Global Health Progress at Risk as Aid Cuts Force Countries to Scale Back Disease Prevention

Cuts to international aid are forcing countries to scale back programmes designed to prevent HIV, tuberculosis and malaria as governments prioritise keeping essential treatment services running, the Global Fund has warned.

The organisation’s latest Results Report shows that countries managed to protect many frontline treatment services during 2025 despite severe financial pressures. Across countries supported by the Global Fund, 26.9 million people received antiretroviral therapy for HIV and 7.4 million people were treated for tuberculosis. A further 196 million insecticide-treated mosquito nets were distributed to help prevent malaria.

However, the picture for disease prevention is more concerning. HIV prevention programmes were reduced or suspended in a number of countries, while TB services experienced disruption to case finding, diagnosis and treatment. Malaria programmes were affected by shortages of essential medicines and delays to prevention campaigns.

One indication of the impact can already be seen in access to HIV prevention medication. Around 1.1 million people received pre-exposure prophylaxis, known as PrEP, in Global Fund-supported countries during 2025, down from 1.4 million the previous year.

The concern is that protecting treatment while reducing prevention may prevent an immediate health crisis but create greater problems in the years ahead. Fewer people being reached through prevention, testing and early diagnosis could ultimately lead to more infections and place additional pressure on health systems already struggling with limited resources.

Global Fund executive director Peter Sands said countries and communities had worked to protect essential health services during an exceptionally difficult period, but warned that maintaining current treatment levels should not be interpreted as evidence that funding reductions can be absorbed without consequences.

The organisation says the impact is being felt across the three diseases it targets. An estimated 10.7 million people developed TB globally in 2024 and more than 1.2 million died from the disease, while malaria was responsible for an estimated 610,000 deaths.

Despite the challenges, the Global Fund says its partnership has helped save 72 million lives since 2002. New technologies are also offering opportunities to make limited resources go further, including long-acting HIV prevention, AI-enabled digital X-rays for TB and newer mosquito nets designed to combat insecticide-resistant malaria.

The warning, however, is that decades of progress cannot be taken for granted. If prevention services continue to shrink while countries concentrate increasingly scarce resources on keeping existing patients alive and in treatment, the consequences of today’s funding decisions may only become fully visible in the years to come.

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