World AIDS Day, observed every year on December 1, is a moment to reflect on where we stand in the fight against HIV—and how policy decisions in the United States are reshaping that fight at home and across the world. Yet, just days before, the Federal Government demands all of its reporting agencies to suppress recognition of World AIDS Day, continuing a pattern of systemic destruction and harm.
Earlier this year, the United States—historically responsible for roughly 75% of all global HIV funding—halted its support for international HIV programs.UNAIDS reports that this move pushed the global AIDS response into “crisis mode,” leaving an estimated 2.5 million people without access to HIV prevention medicine as of October 2025. Clinics have closed, supply chains have fractured, and thousands of health workers have lost their jobs in low- and middle-income countries. These disruptions have already contributed to preventable deaths among people living with HIV.
The same threats are unfolding domestically. Modeling from amfAR estimates that eliminating the Centers for Disease Control and Prevention’s (CDC) Division of HIV Prevention could result in approximately 143,000 additional HIV transmissions and nearly 15,000 more AIDS-related deaths in the United States over five years (amfAR).
Here in North Carolina, the consequences would be immediate and severe. Our state receives more than $30 million annually in CDC HIV prevention and surveillance funding that sustains HIV testing, partner services, PrEP access, and outbreak response in every region. More than 38,000 North Carolinians are living with HIV, and our state’s diagnosis rate remains higher than the national average. Nearly half of all new HIV diagnoses in North Carolinaoccur among Black residents, despite comprising just 22% of the state’s population. Cuts to core prevention and treatment programs further deepen these long-standing racial disparities.
The federal Ryan White HIV/AIDS Program and the AIDS Drug Assistance Program (ADAP) remain lifelines for our community. North Carolina’s ADAP provides medication access, insurance assistance, and cost-sharing support for thousands of people each year—at a time when rising premiums and drug costs are already straining the system. A recent study projects that ending the Ryan White Program could result in roughly 75,000 additional HIV transmissions nationwide by 2030, a 49% increase.
Medicaid is also central to North Carolina’s response. For people living with HIV, Medicaid expansion has strengthened access to comprehensive care, medications, behavioral health services, and treatment for co-occurring conditions. Medicaid is the single largest payer of HIV care in the United States. For people who need HIV prevention services, Medicaid expansion has significantly broadened access to PrEP. As PrEP usage in North Carolina remains far too low—around 22% compared to 36% nationally—cuts to federal programs would place even greater pressure on Medicaid to maintain access.
The Fiscal Year (FY) 2026 federal budget proposals make these risks even clearer:
- Elimination of CDC HIV prevention programs:
The Administration’s FY 2026 budgetrequest zeros out core HIV prevention and surveillance activities—nearly $1 billion nationally and more than $30 million that North Carolina relies on for testing, PrEP access, partner services, and outbreak response.
- Cuts to the Ryan White HIV/AIDS Program:
The budget proposes a $74 million reduction from FY 2025 levels by eliminating Part F programs, including the AIDS Education and Training Centers and the Minority AIDS Initiative. A separate House proposal includes more than $525 million in deeper cuts across the program.
- Elimination of Ending the HIV Epidemic initiative components:
Congressional proposals would eliminate targeted funding that supports HIV prevention and care infrastructure across the South, including counties in North Carolina that rely on these resources to expand PrEP, testing, and linkage to care.
- Severe reductions in HIV research:
The National Institute of Allergy and Infectious Diseases (NIAID) faces a proposed 36% budget cut, threatening HIV vaccine development and next-generation prevention tools.
Global projections underscore the stakes: a recent WHO study estimatesthat sharp declines in donor funding could lead to 4.4 to 10.8 million additional HIV transmissions and as many as 2.9 million additional AIDS-related deaths worldwide by 2030.
This year’s World AIDS Day theme—“overcoming disruption”—rings hollow when the U.S. government is generating much of that disruption. It is impossible to commemorate World AIDS Day with integrity while simultaneously dismantling the domestic and global programs that made our progress possible. The New York Times reports the administration that has issued proclomations for National Manufacturing Day and World Intellectual Property Day forbids recognition of world Sids Day.
The North Carolina AIDS Action Network calls for the protection of critical domestic programs, including CDC prevention, the Ryan White Program, ADAP, and Medicaid, before decades of progress are reversed.
We urge North Carolinians to take action:
- Call and email your members of Congress. Tell them to oppose any budget that cuts funding for:
- The Ryan White HIV/AIDS Program
- The CDC’s Division of HIV Prevention
- Research at NIH/NIAID
- Programs that strengthen PrEP access and ADAP
- Use your voice. Share the facts using the hashtags #RestoreHIVFunding #PEPFAR #WorldAIDSDay.
- Join us December 10 at the Ready to Rise 2026 policy summit. This free event brings together leaders from across the state to move strategically and continue the progress started to end the epidemic.
- Donate to support NCAAN’s programs in advocacy and policy advancement
Demand accountability. Demand action. Save lives.
In solidarity,
NCAAN
