How do we maintain access to life-saving HIV care and introduce a new wave of innovative tools as major funding cuts threaten to unravel decades of progress?
A market under strain
For over a decade, much of the donor-supported HIV market has benefited from coordinated planning, pooled procurement and aggregated demand, helping to secure lower prices, reliable supply and quality-assured products. That system is under increasing pressure: steep cuts to U.S. and Global Fund financing are pushing countries to take on more responsibility for financing, procurement, and supply-chain management, often through a mix of domestic and donor-supported channels. Some U.S. funding continues, routed through the Global Fund, but often without the systems, staff, or funding countries need to manage the shift. At the same time, a new generation of long-acting HIV prevention and treatment tools is emerging. These tools could dramatically improve care for people living with and at risk of HIV, but only if they reach people quickly and equitably.
These two forces are colliding. According to CHAI’s June 2026 HIV Market Impact Memo, published in partnership with Unitaid, funding disruptions are already driving steep declines across prevention, testing, and treatment. Without coordinated action, the same cuts destabilizing today’s HIV market could stall the rollout of tomorrow’s most promising tools, creating supply gaps, higher prices, and unequal access at the exact moment new innovations should be expanding it.
The Future of HIV Markets Forum
In response, Unitaid and CHAI brought together more than 80 organizations from 28 countries for the Future of HIV Markets Forum, held in Nairobi, in June 2026. Ministries of Health, communities, civil society, donors, industry, researchers and technical experts gathered to tackle these challenges.
The Forum was a chance for stakeholders across the HIV response to align on what comes next: a shared set of public health priorities and access needs, and the coordination mechanisms, concrete next steps, and lines of accountability needed to turn this moment of disruption into an opportunity to build a stronger, fairer market for the people living with and at risk of HIV.
Three priorities to steady the market
Across the discussions, a consensus emerged on protecting access today while building a more resilient HIV market for the future:
- Access planning for new innovations must begin earlier and connect decisions across the full pathway to scale.
- Strengthening, expanding, and coordination mechanisms to preserve key market conditions and secure access to life-saving care amid growing fragmentation.
- Country leadership and resourced community participation must be structurally embedded in HIV market planning and throughout new product development and access pathways.
This document was prepared by Unitaid and CHAI and is intended to prompt further discussion and action as circumstances evolve. Please send any questions or feedback to futureofhivmarkets@clintonhealthaccess.org.
