By MONICA KAYOMBO, Zambia,Lusaka
ZAMBIA’s decades-long progress in the fight against HIV could face new challenges as emerging evidence shows that disruptions to the United States President’s Emergency Plan for AIDS Relief (PEPFAR) are already affecting HIV treatment services in several countries, including Zambia.
The findings, released ahead of the 26th International AIDS Conference (AIDS 2026), have raised concern among global health experts, researchers and HIV advocates who warn that funding uncertainties could undermine years of progress in controlling the epidemic.
The conference, scheduled to take place in Rio de Janeiro, Brazil, from July 26 to 31, comes at a critical time under the theme “Rethink. Rebuild. Rise.” It will bring together thousands of scientists, policymakers, healthcare workers, development partners, civil society organisations and people living with HIV to discuss the future of the global HIV response amid an unprecedented funding crisis.
For Zambia, the discussions are particularly significant.
For more than two decades, PEPFAR has been one of the country’s largest partners in the fight against HIV and AIDS, supporting HIV testing services, life-saving antiretroviral treatment, prevention of mother-to-child transmission, laboratory services, health workforce training and programmes targeting vulnerable populations.
Since its launch in 2003, PEPFAR has helped save more than 26 million lives globally and has played a major role in helping countries move closer to the UNAIDS 95-95-95 targets.
However, studies to be presented during AIDS 2026 suggest that recent disruptions to the programme have already begun reversing some of those gains.
One of the studies, conducted across 46 countries, found that more than half of PEPFAR implementing partners had experienced funding terminations, leading to the closure of over 1,700 HIV service delivery sites, including public health facilities, community access points and drop-in centres.
The survey also revealed shortages of HIV prevention commodities, including condoms, antiretroviral medicines, laboratory supplies and pre-exposure prophylaxis (PrEP), while services targeting key populations were among the hardest hit.
Of particular concern to Zambia is a second study analysing PEPFAR-supported paediatric HIV treatment data for the 2025 fiscal year.
The study found that globally 77,163 fewer children living with HIV received PEPFAR-supported treatment, representing a 14.2 percent decline compared to the previous year.
Researchers identified Zambia among five countries, alongside Uganda, Kenya, South Africa and Haiti where declines in paediatric HIV treatment appear to have deviated from historical trends, prompting calls for urgent country-level investigations.
Although the study does not conclude that children have stopped receiving treatment altogether, researchers say the decline in PEPFAR-supported services is significant enough to warrant immediate attention to prevent interruptions in care.
Health experts warn that any disruption to HIV treatment programmes risks increasing new infections, treatment interruptions and preventable deaths, especially among children and vulnerable populations.
Speaking ahead of the conference, IAS President and AIDS 2026 Co-Chair Beatriz Grinsztejn stressed that scientific breakthroughs alone are not enough without sustained investment.
“Science is moving fast, giving us more powerful HIV prevention and treatment tools. But these advances cannot save lives if they never reach the people who need them. That requires robust, stable financing and steadfast political commitment,” she said.
Despite concerns over funding, AIDS 2026 is also expected to showcase remarkable scientific advances that could transform HIV prevention and treatment.
Among the major breakthroughs to be presented are new findings confirming the effectiveness of twice-yearly injectable lenacapavir for HIV prevention, which has demonstrated exceptionally high protection against HIV infection, as well as encouraging Phase Three trial results for the world’s first once-weekly oral HIV treatment combining islatravir and lenacapavir.
Researchers believe these innovations could simplify HIV prevention and treatment, improve adherence and significantly enhance quality of life for millions of people living with HIV.
As delegates gather in Rio, the conference is expected to balance optimism over scientific innovation with urgent discussions on sustaining global financing to ensure that no country is left behind.
For Zambia, where thousands of people continue to rely on HIV services supported through international partnerships, the conference will provide important insights into how the country and the global community can safeguard hard-won gains while embracing new technologies that could accelerate progress towards ending AIDS as a public health threat.
This is according to a statement issued by the International AIDS Society (IAS) ahead of the 26th International AIDS Conference. This follows a scientific hybrid media briefing held in Rio de Janeiro, Brazil.
