HIV and the Volatile New World Order: From Declining Pandemic to One Crisis among Many

In the initial months of the second Trump administration, US foreign aid infrastructure was rapidly dismantled, including the United States Agency for International Development (USAID), a principal implementing agency of the President’s Emergency Plan for AIDS Relief (PEPFAR). This abrupt policy shift placed the lives of millions of people living with HIV at risk and significantly weakened global HIV prevention efforts. Numerous health services and local organizations were forced to close, staff were dismissed, and essential HIV services became inaccessible. Concurrently, financial support was withdrawn from the Joint United Nations Programme on HIV/AIDS (UNAIDS). These changes were enacted without prior notice, consultation or international coordination, and unfolded in the context of a global HIV response unprepared for such a disruption. While the consequences are severe, this unprecedented circumstance offers a critical moment for reflection and reimagining the future of the HIV response.