Doctors Without Borders/Médecins Sans Frontières (MSF) is alarmed by the United States’ vote against the 2026 Political Declaration on HIV/AIDS adopted during the United Nations High-Level Meeting (UNHLM) this week. It marks the first time the U.S. has voted against an HIV political declaration and comes at a critical moment in the fight to end AIDS.

For a quarter century, the U.S. has led global efforts to end HIV/AIDS and has been the largest bilateral funder of the response. Over the past year and a half, however, it has taken actions that have eroded that historic commitment. Cuts and disruptions to global health and humanitarian aid programs, including the President’s Emergency Plan for AIDS Relief (PEPFAR), have weakened the global HIV response, hitting HIV prevention programs and key populations especially hard.

Mihir Mankad, global health advocacy and policy director at MSF USA, said of the decision:

“The U.S.’ decision not to support the 2026 Political Declaration on HIV/AIDS is deeply disappointing and sends a dangerous signal to the global community about the US government’s commitment to ending AIDS.

“The declaration isn’t perfect, but there’s no reason the US should have voted against it. It includes encouraging commitments by governments like, for the first time, a commitment to do more to scale up access to PrEP [pre-exposure prophylaxis] to 20 million people by 2030.

When we’re already seeing clinics shuttered, community programs halted and prevention tools priced out of reach, now is not the time for the U.S. to turn its back and retreat from a response it once led.

“Increasing access to PrEP is especially critical for vulnerable populations in low- and middle-income countries — something for which MSF strongly advocates. This includes groups that are often stigmatized, criminalized and excluded from accessing dwindling global HIV/AIDS services, like gay men and other men who have sex with men, transgender people, people who inject drugs, people in prisons, and sex workers.

“With less financial support from governments and other donors — and vital tools for preventing HIV like lenacapavir out of reach of those who need it — the gap between the tools we have and the people who need them is only growing.

“When we’re already seeing clinics shuttered, community programs halted, and prevention tools priced out of reach, now is not the time for the U.S. to turn its back and retreat from a response it once led.”

This press release was originally published Jun 24, 2026, by Doctors Without Borders/Médecins Sans Frontières.