India Can Lead Global HIV Response as New Treatments Emerge

The global fight against HIV is at a critical juncture, with India poised to play a transformative role. Current estimates from the United Nations indicate that approximately 40.8 million people are living with HIV worldwide, including 2,544,000 in India. In 2024, the country reported 68,450 new infections, contributing to a total of 1.3 million new cases globally.

Advancements in antiretroviral therapy (ART) have significantly changed the landscape of HIV treatment. Individuals with HIV who have access to ART do not progress to AIDS, the disease caused by the virus. Research indicates that the life expectancy of people living with HIV who are on ART is nearly equivalent to that of individuals without the virus. This remarkable progress is attributed to the development of various antiretroviral medications that are administered in combination.

While no vaccine currently exists to prevent HIV infection, the introduction of lenacapavir, a long-acting injectable antiviral, marks a significant breakthrough. Administered biannually as pre-exposure prophylaxis (PrEP), lenacapavir can effectively prevent the transmission of HIV, offering hope in the absence of a cure.

A troubling funding crisis looms over the global HIV response. According to a report by UNAIDS, the funding landscape shifted dramatically at the end of 2025. Just before a significant reduction in global funding, community and government efforts had successfully decreased new HIV infections by 40% and AIDS-related deaths by 56% since 2010. Nevertheless, the report revealed persistent gaps in HIV prevention, as evidenced by the 1.3 million new infections recorded in 2024—an alarming statistic that remained almost unchanged from the previous year.

The withdrawal of the United States, the largest contributor to the global HIV response, has disrupted treatment and prevention programs worldwide. International assistance plays a critical role, funding approximately 80% of prevention programs in low- and middle-income countries. If funding continues to decline, UNAIDS projects an additional 6 million new HIV infections and 4 million AIDS-related deaths by 2029.

Within India, over 95% of funding for HIV treatment and prevention is sourced from the government. The country is also a key player in the global supply of medications, with its generic manufacturers providing 92% of the antiretroviral drugs prescribed worldwide. Despite these positive developments, India has yet to integrate lenacapavir into its national program for PrEP, highlighting a significant gap in its response strategy.

The future of HIV prevention and treatment hinges on a shift in funding strategies. The conventional model of financing may be waning, but there is a growing consensus within the international community to cultivate a more sustainable approach. It is crucial for low- and middle-income countries to take ownership of their HIV prevention and treatment initiatives, rather than relying solely on external assistance.

As noted in the UNAIDS report, 25 of the 60 low- and middle-income countries have begun to increase their domestic spending on HIV initiatives through 2026. This shift towards self-sufficiency represents the next chapter in the global HIV response—one that emphasizes nationally-led, sustainable, and inclusive solutions.

While the transition will not occur overnight, the need for global solidarity and renewed commitment from funding partners remains critical. Countries must plan and execute sustainable transitions towards self-financing of their HIV initiatives. India has demonstrated its potential in this regard and can lead global efforts in the fight against HIV.

The global HIV response has already saved 26.9 million lives, and with the implementation of innovative prevention strategies, the fight against AIDS could see substantial progress. Winnie Byanyima, executive director of UNAIDS, emphasizes that a revolution in HIV prevention could ultimately end AIDS as a public health threat, potentially saving millions more lives. Moreover, embracing new technologies and interventions could reduce the annual cost of the HIV response by approximately $7 billion globally, underscoring the economic benefits of a proactive approach.