A Global Setback: How Funding Cuts Threaten the Fight Against AIDS and Tuberculosis Progress
World AIDS Day serves as a powerful reminder that global cooperation remains essential in the ongoing battle against infectious diseases like HIV and tuberculosis (TB). Yet this year, that message carries an urgent warning — recent funding cuts could dismantle years of progress and place millions at renewed risk.
Early in 2025, major reductions in U.S. foreign assistance, particularly through USAID, shocked health systems across the world. The World Health Organization (WHO) has already sounded the alarm, reporting that these funding disruptions have led to staff shortages, delayed medical supplies, and greater obstacles to both HIV prevention and treatment. And this is where it gets even more concerning — when HIV services weaken, TB often resurges alongside it.
The Global Initiative for Asthma (GINA) and the Forum of International Respiratory Societies (FIRS) are calling for renewed alliances among governments, global health advocates, and NGOs. Their joint appeal emphasizes the importance of coordinated action to halt an impending comeback of infectious diseases. Without collaboration, WHO’s goal of ending AIDS by 2030 could slip out of reach.
The Hidden Ripple Effect of Funding Cuts
In nations such as South Africa, the Department of Health serves as the backbone of medical services and drug procurement. Yet, as Professor Moherndran Archary from the University of KwaZulu-Natal explains, U.S. contributions through USAID and the CDC have long been critical — providing systems for accurate data collection, medicine forecasting, healthcare worker training, and public health infrastructure. When such support disappears suddenly, he warns, “a huge void is created.” Some local programs have managed to absorb parts of these responsibilities, but not without significant strain.
These cuts also strike at organizations like the American Thoracic Society (ATS), which began back in 1905 as the National Association for the Study and Prevention of Tuberculosis. Today, ATS and other FIRS members continue their global mission to improve respiratory health. But without U.S. funding—the world’s cornerstone contributor to TB control—their progress risks stalling.
HIV and TB: A Deadly Partnership
Here’s a sobering fact: TB remains the leading cause of death among those living with HIV. In regions hit hardest by the virus, TB is frequently the first indicator that someone is HIV-positive. Yet nearly half of coinfected individuals are unaware of their dual diagnosis, meaning they miss out on treatments that could save their lives.
WHO experts warn that withdrawing international funding could reverse some of the science-backed breakthroughs of recent years, such as:
- Closer alignment between TB care and patients’ actual medical-seeking behaviors.
- Rapid, more reliable diagnostic tools.
- Shorter and safer treatment regimens — now six months versus the previous 18–24 for drug-resistant strains, and just four months for drug-sensitive TB.
- Innovative uses of new and repurposed drugs that make treatment more effective.
- Promising prevention regimens and vaccines.
- Deeper understanding of TB’s social and economic costs.
Dr. Philip Hopewell, a noted TB expert and ATS member, has stressed in his Breathe Easy podcast that these gains are fragile — and largely dependent on sustained funding, much of it from the United States. Reduce those investments, and the risk is not just slowed progress, but regression.
A Crisis with Long Memory
The relationship between AIDS and TB is not a new one. When HIV first spread globally in the 1980s, it sparked a parallel wave of TB infections that still echoes through low- and middle-income nations today. WHO data shows that people living with HIV are around twelve times more likely to develop TB compared to those without the virus. Life-saving antiretroviral therapies (ART) have since reduced AIDS-related deaths by roughly 70% since their peak in 2004—a monumental achievement that now hangs in the balance.
Interestingly, while South Africa’s ART supply remains stable, Professor Archary notes that other countries in Sub-Saharan Africa have begun seeing shortages. According to UNAIDS, women and girls in the region represent a striking 63% of new HIV cases — underscoring how fragile progress against gender inequality and healthcare disparities can be when funding falters.
A Call to Renew Global Partnership
As the world marks World AIDS Day, FIRS and its partners stress a crucial takeaway: defeating HIV and TB requires more than medical innovation—it demands unwavering international solidarity. The funding gap left by withdrawn aid cannot remain unfilled without risking resurgence.
So the question stands: should wealthier nations pull back from global health funding, or double down to secure the hard-won victories of recent decades? The answer will shape not only the future of HIV and TB control but the very foundation of global public health.
What do you think? Should global health funding be viewed as charity—or as a shared responsibility for humanity’s future? Join the discussion in the comments.
Media Contacts:
Dacia Morris – American Thoracic Society – dmorris@thoracic.org
Helen Dugdale – Forum of International Respiratory Societies – Helen.Dugdale@firsnet.org
About FIRS:
The Forum of International Respiratory Societies (FIRS) brings together leading organizations such as the American Thoracic Society (ATS), European Respiratory Society (ERS), the Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), CHEST, The Union, PATS, GINA, and GOLD—representing more than 70,000 specialists worldwide. Together, they aim to unite global respiratory experts and strengthen collective action for better lung health everywhere.
For more background, see the Global Impact of Respiratory Disease report at https://www.firsnet.org/resources/publications.
