Donor Government Funding for HIV in Low- and Middle-Income Countries in 2024
Key Findings
Between 2020-2023, some donor governments provided COVID-specific emergency contributions to the Global Fund and UNITAID in addition to their contributions for core activities. For the purposes of this report, these COVID-specific amounts have been excluded as they cannot be attributed to a specific area, such as HIV.
U.S. totals represent funding amounts provided through regular appropriations only. In 2021, the U.S. Congress appropriated additional emergency supplemental funding for bilateral HIV activities and for the Global Fund to address the impacts of the COVID-19 pandemic. These emergency supplemental funding amounts are not included in overall U.S. totals.
In 2025, France provided data revising prior year amounts to account for “set-aside” funding (adjusted for an HIV-share) that supports Global Fund related activities. While this funding is considered part of France’s pledge to the Global Fund, it is not counted by the Global Fund as a direct contribution and is instead included under bilateral totals in this analysis. Due to this update, amounts presented in this report will differ from prior reports.
Total HIV funding from the Netherlands in 2024 includes two core contributions to UNAIDS; the first payment was provided for the 2024 contribution, while the second was a prepayment of the 2025 contribution.
KFF analysis of data from USAspending.gov and Treasury.gov.
Report
Donor government disbursements are a subset of overall international assistance for HIV in low-and-middle-income countries, which also includes funding provided by other multilateral institutions, UN agencies, and foundations.
UNAIDS, “UNAIDS Global AIDS Update 2025: AIDS, Crisis and the Power to Transform”, July 2025.
UNAIDS estimates that US$18.7 billion was available for HIV from all sources (domestic resources, donor governments, multilaterals, and philanthropic organizations) in 2024. In addition, while the amounts presented in this analysis include donor contributions to multilateral organizations, the UNAIDS estimate of total available resources for HIV includes the actual disbursements made by multilateral organizations in 2024 rather than the donor government contributions to these entities.
The donor share of total available resources includes bilateral disbursements as well as an adjusted share of Global Fund and UNITAID disbursements (the donor government share of contributions to each of the multilaterals in 2024 is applied to the disbursements from these multilaterals for the same year).
KFF & UNAIDS, “Donor Government Funding for HIV in Low- and Middle-Income Countries in 2023”, July 2024.
U.S. totals represent funding amounts provided through regular appropriations only. In 2021, the U.S. Congress appropriated additional emergency supplemental funding for bilateral HIV activities and for the Global Fund to address the impacts of the COVID-19 pandemic. These emergency supplemental funding amounts are not included in overall U.S. totals.
In 2025, France provided data revising prior year amounts to account for “set-aside” funding (adjusted for an HIV-share) that supports Global Fund related activities. While this funding is considered part of France’s pledge to the Global Fund, it is not counted by the Global Fund as a direct contribution and is instead included under bilateral totals in this analysis. Due to this update, amounts presented in this report will differ from prior reports.
Total HIV funding from the Netherlands in 2024 includes two core contributions to UNAIDS; the first payment was provided for the 2024 contribution, while the second was a prepayment of the 2025 contribution.
KFF, “The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)”, May 2025.
U.S. totals represent funding amounts provided through regular appropriations only. In 2021, the U.S. Congress appropriated additional emergency supplemental funding for bilateral HIV activities and for the Global Fund to address the impacts of the COVID-19 pandemic. These emergency supplemental funding amounts are not included in overall U.S. totals.
Between 2020-2023, some donor governments provided COVID-specific emergency contributions to the Global Fund and UNITAID in addition to their contributions for core activities. For the purposes of this report, these COVID-specific amounts have been excluded as they cannot be attributed to a specific area, such as HIV.
In 2024, 52% of the Global Fund’s disbursements and 48% of UNITAID’s disbursements were directed to HIV activities. These percentages were applied to the full donor government contributions to these multilateral organizations to calculate the “HIV-share” (see Methodology for additional details).
The U.S. has had a long-standing legislative requirement that total U.S. contributions to the Global Fund could not exceed 33% of all contributions (see “KFF – The U.S. & The Global Fund to Fight AIDS, Tuberculosis and Malaria”), which results in year-to-year fluctuations in U.S. payouts to the Global Fund depending on when other donors provide funds. However, this requirement technically expired in March when the authorization legislation ended (see “KFF - PEPFAR Reauthorization: Side-by-Side of Legislation Over Time”).
GDP estimates are from the International Monetary Fund’s (IMF) World Economic Outlook (WEO) Database (accessed July 2025).