Why is it important
- 1.2 million people contracted HIV and 570,000 died from AIDS-related diseases in 2025
- 22 percent of people living with HIV are still not receiving treatment
- International funding for HIV fell 18 percent, the steepest drop in almost 20 years
- New drugs like lenacapavir are almost 100 percent effective in preventing HIV infection
- 20 million people need access to antiretroviral-based prevention to make a significant impact on the epidemic
- Generic versions of lenacapavir could cost as little as $40 per person per year, but will still be unavailable in many countries.
Defined by a paradox
The conference, which will be held in Rio from July 27 to 31, is characterized by a paradox.
By the end of this decade, more than three million people could become infected with HIV; However, the tools already exist to stop this crisis, from innovative prevention medications to community-led interventions with a proven track record. What is missing is sustained financing.
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.
Unless urgent measures are taken, the agency warns, the world is on track for a resurgence of the epidemic.
That 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 protection against HIV comparable to that of a vaccine.
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 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 authorized to manufacture lower-cost generic versions.
Lenacapavir is a long-acting injectable medication that requires only two injections a year and prevents HIV infection in almost 100 percent 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 of people due to high prices and the exclusion of many countries from voluntary licensing agreements.”said Variano Terto Jr., vice president of the Brazilian Interdisciplinary AIDS Association (ABIA).
He was speaking at a side event to the conference organized by the Community of Portuguese Language Countries (CPLP).
He added that patents on essential medicines have been “reinforcement of monopolies and privatization of public knowledge.”
ABIA, one of the conference’s co-organizers, recently published a study showing that Brazil could manufacture lenacapavir domestically for about $75 per patient per year.
By contrast, the patented version costs more than $20,000, a price considered unsustainable for Brazil’s public health system.
Risk of injustice
The true measure of success is not whether the medicines exist, but whether people who really need them can get them at an affordable price, said UNAIDS Executive Director Winnie Byanyima.
“Innovation without access is not innovation; it’s injustice“, 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 to raise health awareness and social support.
Calls for a new financing model
While HIV infections and AIDS-related deaths are 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 decline that marked its lowest level in nearly two decades, and global development assistance fell 23 percent last year, the largest annual decline ever recorded, with health programs, including HIV initiatives, among the hardest hit.
Meanwhile, new HIV infections increased in three regions and 21 countries during 2025.
The current moment must be understood as “the end of the era of dependence on international aid,” said the head of UNAIDS, calling for a new financing model. including measures such as sovereign debt restructuring, to allow governments to invest in “the future of their people”.
