For more than 30 years, collective action against HIV has saved millions of lives. Global solidarity, scientific progress and sustained investment have driven down new infections and AIDS-related deaths — especially among mothers and children — showing what is possible when the world acts together.
But this progress remains fragile. Every day, new mothers acquire HIV during pregnancy or breastfeeding, and their children are born into risk — many without access to timely testing or treatment. In 2025, sudden external funding cuts began disrupting prevention, treatment and care for children and pregnant or breastfeeding women. Countries and communities are responding with resilience, but they cannot face this alone. Without renewed commitment, intervention coverage will fall — and preventable infections and deaths will rise.
This report presents new modelling by UNAIDS, UNICEF and Avenir Health on the potential impact of a 50 per cent reduction in intervention coverage — a plausible outcome if current funding cuts and related disruptions continue. The analysis quantifies the human cost for children by comparing projected new HIV infections and AIDS-related deaths across multiple scenarios.
The future depends on today’s choices
The Cost of Inaction on HIV for Children models three possible futures — each shaped by political and financial commitment to prevention and treatment programmes. The projections show how dramatically children’s lives are influenced by the level of intervention coverage sustained over the next 15 years.
Best-case scenario: With sufficient resources to reach global targets, 410,000 HIV infections and 520,000 AIDS-related deaths in children could be averted by 2040.
Status quo: At the current pace of progress, the world would see 1.9 million new HIV infections and 990,000 AIDS-related deaths in children.
Worst-case scenario: A 50 per cent reduction in programme coverage — a plausible outcome given recent funding cuts — would result in an additional 1.1 million children acquiring HIV and 820,000 additional AIDS-related deaths by 2040.
The human cost of inaction
Adequate resources would sustain prevention of vertical transmission, maintain antiretroviral therapy for women and children, and keep other high-impact HIV services accessible. But if current funding cuts persist, coverage will decline, service delivery will weaken and more children will be born without the protection and treatment they need.
These projected futures are not abstract. They reflect real programme conditions — and a plausible global reality if reduced external financing and related disruptions continue. The direction the world chooses now will determine whether progress accelerates or unravels The modelling makes clear that in the worst-case scenario, global inaction would not only stall progress, but reverse it — resulting in millions of children acquiring HIV or dying from AIDS-related causes. These losses would represent a collective failure, because the tools, science and knowledge to prevent them already exist.
We know what works — but commitment must continue
The message is clear: investments to prevent transmission and reduce AIDS-related deaths in children yield enormous benefits for children, families and societies. The tools, science and knowledge to end AIDS in children already exist. What is missing is sustained political and financial resolve. Protecting progress requires:
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Continued and predictable financing for prevention and treatment
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Safeguarding essential HIV programmes for women and children
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Strengthened global cooperation across governments, donors, civil society and the private sector
Children should never pay the price of global inaction.