HIV Test Kits Run Out First After Global Aid Cuts

55 percent of HIV providers in an International Planned Parenthood Federation survey of 40 countries ran out of a key product in the past year. Rapid tests and PrEP, the daily or long-acting medicine that lowers the chance of getting HIV, were the first to go.

IPPF released the findings on 5 October 2026. The clinics, staff and community programmes are still in place. The cheap goods that make those programmes work are not, which is how a funding cut turns into a new round of infections.

More Than Half Ran Out of HIV Stock

In the second quarter of 2026, IPPF’s Harm Mitigation Task Force asked 55 of the 102 member associations that offer HIV care to report on stocks. Forty replied, a 73 percent response rate, from Africa (18), the Americas and the Caribbean (8), the Arab World (4), Europe (4), East and Southeast Asia and Oceania (3), and South Asia (3).

At the time of the survey, 55 percent of those surveyed had already had a stockout in the previous 12 months. That is 22 of 40 members. Sixteen of 40, or 40 percent, had an active stockout of a product they use. Twenty-four of 40, or 60 percent, said at least one product was at low stock. Another 24 of 40 said products could not be obtained because of market-access barriers.

IPPF HIV STOCK SURVEY, 40 MEMBERS

IPPF is a federation of locally led groups in 150 countries. In 2025 its members delivered 29.8 million HIV-related services. Mallah Tabot, a senior adviser at IPPF Africa’s regional office, said the empty shelves are already costing lives.

These shortages are a warning of what happens when funding becomes uncertain and the supply systems communities depend on grow fragile. We cannot let decades of progress against HIV be undone simply because products aren’t available. This is not a distant risk. It is already happening. HIV infections are rising in a number of countries around the world and lives are being lost.

Mallah Tabot, senior adviser, IPPF Africa regional office

The First Product Off the Shelf

HIV rapid diagnostic tests were the worst-hit product in the sample. Testing is offered by 39 of 40 members, or 98 percent. Seventeen reported low stock of tests and five reported none at all, so 22 of 40 cannot keep point-of-care testing going.

Oral and injectable PrEP were next. Twelve members reported low stock or none across both forms. Without a test, a person who already has HIV does not enter treatment. Without PrEP, a person who does not have HIV loses the medicine meant to keep it that way. Both failures feed the same future caseload.

Condoms and STI screening are offered by 38 of 40 members, or 95 percent. Post-exposure prophylaxis, PrEP and prevention of transmission in pregnancy are each offered by 18 members, or 45 percent. Antiretroviral treatment is offered by 17 members, or 43 percent, and voluntary medical male circumcision by 13, or 33 percent. Injectable PrEP is on the menu at only three members. The network is built to test, prevent and treat in one place. The survey says the testing and prevention goods are the ones running out.

Lori Miller, an HIV adviser for IPPF, said member groups already have clinic networks, digital systems, staff and community trust, but unreliable supplies are letting them down.

Most Clinics Cannot Bypass the Ministry Warehouse

Most members do not buy HIV goods on their own. When a national or donor pipeline stalls, they have few ways around it. That is why a cut in capital cities shows up as an empty drawer in a youth centre or a mobile clinic.

HOW THE 40 MEMBERS GET HIV GOODS

• Ministry supply: 34 of 40 members, or 85 percent, receive HIV commodities through a ministry of health or other government chain.
• Direct import: Only 6 of 40, or 15 percent, import the products themselves.
• Private backup: 15 of 40, or 38 percent, can buy from the private sector in their country when public stock fails.
• No import licence: 18 of 40, or 45 percent, lack authorisation to import HIV commodities at all.

Static clinics remain the main channel, but members also use outreach, mobile clinics, youth centres, telehealth and pharmacy partners to reach people who do not walk into a government hospital. Commodity shortages hit that whole mix, not only the building at the centre of the map.

A Record 23 Percent Drop in Development Assistance

UNAIDS, in a 12 June 2026 brief, said global development assistance from multiple countries fell by 23 percent in 2025, the sharpest drop on record, and that HIV programmes were hit hard. Testing programmes in high-burden settings fell 22 percent between 2024 and 2025. PrEP uptake fell 38 percent in 62 countries that report to UNAIDS. Funding for condoms was cut by more than 90 percent in some cases. Prevention was already 11 percent of total HIV spending in 2024.

A separate KFF and UNAIDS tally of donor governments, a narrower pot than all development assistance, found a $2.1 billion drop in donor HIV funding, from $8.3 billion in 2024 to $6.2 billion in 2025, a 25 percent fall and the lowest level since 2007 ($5.0 billion). United States disbursements fell from $6.7 billion to $4.6 billion, matching the $2.1 billion decline. The United States still provided 74 percent of donor-government HIV money in 2025. Other donor governments, taken together, had already fallen from $3.2 billion in 2011 to $1.6 billion in 2025.

IPPF’s own brief points to abrupt shifts in U.S. foreign assistance and uncertainty around the President’s Emergency Plan for AIDS Relief, or PEPFAR, as drivers of shortages of tests, PrEP, condoms and antiretroviral therapy in some settings. amfAR’s PEPFAR Pulse Study, fielded among 166 implementing partners in 46 countries, found 1,714 HIV service sites closed after awards were ended or payments delayed. Prevention spending among those partners fell 51 percent from 2024 to 2025, and more than 25 percent permanently stopped providing PrEP. Seventy-seven percent of respondents had at least one award terminated or delayed. Less than 2 percent replaced the lost money.

FROM THE 2025 CUTS TO EMPTY SHELVES

1. 2025: Donor-government HIV funding falls $2.1 billion; development assistance falls 23 percent; testing programmes in high-burden settings drop 22 percent and PrEP uptake drops 38 percent in 62 countries.
2. 12 June 2026: UNAIDS calls the disruption the most serious since the global HIV response began and warns that prevention is being taken apart just as long-acting tools arrive.
3. Second quarter of 2026: IPPF surveys 40 member associations on HIV stocks, sourcing and service mix.
4. 5 October 2026: IPPF publishes the results and sets $600,000 in emergency commodity grants, while quantifying more than $1.5 million in unmet need for tests and PrEP over two years.

Winnie Byanyima, executive director of UNAIDS, said the funding cuts, a squeeze on civic space and new criminal laws against marginalised groups had arrived together.

There’s no question that this is the most serious disruption in the HIV response since the world came together to fight this disease. The funding cuts, combined with the reduction in civic space and the further criminalization of marginalized populations have come together to create the biggest storm the HIV response has ever seen.

Winnie Byanyima, executive director, UNAIDS, 12 June 2026 brief

IPPF’s Emergency Grants Cover Only Part of the Need

After the survey, IPPF put $600,000 into emergency HIV product grants through the same task force. Members were ranked by stock, import capacity and programme need. The money was never going to cover every product line, so IPPF limited the buy to rapid tests and PrEP, the two goods in widest use and widest gap.

HIGH-PRIORITY MEMBERS FOR EMERGENCY HIV GRANTS

• Madagascar: FISA, flagged for an immediate needs assessment.
• São Tomé and Príncipe: ASPF, in the same high-priority group of four.
• Barbados: BFPA, the Caribbean member in that group.
• Lebanon: SALAMA, later also backed to ease an urgent antiretroviral stockout.

Thirteen further members were listed as medium priority, including groups in Cameroon, Haiti, Côte d’Ivoire, Liberia, the Philippines, Morocco, Eswatini, North Macedonia, Saint Vincent and the Grenadines, the Solomon Islands, Sri Lanka, Suriname and Zambia. The remaining 23 were classed as low priority, either because they reported no availability problem or because they said they could still work through central ministry supply.

A closer count of high- and medium-priority members found near stockouts in 11 of 12 associations assessed. IPPF also helped its Ukraine member after Russian bombing damaged an HIV product store. The $600,000 went to 13 members with confirmed stock trouble. The same quantification put the product value of test and PrEP gaps among 12 members at more than $1.5 million over the next two years, and that figure leaves out other HIV goods and the rest of the federation.

What Empty Test Kits Do to New Infections

UNAIDS estimates 40.9 million people were living with HIV in 2025. Of those, 32.1 million, or 78 percent, were on treatment, which leaves nearly 9 million people off it. AIDS-related deaths stood at 570,000, down 56 percent from 1.3 million in 2010. New infections stood at 1.2 million, down 43 percent since 2010. Those gains depend on people finding out their status and on people at high risk staying negative.

THE 2025 GLOBAL HIV COUNT

• People living with HIV: 40.9 million, with 32.1 million on antiretroviral therapy.
• AIDS-related deaths: 570,000, compared with 1.3 million in 2010.
• New infections: 1.2 million; 3,000 adolescent girls and young women in sub-Saharan Africa acquire HIV every week.
• Prevention share: 11 percent of HIV spending in 2024, before the 2025 cuts.

A testing programme that shrinks by 22 percent in high-burden settings does not only delay a diagnosis. It keeps people with untreated HIV in the community longer, and it keeps people who need PrEP from ever starting it. Western and central Africa remains about 90 percent dependent on outside money for treatment, UNAIDS said, so even the treatment layer is thin. Eastern Europe and central Asia, the Middle East and North Africa, and Latin America have seen new infections rise since 2010.

Community groups that reach sex workers, gay and bisexual men, and people who inject drugs reported still steeper losses. A community-led study cited by UNAIDS, covering 79 organisations in 47 countries, found a 50 percent drop in support services for people living with HIV, an 82 percent cut in services for sex workers and an 85 percent cut in services for men who have sex with men. When those groups lose funding, the people who most need tests and PrEP lose the only door they use.

Nineteen Members Want Injectable PrEP They Lack

IPPF has made new biomedical prevention part of its Strategy 2028, including the dapivirine vaginal ring, cabotegravir given every eight weeks, and lenacapavir given every six months, alongside oral PrEP. The survey shows demand sitting well ahead of stock.

Oral PrEP is already offered by 18 of 40 members, and 15 more want to start it. Injectable PrEP is offered by only three members, in Eswatini, Malawi and Lesotho, while 19 of the members who replied want to introduce it, the largest such gap of any product in the survey. UNAIDS said that by the end of March 2026 more than 6,000 people were on lenacapavir across five sub-Saharan African countries, against an estimated 20 million people who need antiretroviral-based prevention for it to change the course of new infections.

The political fight over PEPFAR in 2025 already showed where the first blow would land. Prevention contracts, test kits and PrEP were easier to pause than the treatment of people already on antiretroviral therapy. IPPF’s October figures are the shelf-level version of that choice: 22 members that cannot keep HIV testing going, 12 that cannot keep PrEP going, and a $600,000 emergency fund set against more than $1.5 million in counted test and PrEP need.

The 29.8 million HIV services IPPF members delivered in 2025 did not vanish. The staff and the sites are still there. What is missing is the cassette in the drawer and the bottle on the shelf, and that is enough to turn last year’s aid cut into next year’s infections.

Disclaimer: This article is news reporting on an IPPF member survey and on UNAIDS, KFF and amfAR figures. It is for information only and is not medical advice, a diagnosis, or a guide to starting, stopping or switching HIV testing, PrEP or antiretroviral therapy. Anyone who needs HIV testing, prevention or treatment should speak with a qualified clinician or local HIV programme before making a care decision. Stock levels, grant amounts and global estimates reflect the cited sources as of 5 October 2026 and can change as supply chains and funding shift.