How 40.8 Million HIV Infections and 44.1 Million AIDS-Related Deaths Could Happen by 2029

Global health leaders at the United Nations and World Health Organization warn that the fight against HIV and AIDS is at a turning point. New reports show that without urgent expansion of prevention tools and renewed investment in essential services, millions more people could be infected with HIV and die from AIDS-related illnesses by 2029. 

After years of steady progress in the global fight against HIV/AIDS, recent shifts in international funding have raised serious concerns about the sustainability of these gains. A growing funding gap has emerged as several major donor governments and institutions have reduced or reallocated aid, often in response to competing global crises, domestic budget pressures and changing political priorities. These reductions have disproportionately affected low- and middle-income countries that rely heavily on external support to maintain HIV prevention, testing and treatment services.

Historically, programmes such as the United States President’s Emergency Plan for AIDS Relief and contributions from major multilateral mechanisms like the Global Fund to Fight AIDS, Tuberculosis and Malaria provided essential resources for HIV testing, treatment, prevention and care in low- and middle-income countries. Since 2013, international HIV funding has fallen nearly 20 percent from its peak, and total resources available for HIV responses are now at their lowest level in over a decade, leaving a projected shortfall of nearly US $9.5 billion by 2025. Domestic funding has also declined in several regions for the fourth consecutive year, deepening the gap and straining national health budgets. This combination of reduced donor commitments and stagnant domestic spending has weakened frontline services and jeopardized efforts to reach global HIV targets. 

4 Million: AIDS Deaths Could Rise Again

UNAIDS data show that if critical funding gaps remain, the number of people dying from AIDS-related causes could rise sharply in the coming years. A major driver is the sudden drop in international aid that once supported testing, treatment and care programs globally. Without stable support, clinics have closed, supply chains have faltered and many people living with HIV are losing access to lifesaving services. 

International aid reductions hit especially hard in countries that depended on external financing to sustain large portions of their HIV response. For example, PEPFAR support in 2024 helped provide HIV testing for over 84 million people and treatment for more than 20 million across 55 countries. Reductions or freezes in this support have forced clinics to scale back services, left supply chains disrupted, and resulted in layoffs of community-based health workers who play a vital role in reaching marginalised populations. 

In recent years, global AIDS-related deaths had fallen significantly thanks to expanded access to antiretroviral therapy and strong funding commitments. But with less support now reaching the countries that need it most, this progress is at risk. Analysts project that an additional 4 million people could die from AIDS-related illnesses by 2029 if services continue to be disrupted and funding is not restored or replaced.

The impact of more deaths goes beyond individual loss. More AIDS-related deaths also strain local health systems and communities, especially in countries where resources are already limited. Public health experts note that this reversal could undo years of work to reduce stigma and build sustainable care systems.

6 Million: New HIV Infections on the Rise

Alongside the growing death toll, global projections indicate that HIV infections could rise as prevention tools and services weaken. In 2024 alone, an estimated 1.3 million people acquired HIV worldwide even before the most recent funding challenges. 

UNAIDS modeling suggests that if the world fails to strengthen prevention efforts, there could be more than 6 million additional new HIV infections by 2029. These infections include people in key populations such as sex workers, men who have sex with men, transgender people and others at higher risk, who already face barriers to care and prevention services. 

Experts warn that as services falter, gains in preventing new infections could reverse. Community outreach, education and access to prevention tools all depend on steady support. 

Many prevention programs rely on external financing. When funding declines, services such as community outreach, pre-exposure prophylaxis (PrEP) distribution and routine testing are often among the first to be reduced. This leaves gaps in early detection and prevention, making it easier for the virus to spread. Strengthening these services can help stop new infections before they occur.

New Prevention Tools and Investment Can Change the Outlook

Despite these serious challenges, there is hope. The WHO has endorsed new prevention tools that can make HIV prevention more effective and accessible. One notable example is lenacapavir, a twice-yearly injectable medication approved as a new PrEP option that significantly reduces the risk of acquiring HIV for people at high risk. 

This tool can be particularly valuable in places where daily regimens are hard to maintain because of stigma, travel barriers, or limited clinic access. Expanding access to lenacapavir and other WHO-recommended prevention methods can give people more ways to protect themselves. 

But new tools alone are not enough. The WHO and UNAIDS both emphasize that investment in community services, strong health systems and targeted outreach must grow alongside innovation. Sustained funding can help reduce disruptions in treatment, test more people earlier, and support community-led efforts that are often most effective at reaching people who are hardest to serve. 

In many parts of the world, health leaders are calling for governments, donors and partners to work together to expand access to these new tools and ensure that prevention and treatment services are available to everyone. Strengthening care in this way can help the world stay on track to end AIDS as a public health threat and avoid the tragic increases in infections and deaths projected if action stalls.

Understanding HIV and AIDS: The Basics Behind the Numbers

HIV and AIDS are related but not the same. HIV, or human immunodeficiency virus, attacks the immune system. AIDS, or acquired immunodeficiency syndrome, is the most advanced stage of HIV infection and develops when the immune system becomes severely weakened. With timely treatment, many people living with HIV do not progress to AIDS.

HIV spreads through specific body fluids such as blood, semen, vaginal fluids and breast milk. It is commonly transmitted through unprotected sex, sharing needles or from mother to child during pregnancy, childbirth or breastfeeding. It is NOT spread through casual contact like hugging, kissing, coughing or sharing food. AIDS itself is not contagious but results from long term untreated HIV.

There is no cure for HIV, but effective treatment can prevent HIV from progressing to AIDS. Antiretroviral therapy allows people to live long and healthy lives and reduces the risk of transmission. Without treatment, HIV can advance to AIDS, leading to severe illness and early death.

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