The impending closure of UNAids in 2026 marks a profound turning point in the global response to HIV/Aids. The organisation was created to coordinate the world’s efforts against one of the most devastating epidemics in modern history. UNAids brought together the United Nations system, governments, donors, scientists and, most importantly, civil society. Its dissolution, four years ahead of schedule, is a moment for deeper reflection.
For many, the closure is deeply unsettling. UNAids has long served as a global advocate for those most at risk of being left behind. Women and adolescent girls in Africa, gay men, people living in poverty, those who use medicine in criminalised contexts, and people still navigating stigma and silence. UNAids elevated voices often excluded from formal health policy debates and it has helped to keep HIV on the international agenda, even as global attention shifted elsewhere.
But as troubling as this moment is for many people, it must also prompt critical reflection. Was the architecture of the global HIV response ever truly fit for purpose? And can we afford to simply replace one institution with the same ideas and structures that have shown signs of strain?
UNAids operated within a crowded landscape. It shared responsibility with the World Health Organization (WHO) and the Global Fund to Fight Aids, Tuberculosis and Malaria. Each had its own mandate. Technical guidance for WHO. Financing for Global Fund and advocacy for UNAids. In practice, the lines often blurred more than the mandates might suggest. This fragmentation, while at times productive, also led to confusion, inefficiency and overlapping roles. It is worth asking whether three major institutions were truly needed to address one disease. Or whether such a setup served more to appease institutional rivalries and donor preferences than to meet the needs of communities most affected.
Moreover, for all its commitment to civil society, UNAids has often struggled to realise meaningful inclusion. The promise of equal partnership between governments, donors and community organisations was frequently undercut by power imbalances. Governance structures sometimes reflected geopolitical interests more than grassroots realities. The largest funders often had the loudest voices. And civil society, particularly from the Global South, was too often reduced to symbolic participation in processes shaped elsewhere.
This power dynamic played out in how programmes were funded. It affected how data was interpreted and how priorities were set. Communities on the front lines of the epidemic were included, but rarely genuinely empowered. UNAids became, at times, another arena where Global North donors steered the agenda with their dollars, however well intentioned.
Yet none of this negates the very real value UNAids has provided. In many countries, it was a critical bridge between ministries and communities. It facilitated access to essential medicines, challenged stigma and insisted that the epidemic could not be treated purely as a clinical issue. Where governments looked away, UNAids often held up a mirror, insisting that HIV be seen, addressed and funded. Its data shaped policy. Its presence mattered.
The danger now is that the global response may lose its most visible advocate at a moment of growing complacency. HIV is no longer front-page news. Budgets are shrinking. Political will is uneven. Without an agency dedicated solely to this issue, there is a real risk that HIV will be folded into broader health agendas and quietly deprioritised.
The future of HIV advocacy, coordination and accountability cannot be left to chance or dispersed responsibility. If UNAids is to be sunset, there must be a deliberate and inclusive process to decide what replaces it. This is an opportunity. Not to replicate the past, but to design a more just, more representative and more effective system. One where communities most affected lead, not consult. Where equity is more than a principle, it is the foundation.
The end of UNAids may close one chapter, but the story of the global HIV response is far from over. What comes next will tell us a great deal about the world’s willingness to finish the work it once promised to do. Not just to fight a virus, but to fight for dignity, voice and justice. DM