Why it matters
- 1.2 million people contracted HIV and 570,000 died from AIDS-related illnesses in 2025
- 22 percent of people living with HIV are still not receiving treatment
- International HIV funding has fallen by 18 percent, the biggest drop in almost 20 years
- New drugs like lenacapavir are almost 100% effective in preventing HIV infection.
- 20 million people must have access to antiretroviral-based prevention to have a significant impact on the epidemic
- Generic versions of lenacapavir could cost as little as $40 per person per year, but will remain unavailable in many countries
Defined by a paradox
The conference, which takes place in Rio from July 27 to 31, is defined by a paradox.
By the end of this decade, more than three million people could be infected with HIV, but the tools to end this crisis already exist, from groundbreaking preventative medications to proven community interventions. What is missing is sustainable funding.
This growing funding gap is already forcing countries to cut essential services and close community organizations, according to the new report from UNAIDS, the agency working to end the epidemic by 2030.
If urgent measures are not taken, the agency warns, the world is on track towards a resurgence of the epidemic.
This contradiction defines the 26th International AIDS Conference.
On the one hand, there is a revolution in HIV prevention, with a new generation of drugs now offering vaccine-like protection against HIV.
On the other hand, there is growing concern that these advances remain out of reach for millions of people because they are priced too high and controlled by pharmaceutical patent holders.
Brazil excluded from generic production
Few countries illustrate this paradox more clearly than the conference host country itself.
Although Brazil played a key role in the clinical trials that helped bring lenacapavir to market, it was excluded from the list of countries allowed to manufacture lower-cost generic versions.
Lenacapavir is a long-acting injectable drug that requires only two injections per year and prevents HIV infection in almost 100% of cases, according to the latest studies.
Universal access is a “distant reality” for most
“Equitable and universal access remains a distant reality for millions due to high prices and the exclusion of many countries from voluntary licensing agreements.” said Variano Terto Jr., vice president of the Brazilian Interdisciplinary Association to Fight AIDS (ABIA).
He was speaking at a side event to a conference organized by the Community of Portuguese-Speaking Countries (CPLP).
He added that patents on essential medicines have been “strengthening monopolies and the privatization of public knowledge”.
One of the conference’s co-organizers, ABIA, recently published a study showing that Brazil could manufacture lenacapavir domestically for about $75 per patient per year.
In contrast, the patented version costs more than $20,000, a price considered unsustainable for the Brazilian public health system.
Risk of injustice
The true measure of success is not whether the drugs exist, but whether people who need them can actually get them at an affordable price, said Winnie Byanyima, Executive Director of UNAIDS.
“Innovation without access is not innovation; it’s an injustice“, she said.
UNAIDS estimates that 20 million people need access to antiretroviral-based prevention if the world is to significantly reduce new HIV infections.
A safe space for HIV/AIDS support in Lahore, Pakistan, where marginalized communities come together for health awareness and social support.
Calls for a new financing model
With HIV infections and AIDS-related deaths at their lowest levels in more than three decades, global response remains dangerously fragile.
International funding for HIV fell by more than $1.5 billion between 2024 and 2025, an 18 percent drop that marks its lowest level in nearly two decades, and global development assistance fell 23 percent last year, the largest annual decline on record, with health programs, including HIV initiatives, among the hardest hit.
Meanwhile, new HIV infections increased in three regions and 21 countries in 2025.
The current moment should be understood as “the end of the era of dependence on international aid,” the UNAIDS chief said, calling for a new financing model. including measures such as sovereign debt restructuring, to enable governments to invest in “the future of their people”.
