The UNAIDS report was published this June showing improvements on every top line measure including deaths, coverage, and new infections. This is excellent news and is largely due to the preservation of the most valuable programs under the state department as well as successful local adaptation. It’s frustrating—bordering on irresponsible—that articles are still making claims about millions of deaths based on prospective models when we now have real data. Not everything is rosy—PreP usage has 38% declined and at least one country has seen a 22% reduction in testing—but things are much better than the earlier models assumed. There is a real conversation to be had about the state/future of global health aid but you have to engage with reality.

Also the 2025 decline in PreP is actually much less concerning than it initially seems. Starting this year and going fully into gear in 2027 we are rolling out lenacapavir, a twice yearly injection rather than a daily pill, thats 95% effective at preventing transmission. As of April, the Global Fund and PEPFAR have expanded the targets by more than a million people and the generics are going to be widely dispersed.