| June 28, 2026
Sunset or new dawn? UNAids fights for survival
By Michelle Langrand
Thirty years after its founding, the UN is considering shutting down its leading organisation focused on HIV/Aids just as the very epidemic it was built to end intensifies.
Last week, UN delegates in New York adopted a new political declaration on HIV/Aids – the final one before the 2030 deadline that countries gave themselves to eradicate the disease. But behind the diplomatic victory, the existence of the very organisation created to spearhead the battle against HIV/Aids is under threat.
UNAids’ coordinating board meets this week with the organisation’s future on the agenda. The meeting comes amid a push by the UN chief António Guterres to quickly wind it down as soon as 2026 as part of his efforts to shrink the UN system. But the board has pushed back and is exploring alternatives. What UNAids looks like next year or in 2030 remains an open question.
Losing momentum
Strides have been made in the past 25 years – Aids‑related deaths have fallen by 54 per cent since 2010, reaching their lowest level since the early 1990s, but the fight against HIV/Aids has hit a slump. With only four years to go, 40 million people are living with HIV, including nine million without access to treatment. The virus continues to spread, with 1.4 million new infections recorded last year.
“Let us not confuse progress with success,” warned UNAids head Winnie Byanyima at the start of the high-level meeting in New York on Monday, described by Health Policy Watch as “poorly-attended” – a possible sign of waning political commitment. The declaration meant to chart the path for the next five years was adopted, though not without friction. The US and Russia joined six other countries in voting against it.
Countries acknowledged in the political document that progress was “threatened by slowing momentum, decreasing financing, growing inequalities, conflict and compounding global crises”.
Cuts by the Trump administration last year in US foreign aid – still the largest supporter of the fight against Aids – left organisations scrambling to maintain prevention, treatment and research programmes. According to figures by UNAids, “HIV testing programmes fell by 22 per cent in high-burden settings between 2024 and 2025”, while funding for condoms was cut in some cases by over 90 per cent. Use of preventive treatment, PrEP, dropped by 38 per cent between 2024 and 2025 in 62 countries.
UNAids itself has been hard hit by the US cuts. Last year, it had to shrink its workforce by more than half from 600 to just under 300. Its headquarters in Geneva, once home to 127 staff, now just runs with 19 after many were relocated to Bonn.
A US package ratified by Trump in January included $45 million for UNAids – less than half of what it received in 2024 under the Biden administration – offering some relief while highlighting the risk of relying on a large, unpredictable donor. Last week, Washington suspended all HIV/Aids funding for South Africa over its widely discredited claims of a “white genocide” against the Afrikaner minority. Eight million people still live with the virus in the country – the highest rate of infection in the world.
Sunset or reinvention?
It’s against this backdrop that Guterres floated his proposal to “sunset” UNAids and fold its work into other UN bodies like the World Health Organization. The organisation’s coordinating board – composed of 22 governments, six UN organisations and five civil society representatives – has resisted. In January, it set up a working group to come up with an alternative path, one that integrates it better into the broader UN system while preserving what makes UNAids distinctive – the formal role of civil society and people living with Aids/HIV in its governance structure, a rare arrangement in the multilateral world.
The working group’s interim report, published this month and expected to be discussed at a board meeting this week, says operation as before is “neither advisable nor feasible”, citing factors including resistance to multilateral cooperation, the decline in international HIV assistance, but also a push for country-led and financed responses. But the report is equally categorical in rejecting the sunset proposal, arguing that a “rushed or under-resourced transition risks doing serious damage to the global HIV response and undermining the UN’s credibility”. It further points to the problematic use of the word “sunset” at a time when the HIV crisis is far from over.
Gracia Ross, who leads the World Council of Churches’ HIV, reproductive health and pandemics programme and lives with HIV, says that UNAids closure would be “a big loss”. “UNAids has been a tremendous ally,” she tells Geneva Solutions.
The options being explored, according to the document, include downsizing the secretariat further, turning it into a “leaner partnership or hub” within the UN system, transferring work to partner agencies or – further down the line – a merger with another existing health partnership. A final proposal is expected in October.
Ross, who will be attending the board meeting as a civil society observer, recognises that changes might be necessary to contend with the funding landscape, but she worries about HIV/Aids fading into the already overwhelmed programmes of other agencies. “Countries do not always prioritise HIV, precisely because it’s linked to populations that are not a priority and are even targeted and criminalised by some governments,” she says.
The HIV community is also suspicious about the motivations behind the sunset push. Ross believes it may be “politically driven and meant to satisfy some member states”. She points to the fact that UN Women – one of the other few UN organisations advocating for gender-related issues – was also picked in Guterres’s reform plan for a merger with the UN Population Fund. Both organisations are also relatively small compared to others, she adds, making the potential for savings rather modest.
The US’s foreign aid cuts, which have been widely viewed as the trigger for Guterres’s reform push, have specifically targeted gender-related programmes.
The New York declaration may have offered some assurances, with states committing to “fully resource the Joint Programme within the future institutional set-up, and support its current efforts to refine and reinforce its unique operating model so that it can continue to lead global efforts against Aids”. But with the once-ambitious 2030 deadline increasingly out of reach, the gap between political commitments and actions – and the funding to go with – has never been wider.
Geneva Solutions content is licensed under Creative Commons BY 4.0
Source: Geneva Solutions
https://genevasolutions.news/global-health/sunset-or-new-dawn-unaids-fights-for-survival
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