The global fight against HIV is entering a dangerous new phase, with unprecedented scientific breakthroughs colliding with shrinking international funding, raising fears that millions of people -- including vulnerable populations in countries such as Bangladesh -- could be left without access to life-saving prevention and treatment services.
Ahead of the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, International AIDS Society (IAS) President Dr Beatriz Grinsztejn warned that declining donor support is threatening decades of progress against the epidemic just as science has delivered the most effective HIV prevention technologies in history.
Responding to a question from Dhaka Tribune during an international media briefing, Grinsztejn said governments can no longer rely solely on foreign assistance and must increase domestic investment, particularly in community-led HIV programs that reach people excluded from conventional healthcare because of stigma and discrimination.
“It is very painful that funding for communities has been highly affected,” she said.
“Governments must make an effort to fund communities to keep them engaged in prevention work.”
Her warning reflects one of the central debates expected to dominate AIDS 2026: whether governments and donors can sustain the global HIV response as international financial support declines.
Grinsztejn said the world has reached a remarkable scientific moment, with long-acting HIV prevention medicines capable of dramatically reducing new infections.
“We have the prevention technologies we have always dreamed of,” she said.
“Unfortunately, at the same time, we don’t necessarily have the funding to make these prevention technologies available as services for those who need them.”
She said the widening gap between scientific progress and financial commitment risks preventing breakthrough medicines from reaching the populations that need them most.
Community organisations, she said, remain indispensable because they serve people who frequently avoid healthcare facilities due to discrimination based on gender identity, sexual orientation or other forms of social stigma.
Beyond national programs, Grinsztejn also defended the continued role of UNAIDS, saying the agency remains critical for tracking infections, deaths and treatment coverage worldwide.
“We need them in place to track numbers of infections, deaths, and people on treatment,” she said.
“To lose them now would be a disaster.”
Asked whether she expected the United States to reconsider recent reductions in HIV funding following discussions at the conference, Grinsztejn replied that she did not.
“I do not expect a reaction as we have no funding from the US government to run this conference.”
She said funding reductions are already affecting treatment programs, prevention services and countries’ ability to introduce new medicines, despite significant advances in HIV science.
The IAS president also expressed concern about uncertainty surrounding research funding, particularly support from the US National Institutes of Health (NIH), describing decades of investment as the foundation of global HIV research infrastructure.
Drawing on her own experience as an NIH-funded researcher, she said those investments helped build laboratories, clinical trial networks and scientific capacity that later proved invaluable during the Covid-19 pandemic.
Asked what contingency plans existed should NIH support continue to decline, she replied: “I wish I had one.”
She warned that many low- and middle-income countries lack domestic research funding systems capable of replacing long-standing international investment.
“Without research, nothing will come for the future,” she said.
Grinsztejn also questioned whether the world remains on track to meet the United Nations target of ending AIDS as a public health threat by 2030.
“If we continue at the current pace, I honestly do not see us getting there,” she said, adding that progress for children was particularly worrying.
“The data regarding children is really scary.”
She stressed that scientific innovation alone will not end the epidemic unless governments also tackle discrimination that continues to keep many vulnerable communities away from HIV prevention and treatment services.
“High levels of discrimination, homophobia and transphobia prevent the most vulnerable from accessing services,” she said.
Despite mounting financial pressures, organisers have expanded scholarship opportunities to ensure participation from lower-income countries, with nearly 800 scholarships awarded, mainly to delegates from Africa and Latin America.
Grinsztejn said the conference has also reduced costs to maximise participation, describing AIDS 2026 as “the cheapest AIDS conference ever.”
Her overarching message, however, was that scientific progress alone cannot end AIDS.
Without sustained investment in prevention, research and community organisations, she warned, the world risks squandering the greatest advances ever made against HIV just as the tools to control the epidemic have finally arrived.
