The United Nations Office at Geneva
Multimedia Newsroom
UNAIDS Press conference 24 March 2025
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1:13:54
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MP4
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4.3 GB
STORY: UNAIDS funding crisis
TRT: 04’12”
SOURCE: UNTV CH
RESTRICTIONS: NONE
LANGUAGE: ENGLISH / NATS
ASPECT RATIO: 16:9
DATELINE: 24 March 2025 GENEVA, SWITZERLAND
Speakers:
- Winnie Byanyima, UNAIDS Executive Director
SHOTLIST
- Exterior medium shot: Palais des Nations, Flag Alley
- Wide shot of podium with speakers.
- SOUNDBITE (English) – Winnie Byanyima, UNAIDS Executive Director: “If the US assistance for HIV is not restored after the pause - as you know, the pause ends in April - and is not replaced by other funding and we have not heard of other governments pledging to fill the gap, there will be an additional in the next four years 6.3 million AIDS-related deaths.”
- Medium-wide, TV screens showing speaker, journalist taking video with phone.
- SOUNDBITE (English) – Winnie Byanyima, UNAIDS Executive Director: “We will see a resurge of this - a real surge in this disease - will see it come back and we see people dying the way we saw them in the 90s and in 2000s.”
- Medium, Press room, photographer, journalists.
- SOUNDBITE (English) – Winnie Byanyima, UNAIDS Executive Director: “We're seeing the centres that we are providing them with prevention services not reopening for fear that this might not be consistent with the new guidelines.”
- Wide, Press room, podium speakers, TV cameras.
- SOUNDBITE (English) – Winnie Byanyima, UNAIDS Executive Director: “At the last count – 2023 - we had 600,000 deaths globally, AIDS-related deaths. So, you're talking about 10-fold increase. We also expect an additional 8.7 million new infections. At the last count, there were 1.3 million new infections globally - 2023.”
- Wide, Press room.
- SOUNDBITE (English) – Winnie Byanyima, UNAIDS Executive Director: “It is reasonable for the United States to want to reduce its funding - over time. But the sudden withdrawal of lifesaving support is having a devastating impact across countries, particularly Africa, but even in Asia and Latin America. We urge for a reconsideration and an urgent restoration of services – of life-saving services.”
- Wide shot, Press room, journalists, photographer, TV cameras.
- SOUNDBITE (English) – Winnie Byanyima, UNAIDS Executive Director: “It could be President Trump - another Republican president - who leads the prevention revolution leading towards the end of AIDS. But the deal is that an American company is enabled to produce and to license generics across the regions to produce millions and roll out this injectable to those who really need it.”
- Medium, podium speakers, TV screen showing speaker.
- SOUNDBITE (English) – Winnie Byanyima, UNAIDS Executive Director: “This sudden withdrawal of US funding has led (to) shutting down of many clinics, laying off of thousands of health workers, these are nurses, doctors, lab technicians, pharmacy workers, all kinds of data entrists; it's a lot.”
- Medium-wide, Press room, journalists, photographer.
- SOUNDBITE (English) – Winnie Byanyima, UNAIDS Executive Director: “And for Africa, the closing down all of a sudden of drop-in centres for girls and young women will be disastrous because more than 60 per cent of new infections - amongst young - new infections on the continent are amongst girls and young women.”
- Medium, journalist working on laptop.
UNAIDS chief warns of ‘real surge’ in deaths without US funding
Amid continuing uncertainty about the impact of deep US funding cuts to humanitarian work worldwide, the head of the UN agency coordinating the fight against HIV-AIDS warned that an addition 6.3 million people will die in the next four years, unless the support is reinstated.
“We will see a …real surge in this disease - [we] will see it come back and we see people dying the way we saw them in the 90s and in 2000s,” said Winnie Byanyima, UNAIDS Executive Director, pointing to a “tenfold increase” from the 600,000 AIDS-related deaths recorded globally in 2023.
“We also expect an additional 8.7 million new infections. At the last count, there were 1.3 million new infections globally (in) 2023”.
Speaking in Geneva, Ms. Byanyima noted that the funding freeze announced by the White House on 20 January was due to end next month, after a 90-day review.
“We have not heard of other governments pledging to fill the gap,” she told journalists.
Already, drop-in centres where HIV patients can pick up the anti-retroviral medicines they need are not reopening, “for fear that this might not be consistent with the new guidelines”, she maintained.
“This sudden withdrawal of US funding has led (to) shutting down of many clinics, laying off of thousands of health workers, these are nurses, doctors, lab technicians, pharmacy workers…it's a lot.”
Focusing on Africa – where the east and south of the continent share 53 per cent of the global HIV burden - Ms. Byanyima warned that closing down “all of a sudden drop-in centres for girls and young women will be disastrous, because more than 60 per cent of new infections - amongst young - new infections on the continent are amongst girls and young women”.
Several other UN agencies that are heavily reliant on US funding have also warned that the cut in support – in addition to chronic under-investment in humanitarian work globally - is already having a serious impact on the communities they serve.
On Friday, the UN refugee agency, UNHCR, said that thousands have been left without lifesaving aid in the war-torn eastern Democratic Republic of the Congo.
The UN International Organization for Migration (IOM) also announced that funding cuts have severe repercussions for vulnerable migrant communities, exacerbating humanitarian crises and undermining essential support systems for displaced populations. Together with IOM, the UN Children’s Fund (UNICEF) warned that that the liquidity crunch has jeopardized lifesaving work, including progress in reducing child mortality, which has fallen by 60 per cent since 1990.
“It is reasonable for the United States to want to reduce its funding - over time. But the sudden withdrawal of lifesaving support is having a devastating impact across countries, particularly Africa, but even in Asia and Latin America,” said UNAIDS’ Ms. Byanyima.
“We urge for a reconsideration and an urgent restoration of services – of life-saving services.”
And in a direct appeal to President Trump, the UNAIDS chief noted that just as President George W Bush had introduced the groundbreaking Pepfar initiative to combat HIV/AIDS in 2003, the new White House incumbent could also be part of the “prevention revolution” involving injectable HIV injections required just twice a year.
“The deal is that an American company is enabled to produce and to license generics across the regions to produce millions and roll out this injectable to those who really need it,” she insisted.
According to UNAIDS, approximately 40 million people globally live with HIV, based on 2023 data. Of this number, some 1.3 million became newly infected with HIV in the same year and 630,000 people died from AIDS-related illnesses.
ends
Teleprompter
[Other language spoken]
Thank you very much.
[Other language spoken]
We're 24th of March and this is the UN AIDS press conference.
Thank you very much for coming online and in the room.
[Other language spoken]
The press de la Nucida doc over the remark de Winnie be anima Quila directory executive de la Nucida.
This is our Director, Executive Director from UN AIDS.
She will be giving remarks and then we will take questions.
Also to my left is Anjali Ashrikar, who is the Deputy Executive Director.
She's also here to field your questions.
Merci Buku, over to you, Winnie.
[Other language spoken]
[Other language spoken]
[Other language spoken]
[Other language spoken]
Wherever you are, members of the press, thank you for coming.
I'm here together with my colleague, Deputy Executive Director Anjali Ashrika, and of course, shallow.
Thank you for moderating.
When I just taken up my role as the head of UNAIDS, that was in 2019, one of the first things I did was to visit Kenya.
There I met a woman called Juliana Atieno.
She had been diagnosed with HIV as a teenager.
She had been raped when she was in **** school.
But she'd gone on to fight to get on treatment and was now working as what we call a mentor mother in the HIV language.
That is someone who connects pregnant women to services, looks out in the community, encourages them to come to a clinic to get tested, to get antenatal care and to stay on treatment until they have a baby who is free from HIV.
So important is her role in the community.
In Africa, where there is strong patriarchy, men dominating women, you have even violence in families when one shows up as HIV positive.
There's a risk of even being thrown out of a home if you go to a clinic and find your HIV positive, getting your husband to also come and be tested.
And that whole story, this the mentor mother does.
[Other language spoken]
[Other language spoken]
[Other language spoken]
I was so impressed by her.
Now, recently, I called her again because I know that the project she was working on connecting people, pregnant women to the clinic was funded by USCID and I wanted to know whether she was OK.
She told us that the project had received a stop work order from the United States in in January and that all the staff had been put on unpaid leave, including herself.
She told us that mothers had panicked and were running to different clinics trying to stockpile medicines, expecting them to run out.
She said that she put on a plastic smile to these mothers to make them feel calm, but deep down, she was herself in panic.
Because, you know, Juliana, when I met her, had two little children, had just given birth to a baby girl four months earlier and was still breastfeeding to prevent transmitting to her baby.
She needed to stay on treatment herself, wasn't sure whether she was going to be able to.
She has no income, by the way.
Her income at that time, she told me, was $20.00 a month.
She was not earning a salary.
She was getting a stipend for doing this incredible work, life saving work.
That $20 wasn't there anymore.
She lives in a little slum dwelling.
She rents it.
She had an unemployed husband.
There she was.
But she was there, still optimistic, still struggling, still expecting to survive and also keep other mothers alive and well, saving their babies.
[Other language spoken]
Kenya is less reliant on US funding than many other countries.
Actually, Kenya pays for 63% of its own HIV response.
But now think about a country like Tanzania, which depends 94% of its response from external supporters, mostly from the United States.
So you can see and then even short term interruptions to treatment are devastating for people living with HIV.
If someone skips their doses, this leads to drug resistance, this leads to a viral load increase and this leads to infections.
So I could give you more stories I can tell you about a guy in Uganda, just 22 years old, Emmanuel, who said that the US funded clinic he was going to was closed and the government advised all people who were in in such clinics to report to the government funded hospital or clinic.
But he said that that's what everybody did.
And so he went, he waited six hours in the line and at the end of six hours, they said they had run out of ARVs and told him to come back after two weeks.
That's how resistance builds up.
He doesn't take treatment for two weeks.
He becomes starts getting resistant to the drugs so and and then get sick.
And then that's how we see deaths increasing.
So this sudden withdrawal of US funding as late shut, shutting down of many clinics, laying off of thousands of health workers.
These are nurses, doctors, lab technicians, pharmacy workers, kinds of data entries.
[Other language spoken]
And all this means that we expect to see new infections rising.
UNAIDS has estimated that we could see new, we may be having 2000 new infections every day, more new infections every day.
This is our, our, our prediction, our estimate.
And for Africa, the closing down all of a sudden of drop in centres for girls and young women will be disastrous because more than 60% of new infections amongst young, new infections on the continent are amongst girls and young women.
And they, many of them have been going to centres created to give them the privacy, the confidence to get what they need to prevent infection.
So there we I could give you more examples if you ask me later, I will give you some more examples of the evidence we are getting on the impacts, devastating impacts.
We have estimated as UN AIDS that if the US assistance for HIV is not restored after the pause, as you know, the pause ends in April and is not replaced by other funding and we have not heard of other governments pledging to fill the gap.
There will be an additional in the next 4 years.
6.3 million AIDS related deaths, 6.3 million more in the next 4 years.
At the last count, 2023, we had 600,000 deaths globally, AIDS related deaths.
So you're talking of a tenfold increase.
We also expect an additional 8.7 million new infections.
At the last count, there were 1.3 million new infections globally, 2023.
You're talking of losing the gains that we have made over the last 25 years.
It is very serious.
Today's World TB Day.
Nearly one third of all deaths among people living with HIV are from TB Co infections.
Very, very, very closely related.
The US cuts mean that today 27 countries in Africa and Asia are experiencing shortages of stuff.
Disruptions of diagnostics, treatment and surveillance systems are collapsing.
The door is being opened to 1,000,000 more AIDS related deaths through TB.
Let me lastly talk about prevention.
Prevention is actually being impacted even more than treatment.
Since there was a waiver to PEPFAR, we've seen some services coming back, particularly treatment services.
But challenges are there, particularly for key populations, girls and young women, these people who have been served by special services that help them to overcome stigma, discrimination, criminalisation.
I'm talking of LGBTQ people, sex workers, people who inject drugs and as I said, girls and young women.
Prevention services are not coming back that easily because the cuts, in addition to the cuts, there is also a push back on rights and people who have been experiencing discrimination, stigma, who are criminalised, are afraid to come for services to places where they might face discrimination.
So we're seeing the centres that we are providing them with prevention services not reopening for fear that this might not be consistent with the new guidelines.
So there we are.
I want to say that it was probably the greatest the the United States leadership has been really the greatest act of humanity in global health just for HIV, but supporting the eradication of so many other diseases, progress against other diseases.
We are so grateful for that and we continue to count on American leadership in global health.
the United States has been an incredible partner for us.
UN AIDS, of course, Global Fund working closely with their PEPFAR programme.
It is reasonable for the United States to want to reduce its funding over time, but the sudden withdrawal of life saving support is having a devastating impact across countries, particularly Africa, but even in Asia and Latin America.
We urge for a reconsideration and an urgent restoration of services, life saving services.
I want to be clear that.
We cannot claim that the way we have worked, delivered for people living with HIV and at risk has been the most efficient or the best way to use money.
I think some of the criticism is valid about the strategy that has been used and how we have addressed our work.
It is an opportunity to rethink and find more efficient ways of delivering life saving support.
But the suddenness, the with sudden withdrawal of services, I repeat, it's devastating course.
It's going to cost many lives and needs to be reversed quickly.
America also has been a leader in innovation for health technologies for HIV.
Let's also remember that that America has dominated the field of innovation for HIV, whether it's diagnostics, prevention tools, treatment tools, a list of companies that have made fortunes out of working on this disease and have saved many lives.
PEPFAR has saved like 26,000,000 lives since it first came on on board 20 years ago.
US innovations have led to a revolution in treatment.
Now we are at the cusp of another revolution in prevention treatment.
We've brought 31 million people on treatment out of 40,000,009 million people are not on treatment today.
This this amazing work has come from US leadership and European leadership.
[Other language spoken]
One of them is called lenacapavir.
I've called it a magical, a magical tool for prevention because it's proved to be 100% efficient and can be delivered as two injections by year.
Right now, trials are going on for even delivering it as one injection per year, 1 injection per year.
That is almost like a flu vaccine.
Can you imagine 1 injection for an African girl will keep her safe?
Now if this could be rolled out ambitiously across all the we could cut down new infections to close to close to 0.
We could see the end of AIDS.
This is the opportunity that must be seized to drive down new infections, to get it down to zero.
And then the challenge will be getting those who are living with HIV today on treatment, staying on treatment.
That is a job we already know how to do very well.
[Other language spoken]
This is an American innovation.
Then a Cuppaviru Gilead is an American company that stands to make the profits out of this innovation only if only if the president of the United States, his administration, see the deal that it is.
It is an amazing deal.
[Other language spoken]
[Other language spoken]
So I'm making this message directly to his administration.
There is a deal here.
It was a Republican president who led the revolution on treatment, President Bush who started PEPFAR in 2003 and rolled out antiretrovirals across the world.
It could be President Trump, another Republican president who leads the prevention revolution leading towards the end of AIDS.
But the deal is that an American company is enabled to produce and to licence generics across the regions to produce millions and roll out this injectable to those who really need it.
The new infections, they are in middle income countries, they're in the low income countries of the South.
To roll it out to all those people who need it, to make profits for Gilead, to create good jobs for Americans and to save lives in the South.
That's the deal.
And I believe that this is an opportunity not to be missed.
[Other language spoken]
That this and this is my last point that you see, this is also the way that developing countries, particularly the low income countries can be sustainable, can't sustainably support their own responses.
They were already on the path to progressively pay for their own responses.
Many of them were on the path and we UNAIDS have been supporting them to draw these Rd maps.
Now with a reducing load number of people living with HIV with no new infections, now the burden, the financial burden becomes manageable for these countries, particularly low income countries that face many challenges for their development.
So I want to stop there and take your questions and I'm also keen to hear you on what you think of the deal that I'm putting down.
[Other language spoken]
Start with some AFP.
[Other language spoken]
Sorry, can you hear me?
Sorry.
[Other language spoken]
[Other language spoken]
[Other language spoken]
So I just wanted to ask you, it's Nina Larson with AFP.
Yes, this is Nina from AFP.
[Other language spoken]
You mentioned the the risk that they could be 6.3 million more.
Deaths within the next 4 years at the same time as infections will be rising if if the aid is not reinstated.
Could you sort of see the, the trajectory, trajectory further along?
I mean, if there are more more infections and I assume that you're, you're looking at a very large number of more, more deaths if going forward if the aid is not reinstated?
[Other language spoken]
Very quickly I've mentioned the projection for four years.
In the longer term, we see the AIDS pandemic resurging and resurging globally, not just in the countries where now it has become concentrated low income countries of Africa, but also growing amongst a key, what we call key populations in Eastern Europe, in Latin America.
We will see a research of this, a real surge in this disease.
We'll see it come back and we'll see people dying the way we saw them in the two in the 90s and in 2000s.
That is the short answer to your question.
Hello, Catherine.
Who's the Akanu president?
Catherine Fiencon Bogar, over to you.
[Other language spoken]
[Other language spoken]
Thank you, Madam, for being here.
I have, in fact, a series of questions.
You spoke about an estimate of plus 2000 infections per day.
What is the rate of infections today so we can compare?
Also, you spoke about the fact that the pose ends in April.
Have you already found some donors who would be ready to take it over and help you support your programmes?
You spoke also in the press about certain percentage of programmes that have already been suspended.
[Other language spoken]
Please correct me if I'm wrong.
The number, the percentage of programmes that have already been suspended.
So if you could give us the figure, share the figure.
And also how many staff have already lost their jobs in Geneva and in the field because of this?
Excuse me, not for UNA.
[Other language spoken]
What is the percentage or the number of UN aid staff who has already lost their jobs in Geneva or in the field?
And my last question for the moment will be about Europe, because we've heard that young people seem to be less likely to protect themselves during sexual intercourse.
So what about the risks also in Europe?
And particularly you spoke about TB cause infections and we know that the, I would say the heart of TB infection is in Central Europe.
So what about the programmes there?
Thank you so much for your answers.
You yeah, because what was that last question?
So my last point was that you mentioned that 1/3 of deaths are of TB cause infections.
And if I'm not mistaken, the the heart of infections regarding TB is particularly alive in Central Europe.
And I'd like to know how your programmes are able to continue their work there or have already been suspended.
OK, those are many questions.
[Other language spoken]
I've tried to record them.
First of all, congratulations Catherine on your role.
It's so important that you you've taken that responsibility.
Then you ask about new infections and how many are they per day.
We at the last count we had 1.3 million for 2023.
[Other language spoken]
How much does that amount to per day now?
[Other language spoken]
[Other language spoken]
So we have 3500, we're talking of another 2000.
So you see you're almost doubling the new infection.
Second question was about have the next questions were very much around UN AIDS, if I understood them.
One was about have we found new donors to fill the you mean to fill the US gap?
Yeah, in prevention if, if, if it if it's if in prevention in countries.
I mean no, in case United States of America after this pose that means from beginning may doesn't support in another form, doesn't support financially in another form.
Your work, your programmes, how are you and AIDS?
You and AIDS always, Have you already identified new donors, foundations, countries, individuals?
[Other language spoken]
[Other language spoken]
You're now asking about us as UN AIDS.
Tell you the truth, for me always, I come from activism, that's who I am.
My focus is always about people living with HIV, my 'cause people living with HIV, people at risk and how they are being affected.
And I also think about the work we do for them.
Thinking about that first.
We had a budget, a core budget of $144 million in 2024.
Out of that 50 million was a contribution, very generous contribution from the United States.
That's about 35% of our total core budget.
The core budget, now that we do not know whether it will be restored for next year, we don't know.
We are indeed engaging with the United States government.
What's important for us is to let them understand that the role of UN AIDS complements the role of PEPFAR.
[Other language spoken]
In the whole ecosystem of HIV, we have our specific role, just like PEPFAR has its role and Global Fund has its role.
Among our roles is the data role.
We gather because we have the presence on the ground in countries.
We have the data role.
We gather all the data that everyone uses, including PEPFAR.
We also have our political role of setting the goals every five years, mobilising the whole world to agree on ambitious targets and holding them accountable to them.
That's our role.
Without that, every country would take its own direction, set a very low bar for itself.
We would not see ambition of the response.
Pepfa would not get the results from the funding of American taxpayers.
So, and that's just two of the roles we play, a community role, for example, the people who are most in need, who live with HIV on the margins of society, they need to be connected to the planning, to the delivery of services.
That's our role.
Support communities of excluded people to come and get what they need to claim their rights to services and to be part of the process.
That's our role to set the policies that must be there for the money to deliver.
You need some clear policies both on the science and also on rights to make the money work.
So all these things are ours to do so that PEPFAR can do its programme work.
So we are engaging with the American government and my colleague, Deputy Executive Director leads that role to persuade the government that we are a compliment that if you put PEPFAR back, you also need your needs to fit into plug in.
That is very important.
Regarding other donors, I mean the European donors already contribute to us, already contribute, make contributions to the joint programme.
But we've been trying some from a couple of years to engage some more and with some success given that European countries have been reducing their age budgets, as I talk now, they are, some of them have indicated significant cuts because of commitments in defence and other reasons.
So we are not seeing any of them promising to fill this gap, not at all.
That's the answer.
What we are seeing and hoping is that they will stay the course, They will stay the course and continue to to fight.
In terms of what has been suspended, I didn't understand that question.
But we are indeed in a restructuring process.
We're looking at different scenarios of how we can manage to keep this important role going.
But let me be clear in looking at this, we are not trying to protect a brand.
That's not me, that's not my way.
I am an activist leading an activist organisation.
We are an advocacy body.
We are looking at how to make sure that this important role we play continues to be played so that people living with HIV, people at risk, continue getting what they truly deserve, this life saving services.
Whatever way it comes.
Whether it comes as a smaller UN AIDS, whether it comes as a UN AIDS in partnership with somebody else, I don't know.
But we are looking at many scenarios of the future, a future that could include less or even no contribution from the United States.
[Other language spoken]
We can't assume the contribution now how many staff have lost jobs?
[Other language spoken]
[Other language spoken]
We are looking at these scenarios.
We are in a restructuring process, but we haven't yet given anybody a pink slip if if that's the simple answer to your question.
But indeed, they are going to be painful decisions to make.
But these decisions are right now being considered TB.
It's true in Eastern Europe and Central Asia, it is a big issue.
I could pass that question to Anjali about what we're doing there.
[Other language spoken]
[Other language spoken]
Yes, thanks.
Thanks, Winnie.
Maybe I'll comment on on and compliment some of the responses that Winnie provided.
First, the I think it's important to note that of the 1.3 million new HIV infections that that were described earlier, that's around the world, they're still in Europe and North America, 56,000 new HIV infections as of last year.
So still significant amount of new infections that are still there.
When you compare that to East and Southern Africa, for example, where there are 450,000 new infections, you can see the just, you know, the contrast.
But again, our goal here, in order to get to the first question around the trajectory of where we're headed to end AIDS as a public health ****** by 2030, the issue is, is that we must, as a globe, we must drive down all of those new infections and all of the AIDS deaths in order to meet that goal of ending AIDS as a public health ****** by 20-30.
So that's why in a context where we don't have a vaccine or a cure, where the closest thing we have is to ensure that those people living with HIV are on treatment and virally suppressed.
And these new tools that that our executive director mentioned, like the long acting injectables for prevention.
These new tools are absolutely critical in order to scale so that the hope and the promise of achieving the Sustainable Development Goal 3.3, which by the way, is one of the only goals that's actually moving in the right direction and there.
And we can claim victory, but only if we take it to the last mile, which is so critical that we make sure that no new infections are occurring as we move toward the next five years, toward 2030, and that those AIDS deaths continue to be dropping.
[Other language spoken]
Olivia Lupedra from Reuters over to you.
Thanks everybody for this briefing.
Hi there.
[Other language spoken]
Just in terms of you mentioned there about kind of people stepping in to help fund the gap that you're trying to do at the moment.
One thing I noted in a report you recently released is that some governments had said that they might step in to help with funding, however that they're not going to do that until such time as the US has completed its funding review.
Hi there.
Hopefully that's better for you.
[Other language spoken]
I'll just repeat my question from from the top.
In one of your recent reports by UNAIDS, you were saying that some governments have said that they might step in to help with some funding after the US completely withdraws its funding.
However, in the meantime, until such that until such time there's that review by the US, US is finished, they won't actually offer the money.
And so my, my, my kind of question is in this kind of interim.
What kind of impact is that having?
My second question is, could you just explain a bit more as to why you're concerned about a kind of key populations in Eastern Europe and Latin America in terms of the kind of broadest surge?
If you could just explain that, that would be helpful.
And also in terms of kind of key population areas who are impacted, I noted also that testing for pregnant women is one of your areas of concern.
Again, are you able to describe what kind of impact that you know, the shuttering of US funded facilities for testing pregnant women is is having having?
[Other language spoken]
Thank you for your questions.
First, I I'm uncomfortable talking about the impact of the US cuts, the pause and the role that other donors play and can play without speaking about the role of developing countries themselves.
I do not place them in that passive position of.
Sitting there waiting for money to come to them.
This is not the case.
They are fighting.
These countries, particularly the low income countries of Africa are facing huge challenges today.
They are the ones facing the worst impacts of climate change.
They are facing some of them.
They are in debt distress, others are close to debt distress.
They are paying towards interests on their debts 3/4 times more than they are putting in the health of their people.
This this this debt isn't entirely their own creation.
Interest rates shot up globally during COVID and even shot up further because of the war in Ukraine, which they had nothing to do with.
They found their debt multiplying 3-4 times over.
So these countries are facing the consequences of global challenges that they have contributed very little to, but they are now losing global solidarity, the support that really is justified support to them that compensates a little for much of what is unjust in the global economy.
Many of these countries, Africa loses $88.6 billion through illicit financial flows, most of it tax dodging, just avoiding the rules of using the rules that help companies not to pay their taxes where they're do, where they do their production, 88 billion.
Their total bill for health is 144 billion, but they already lose 88, six through tax dodging.
You need to see this problem more globally comprehensively.
But these countries are fighting.
[Other language spoken]
We are seeing so many of them trying to stretch already very weak, fragile health systems to absorb people living with HIV and people at risk.
We're seeing some of them making small reallocations out of tight budgets that they have.
We are seeing them asking civil society to work with them closely.
They are coming to us to give them advice on smart ways to, to, to, to deal with the gap.
So let's not assume that they are sitting there just waiting for help.
They are fighting and they need support.
Coming to the the, I think the question was very much around the impact.
If there's no gap feeling, one thing I'm sure of is that the ingenuity, EU unity of this movement of people living with HIV will fight for survival.
I see a changed way of responding to HIV.
I can see us being forced to be innovative at the country level.
I can see donors changing how they work.
I mean, some of it is just was not going to be sustainable anyway.
The parallel systems that exists through which PEPFAR delivers this may not be viable anymore.
There'll there's going to be a lot of changes, but I can see that it change will be driven by people leaving them with HIV themselves, demanding and fighting to live just like they did.
How did they get treatment?
[Other language spoken]
It wasn't just handed to them.
People living with HIV in the South and in the and gay people in the North came together and demanded that ARVs that were already available in the North become available for everyone living with HIV.
And that's how it happened, through a movement, through struggle.
I see that.
I am optimistic as always as a fighter, as a social justice fighter, that we will mobilise the movement, we will make demands and governments and companies will follow.
I believe that key populations, why we talk about them is that, you know, new infections are growing in middle income countries, 41% I believe of new infections are in upper middle income countries at the last count, 41%.
And you see when you say middle income country, you start to think these are rich countries.
They are serving their people.
No, you're talking of the poorest people, like black women I met in the favelas of Brazil, like the gay men, indigenous, black that I met in Colombia.
It's like, yeah, these are people not being served.
These are people where these middle income countries are amongst the most unequal countries in the world.
There are people go to work in in jets and helicopters and there are people who live in the worst slums in the world and that's where the disease is.
So we insist that to end this disease, we have to end it everywhere.
There's no pandemic you can end by serving some rich people and leaving others out.
So we insist that everyone should be reached, particularly it it not only in low income countries of Africa because they are poor, but in every country where people are at risk or are are.
So if you're talking of prevention, people at risk testing pregnant women, you know it will be so sad because this is 1 area where we were making the fastest progress.
Countries we're moving towards ending mother to child transmission.
But we are seeing this falling back partly because the supply of the treatment, the paediatric treatment itself is supplied in many countries by the brand maker, not generically production is controlled by one company supplies.
We are, we are beginning to see shortages in many countries.
Angela can speak more accurately on that.
But also, pregnant women living with HIV want so badly to save their baby.
They want so badly save their baby.
But many, many times the challenges around them accessing the services have to do with many other social factors and that's where the ecosystem works.
We've got these mother mentors, we've got counsellors, we've got, we've got a whole army of support for them to be able to prevent the transmission to their babies.
Now what we are seeing is that it's the the system is being dismantled, parts of it is falling apart.
So that is what I would say about mother children.
I'm giving long answers and yet there may be many questions.
Can I, could I leave it there?
Yes, leave it there.
I have one question from Christina Okello, who is a journalist from Radio France International.
My question to you, Miss Bianima, is you mentioned that countries like Kenya fund the majority of their HIV response domestically.
Do you believe other African countries can realistically follow Kenya's example?
And what concrete steps can be taken to encourage more African governments to take ownership of the HIV response?
Over to you when?
Oh, thank you for that question Aquilo from EREFI.
I am proud of you because you are from my Anglophone region and you are on EREFI.
Well done.
[Other language spoken]
There are many countries who have been on the road towards self-sufficiency self financing.
I mentioned South Africa 76% of its responses funded by from their own budget.
South Africa is a country with 8 million people living with HIV and it has put 6,000,000 on its largest number has 6,000,000 on treatment funded mostly by itself.
Botswana, 66% of its of its response is self financed.
[Other language spoken]
I mean, no, this is also a myth.
Countries, governments don't want to be dependent.
They try.
So the idea that they're just sitting there not trying is wrong.
They face enormous challenges, enormous challenges.
They manage their they, they are really right now in, in, in, in, in austerity, self-imposed austerity.
So let us let us understand that it's not just Kenya.
There are many who are trying, but there are many who are a long way.
That's the truth from getting there.
[Other language spoken]
Many countries are still a long way off.
What can we do to get them there?
Well, to tell you the truth, this disruption is a wake up call.
They are right now looking at how to do this in Uganda.
UN AIDS, working with networks of people living with HIV, has been engaging the Parliament parliamentary committee on HIV and health to call for an increase in the budget for the HIV response.
At the last meeting of the ruling party, the president committed to fill the gap that has been of about more than 700 and three $170 million that the Americans were putting down for Uganda.
So we're seeing countries trying.
We are supporting them.
And yeah, it's not.
I don't look at this as lack of will.
This is also one of the myths that I really want to bust here.
Lack of will you?
You just have to look at the needs and the available resources and the debt.
So these countries are really not just sitting there comfortably waiting to be supported.
They are fighting.
So Aquello, that's my answer to your question that we have made worked with them to make their Rd maps.
They are on their way.
And actually if when PEPFAR comes back, because it will come back, there's a promise to bring it back.
One of the key things it can work on together with us UN AIDS, is to work with the government, the civil society on realising real transitions in that are time bound towards self-sufficiency.
This this is something that the United States together with the other donors, the Europeans can work with us on to build commitments towards these transitions is possible.
[Other language spoken]
I see that Isabel from AFA, which is the Spanish Press Agency has a question over to Isabel Gracias.
[Other language spoken]
[Other language spoken]
Firstly, I am interested in if you have a details or you can share some information with us because you mentioned the, the lack of that an American company who, which is the, is the company that produces this treatment for prevention for injectables.
And I would like to know if you were, because I remember in January we, I made, I, I did an interview with you and you mentioned already this.
And I want to know if your agency was already planning purchase of this or the the procurement of this product to go for, for prevention programmes.
And in in this case, if you can quantify the loss of business by this American company, if you, I mean if they don't associate with UN AIDS, because we know that you, I mean your procurements are very important for the developing countries at different prices of course than the market.
And this is one question.
And the second one is on, you mentioned the 144, $1,000,000 of that the United States give for your core budgets, but there is also the non core budget.
So could you clarify this?
I understand that altogether it represents 65% of your finance.
So if you could confirm this?
[Other language spoken]
[Other language spoken]
I will start with that last one.
No, it's not 65% non core your rate that we also get a contribution from the United States.
This varies because it's it's targeted to specific activities.
If I can mention, I mean for 20/24 it was close to it was around 60 million, $60 million.
And if I look at the total budget, the total budget was about 200 and 20 million, so 6050 hundred.
So they were close to 1/2, they were about 1/2, a little bit more than 1/2 of our total budget.
[Other language spoken]
And and so we we are facing quite a a shortfall.
But let me say we are not on a clip about fall over.
We saw the cuts coming.
We started our restructuring process actually in December last year, well before the pause.
We had our **** level panel reviewing how we operate.
It started its work last year in June.
So we've been monitoring the declines in aid.
As I said, it's not just this pause, it has been a decline generally in in aid coming from all the donors.
So we are managing very responsively.
We do not have a liquidity problem as such.
So we are not about to to fail in our contractual obligations to staff or to fail to pay their salaries.
No, but we do face a very difficult future and we're looking at that.
But right now we are managing responsibly and our staff are safe.
They are not.
We are not failing to pay and we are not in a liquidity crisis, but we are restructuring to fit in a much smaller envelope and, and, and to change the way we work, change ourselves.
[Other language spoken]
So regarding Lena Cuppavir, when you mention that, I get excited because for me, I see real opportunity here.
The company's called Gilead.
It's an American company.
It's doing very well, actually.
[Other language spoken]
It turned in.
It declared a profit last year, $480 million declared.
I have to underline because these companies don't always tell the truth, they hide.
So it's a rich company.
It has an innovation, something that actually they were already looking at how to sell it in the richer markets.
It's our pressure with civil society that push them now to licence 766 companies to produce Generics One in Africa now.
They also entered an agreement with Global Fund and PEPFAR last year to roll out 2 million of this.
Magical product of the this long acting injectable.
For us at UNAS as the data source, we know that to reach the goal of ending AIDS as a public health ****** in 20-30, the SDG goal, we would need to be rolling out 10 million in the next three years, not 2.
So we were pushing Gilead and saying you can do better, don't delay the production of generics so that you can maximise on your brand licence.
[Other language spoken]
After all, during COVID, didn't we vaccinate 440 million people in one year?
One year 450 million people were vaccinated globally.
What's hard about 10 million.
So we've been pushing Gilead.
Now Gilead is right to be scared.
I think that's why they are keeping quiet because they were also depending on this market shaping role by PEPFAR and Global Fund and us on the ground WHO organise the countries, get the policies in place so that the roll out can happen.
But now this whole system has was getting an important contribution through PEPFAR, through Global Fund and through US.
So they are right to worry their, their, their deal is in trouble.
And on that note, I am an ally to them.
[Other language spoken]
They are our allies.
These companies have been our allies, but we are critical friends because we we look at what they are doing.
They are not transparent.
They were not being transparent on the countries where the how they are selecting countries where the generics will go, 120 countries, but they don't include some of the countries with the **** numbers of infections because they are looking at profits, right?
They are not transparent on prices.
They say it will be at no cost.
But even though they say it's at no cost, they don't tell us their production cost.
So how are we to know they are not making profit?
We don't know their production cost.
So there were things that were still pushing them on to do right, to stop playing this Monopoly card and delaying and hiking price.
But we are allies because they were moving slowly in the right direction.
A long answer to your question.
So to Mr Oday, I say let's work together, fight for PEPFAR to return and help shape the market and let's us convince President Trump to do a deal on prevention.
[Other language spoken]
Last question will be from Jenny Lee Ravello from Devex.
Over to Jenny.
[Other language spoken]
Hi, Thank you so much, you know, for doing this press conference and for taking my question.
I just want to clarify because I mean, you mentioned about 50 + 60 million in US funding.
I just want to get a sense is that the total funding that's been terminated by the US government to UN AIDS.
And also a second question is about the restructuring.
You mentioned that you're in the middle of a restructuring process right now, but have you what, what would potentially be the worst case scenario that you're looking at because some staff are concerned that, you know, up to 40% are thinking they may lose their jobs.
[Other language spoken]
[Other language spoken]
Can you repeat it your first question, yes, just want to clarify if the hundred 110 million total US funding was terminated by the US or just part of that was terminated.
OK, what's the was the terminations where about all their funding.
However we are we've been talking with them and seeking clarity.
There wasn't full clarity and I cannot say but I, I think that the I think that the termination was probably around our non core rather than the core funding.
But we are in a discussion and the discussions are very positive.
So I want to leave it there.
And unless Anjali wants to add to that, then regarding restructuring, Jenny, I'm giving you no numbers because as I said, we are looking now at scenarios of the future.
We have not come down to any numbers.
This is speculation and Jenny Devex, you shouldn't add to the speculation by reporting rumours.
You are now hearing from the source.
We have not reached any numbers.
There are no numbers that we have reached.
We are still looking at scenarios of the future and we will get to numbers and at that point we will we we keep our staffing informed.
We have a staff platform through which we are talking to all the staff and consulting.
And so worst case scenario, worst case scenario is supposing we do not get any more funding in the future from the United States, Supposing the European donors who some have already said they are reducing their aid, but they haven't told us yet.
You know, for example, today I think we're going to hear the the Secretary to the Treasury in the House of Commons spelling out cuts to their government.
And and that might include some more details about how they're moving from 0.5 to 0.3 of their GNI for aid, percentage of GNI for aid.
So we will get, and even then we will not know yet what that means for us.
The French have said they are going to cut their aid by 30%, the Belgians by 25%.
So all this may have implications for us too.
And we are looking at a scenario where those might mean reductions as well.
So worst case scenario is about more reductions from Europe as well as the possibility of 0 from the United States.
But as I said, I mean we are in a, we are engaging, we are engaging and we are seeing, I mean for example, we're moving ourselves from Co funding to non to more non Co funding and we are being successful.
Last year we got the French coming on board with some significant funding for West and Central African countries that is non core and also for some countries in Asia that's non core.
So we're doing more to raise non core.
We are also looking at the problem without any, any, what's the word now?
The English is lost.
We are being very realistic about core funding continuing to come down, but we are also stepping up in another direction and, and looking at different futures.
That's all I can say.
No numbers, Jenny, sorry.
[Other language spoken]
Thank you so much for attending.
Before you end, I would like my colleague to fill in for some of the questions that I was answering over to Anjali.
[Other language spoken]
[Other language spoken]
[Other language spoken]
Thanks, Winnie.
I'll maybe just compliment on a few on a few things.
First on the on the question around Jenny from Dev X, the US government gives UN AIDS resources through USAID and through CDC.
These are all PEPFAR resources from the State Department.
So what was terminated was the resources coming from USAID which in total is 50 million core and then roughly 40 million of non core, which is what, which is what Winnie described.
But but we will we will see how this how this unfolds as the review is completed.
One question that I wanted to come back to from Isabel, UN AIDS, we don't procure, we don't procure products.
But, but as Winnie, as Winnie said, one of the most important things that we do as UN AIDS is we can help set the global market.
And we do this by global target setting.
And we're in the process right now of developing the targets for 20-30 that will take the world to end AIDS as a public health ****** by 20-30.
And our goal is to be ambitious.
They're both with treatment, but especially with prevention targets because there's a real opportunity.
So you'll see how we're mobilising around setting the market, setting the the ambition.
The.
Question around Olivia from Reuters on in in Latin America, I think the question around key populations in Latin America and the Caribbean, there are about 120,000 in Latin America, 120,000 new infections in Latin America.
And many of those are among marginalised populations, especially key populations, which is why as Winnie described, we're really needing to focus on where the where the virus is, where the virus is being transmitted and most it's in these marginalised populations like key populations in Latin America or adolescent girls and young women in on the continent of of Africa, for example.
So we really need to make sure interventions are focused where they're needed.
Your question around prevention of mother to child transmission, that is, that is one of the services that we know is part of the waiver from the Secretary of State Rubio.
And so those services should be picking up to ensure that women that are going into antenatal clinics are indeed being tested.
And then those that are positive for HIV will indeed be put on treatment so that their baby will be born without HIV because there's been a disruption in these services.
We know that there have been, there have been challenges with testing and ANC centres, but also with babies being born with HIV needlessly.
So it is we've modelled this out and we know that if prevention of mother to child transmission or, or you know, this does not continue forward, there'll be about 350,000 babies that are born with HIV in the next four to five years.
And that's something that we really worry about.
So, so again, we're, we're really working at the country level, we as UN AIDS, working with the governments, with civil society, with all the partners on the ground to really make sure that those essential life saving services are, are indeed moving forward and that country governments are not, are not forgetting about the importance of prevention because it is critical to sustainability.
So those are just the few that I would add.
[Other language spoken]
Merci Beaucoup, thank you so much.
Thank you very much to Eunice and your help.
Just know that as I said in the chat, we have situation reports on unaids.org.
These are updated every week.
We also have country impact reports that are updated daily.
[Other language spoken]
[Other language spoken]