As financial leaders meet in Washington for the annual Spring Meetings of the World Bank and the International Monetary Fund, UNAIDS is calling for increased and sustainable investments in the global response to HIV and other health threats.

“At a time of multiple geo-political and economic crises, the need to tackle the financial constraints threatening the global fight against HIV and other health threats has never been greater,” said UNAIDS Executive Director Winnie Byanyima, “At their Spring Meetings in Washington, global financial leaders must find the courage to reject calls for more fiscal restraint and embrace measures that can release the necessary investments to save millions of people and transform the lives of the most vulnerable all over the world, including women and girls.”

As the world struggles to achieve many of the health goals set out in the United Nations Sustainable Development Agenda, investments in the HIV response have returned extraordinary gains for humanity. Since 2010, AIDS-related deaths have declined by 51% worldwide and new HIV infections have fallen by 38%.

But more than 9 million people are still waiting to receive HIV medication that will stop them dying from AIDS and there were still 1.3 million new HIV infections in 2022. Increased investments in the HIV response today are crucial to reach everyone who needs treatment and to prevent new infections that will only increase future treatment costs.

However, there is a huge shortfall in the global investments required to end AIDS as a global health threat by 2030. A total of US$ 20.8 billion (constant 2019 US$) was available for HIV programmes in low- and middle-income countries in 2022––2.6% less than in 2021 and well short of the US$ 29.3 billion needed by 2025.

In many countries with the most serious HIV pandemics, debt service is consuming increasingly large shares of government revenue and constraining public spending.

In Angola, Kenya, Malawi, Rwanda, Uganda, and Zambia, debt service obligations exceed 50% of government revenues. Last year, in GDP terms, Sierra Leone spent 15 times more on public debt servicing than on health, 7 times more on public debt servicing than on education and 37 times more on debt servicing than on social protection. For Angola, debt servicing was 7 times more than investments on health, 6 times more than on education and 14 times more than on social protection.

UNAIDS maintains that reform to the global financial system including the cancellation of debt, the introduction of fairer and affordable financing mechanisms and global taxation reform is key to releasing transformative funding for health, education and social protection also required to end AIDS as a public health threat by 2030.