CHAI 2023 market report: decline in HIV funding threatens 20 years of progress

Polly Clayden, HIV i-Base

CHAI recently released the fourteenth issue of its annual HIV market report. This excellent publication provides a detailed overview of “the complex, ever-changing HIV landscape in low- and middle-income countries based on aggregated market intelligence from our work in over 20 countries”.

CHAI warns that with just two years left to meet the UNAIDS 95-95-95 targets, declining and uncertain funding threaten to erode the advances made in the HIV response over the last 20 years.

And stresses that in order to make continued progress towards ending HIV, global initiatives must prioritise key populations and their partners, bridge treatment gaps between adults and children, and ensure sufficient and sustainable funding, among others.

Key highlights include:

  • Thirty-nine million people living with HIV (37.5 million adults and 1.5 million children). Of which 77% adults (15 plus) and 57% children are on ART.
  • 91% of adults in generic-accessible low- and middle-income countries (LMICs) use dolutegravir (DTG)-based ART, the WHO-recommended treatment, which costs less than US $45 per person per year.
  • Over 160,000 of children are on paediatric DTG, which had the shortest regulatory approval on record for a generic HIV product. And for the first time there is a generic triple fixed-dose combination containing DTG for children: ABC/3TC/DTG. Over 80 LMICs are procuring this product.
  • HIV diagnosis is still the largest gap among the UNAIDS 95-95-95 targets and testing rates for children and adolescents are significantly below those of adults. But, diagnostic services are improving, with self-tests available for US $1, the introduction of affordable combination tests including a dual HIV/syphilis test, and the continued decentralisation of multiple point-of-care options for CD4, viral load, and early infant diagnosis.
  • Despite improvements in ART coverage, 630,000 people died from AIDS-related causes in 2022. Tuberculosis, cryptococcal meningitis and bacterial infections remain among the major causes of death for both adults and children. There is an urgent need to prevent advanced HIV disease, particularly for children.
  • Overcoming political and social barriers remains critical to sustaining and expanding the HIV response, especially among key populations.


CHAI. 2023 HIV market report. Issue 14. October 2023. (pdf)

This report was first published on 2 Novembr 2023.e

Links to other websites are current at date of posting but not maintained.