treatments have also been hit hard – 80 per cent of these PEPFAR-funded programmes were slashed, with community-based initiatives hardest hit. 

“The treatment numbers are still quite solid, but we could see a problem in the future as these critical services stop working,” said Dr Mahy. 

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