Research says global HIV efforts need renewed funding and focus

As the world marks World AIDS Day on Dec. 1, world-renowned infectious disease expert Anthony Fauci, MD, and his colleague Greg Folkers, MS, MPH, highlight advances made in the treatment and prevention of HIV that could finally end the pandemic, but caution, "History will judge us harshly should we squander this opportunity."

Writing in PLOS Medicine ("Treatment and prevention of HIV/AIDS: Unfinished business," December 1, 2025), Fauci, Distinguished University Professor in Georgetown's School of Medicine and McCourt School of Public Policy, and Folkers, Fauci's long-time chief of staff at the National Institutes of Health explore a path forward for eliminating HIV/AIDS. The number of people living with HIV globally in 2024 exceeded 40 million, with 1.3 million new infections and 660,000 deaths in that year alone.

They reflect on significant advances made in the development of powerful therapeutics to treat and prevent HIV and underscore the importance of programs such as the Global Fund and the President's Emergency Plan for AIDS Relief (PEPFAR), which have allowed for successful implementation and scale up of treatment and prevention interventions that have saved millions of lives.

However, pauses in U.S. foreign development assistance leading to the termination of clinical services "likely has resulted in the illness and death of thousands of people with HIV. Modelling studies suggest that millions of additional HIV infections and deaths could occur if withheld funding is not reconstituted and expanded," they write, adding, "The time is now to advocate for the US Congress to renew funding of the Global Fund and PEPFAR at robust levels."

Fauci and Folkers acknowledge that these two programs alone will not end the epidemic and they highlight the importance of countries taking control of their own HIV responses complemented by the work of international agencies, donors, community groups, drug manufacturers, researchers and implementers.

"Only with such a multi-pronged effort will we end the HIV/AIDS pandemic," they write.