The sudden stop-work order from the US government in early 2025 triggered a global funding crisis for HIV, sexual reproductive health (SRH), and youth programmes. This abrupt halt has left countless youth-led and youth-serving organizations struggling to survive, with devastating consequences for young people worldwide. The impact is profound, and the need for immediate action is critical.

A survey conducted by Y+ Global, Youth LEAD, Youth RISE, The PACT, and J+LAC in March 2025 among organizations delivering HIV and SRH youth programmes reveals the stark reality faced by youth-led and youth-serving organizations. Forty-five youth-led and youth-serving organizations from around the globe completed the survey, with 56% of responses coming from Eastern and Southern Africa, the region hosting the largest population of young people living with HIV. Sixty percent of respondents reported disruptions to their core HIV services, severely hindering their ability to provide essential HIV prevention, treatment, care, and support. These disruptions directly impact the health and well-being of young people in all their diversity and undermine ongoing efforts to strengthen youth-led HIV responses.

Beyond HIV services, other crucial youth-focused programmes have also been affected, with SRH, mental health, and life-skills education programmes each experiencing a 12% decrease. Furthermore, activities like youth-led advocacy and engagement in policy and decision-making discussions have also been impacted, leaving youth voices under represented and unheard in the HIV response as well as other development areas.

The survey also warns about the abrupt policy changes occurring as a consequence, including the integration of HIV-specific clinics into general health systems, and the surge of restrictive laws targeting organizations working on gender, diversity, and sexual and reproductive health and rights, using the term “foreign agent” to criminalize their work. These changes are causing the collapse of service delivery models and increased barriers to youth-led organizations, further reducing accessibility for young people.

“The funding cuts are not just numbers on a spreadsheet; they represent real lives, real services, and real hopes lost. Youth-led organizations are the lifeline for so many young people, especially those most at risk,” shared Maximina Jokonya, Executive Director of Y+ Global. “We need urgent action from donors and governments to recommit and reinvest in youth leadership and safeguard the future of the HIV response,” she added.

Despite these setbacks, youth-led organizations are showing incredible resilience by launching crowdfunding campaigns, seeking alternative national and international partnerships, and continuing peer outreach with limited resources. Still, the long-term sustainability of these efforts is threatened by the funding crisis.

Youth and the next Global AIDS Strategy

Amidst this crisis, UNAIDS convened two global youth consultations in the context of the Global AIDS Strategy 2026 - 2031 development process to gather young people’s views and priorities for the future of the HIV response. More than 120 young people from diverse young key and vulnerable population groups participated in this consultative process. The key messages resulting from these consultations are unequivocal: young people demand involvement in decision-making spaces of the HIV response and in the development of alternative funding strategies, such as the sustainability roadmaps. They also demand a leading role in the implementation and monitoring of these decisions, as well as the positioning of human rights, gender equality, mental health, and innovation at the centre of the HIV response.

Call to action

Youth-led organizations are making an urgent call to all donors, partners, and policymakers to act now to save youth-led responses by reinstituting traditional funding support, increasing domestic and emergency funding solutions to maintain the operational stability of youth-led organizations, and supporting youth leadership in the HIV response.

The United Nations Secretary-General António Guterres will present his report on HIV to the 79^th United Nations General Assembly at the UN in New York on 5 June 2025.

The report, The urgency of now: AIDS at a crossroads – progress report on the 2025 targets and strategic directions for the future, contains a review of progress towards realizing the targets and commitments set out in the 2021 Political Declaration on HIV/AIDS and an outline of the work that still lies ahead.

It comes at a critical moment in the global HIV response, when urgent action is needed to protect the hard-won gains and accelerate progress towards ending AIDS as a public health threat.

UNAIDS has been supporting countries to gradually reduce their reliance on external assistance.

The current Global AIDS Strategy 2021–2026 has led the HIV response with a bold vision of ending inequalities that continue to fuel the epidemic. The midterm review of the Strategy, published as part of the annual Global AIDS Update in July 2024, highlighted key achievements and remaining challenges to inform the development of the next phase of the response.

Under the current strategy, fewer people acquired HIV in 2023 than at any point since the late 1980s. Over 30 million people were receiving life-saving antiretroviral therapy, reducing AIDS-related deaths to their lowest level since the peak of 2004. Significant gains have been made in sub-Saharan Africa, underscoring the power of existing interventions to end AIDS as a public health threat by 2030. As the United Nations approaches its eightieth anniversary, the results of the HIV response stand as a powerful testament to the impact of multilateral action and must be protected.

Amid recent challenges and the fragility of the HIV response, the world is falling behind in achieving the 2025 HIV targets. Obstacles to accessing treatment, insufficient prevention programming, a failure to adequately support the work of communities, rising inequalities and a lack of political will and financial support threaten the response.

The next Global AIDS Strategy, for the period 2026–2031, led by UNAIDS, is being developed at a time when the response to the HIV epidemic is at a crossroads. The strategy will be among the most important in 40 years of response to the pandemic. Developed in a context of instability for many countries, in particular with regard to HIV-related funding, the strategy will be crucial for accelerating the achievement of the 2030 Agenda for Sustainable Development and setting the foundation for a sustainable response to HIV post-2030.

This report is also available in Arabic, Chinese, French, Russian and Spanish.