HIV Market Impact Memo - June 2026 - Key findings and market analysis

Sep 11, 2026

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The Clinton Health Access Initiative (CHAI) presents key findings from its first Market Impact Memo of 2026, analyzing current HIV market conditions across select countries in Africa and Asia. The update examines donor allocation declines from the U.S. Government and the Global Fund, rising co-financing demands, and supply chain risks tied to the GHSC-PSM transition, alongside country-level HIV metrics through Q1 2026 across the continuum of care. Results highlight widespread declines in HIV service indicators, a growing financing gap, supply readiness challenges, and unmet pediatric treatment needs.

LanguageEnglish

CategoryGeneral

FormatPDF

Pages12

Reading Time4 min

AccessFree to download

Executive summary

Nationwide indicator declines

Financing gap and co-financing demands

Supply chain transition risk

Pediatric ART impact

CHAI analysis data sources

Data methodology and scope

Donor funding reductions

USG MoUs and bridge funding changes

Implications for HIV response financing and delivery

HIV MARKET IMPACT MEMO JUNE 2026 The Clinton Health Access Initiative's (CHAI's) first Market Impact Memo of 2026 presents key findings from our analysis of the current HIV market across select countries in Africa and Asia. Building on three market publications in 2025, this update examines declining donor allocations from the United States Government (USG) and Global Fund, rising co-financing demands, and supply chain risks associated with the Global Health Supply Chain – Procurement and Supply Management (GHSC-PSM) transition, and country-level HIV metrics through Q1 2026 across the continuum of care. Findings Based on CHAI’s Analysis Data Sources | National-level data show declines across most key HIV service indicators, with little to no recovery to date. PrEP initiations fell 42%, HIV testing dropped 12% while new HIV-positive diagnoses dropped 28%, and viral load testing declined 21%. | X National-level data collected by CHAI | | | --- | --- | --- | | Countries face a growing financing gap as donor funding declines. USG funding | X | CHAI-collected MOUs and publicly available sources | | is set to decline 42–97% by 2030 across 11 MoUs, Global Fund HIV allocations are | X | The Global Fund | | down 18% on average, and in seven of 11 countries analyzed, combined co-financing requirements exceed projected domestic health spending. | X | The Institute for Health Metrics and Evaluation | | The supply chain transition is outpacing country readiness. 11 of 14 countries face medium-to-critical supply chain risk, with GHSC-PSM activities winding down and critical in-country functions still without replacements. | X | National-level data collected by CHAI | | Children are being left behind. New pediatric ART initiations dropped 15% and total children on ART fell 11% —26,000 fewer kids on treatment across nine countries. | X | National-level data collected by CHAI | Global Fund Eighth Grant Cycle (GC8); pre-exposure prophylaxis (PrEP); memoranda of understanding (MoUs); antiretroviral therapy (ART). Data sources: Eligibility, Allocations & Funding ([archive.theglobalfund.org](archive.theglobalfund.org)); IHME Global Expected Health Spending 2023–2050 ([ghdx.healthdata.org](ghdx.healthdata.org)), accessed May 2026. Nationwide data show declines across most key HIV indicators with no rebound In this report, CHAI collected and analyzed nationwide data on key HIV program indicators, adding new data (calendar year Q4 2025 and Q1 2026) to previously published information. These national data are inclusive of all sites where services are provided within a country, rather than selected sites where a specific funder, such as the USG's President’s Emergency Plan for AIDS Relief (PEPFAR), operates. As such, the findings provide a clearer picture of trends over the past year. While donor-reported data, such as that from PEPFAR, offers valuable insight into some of the programmatic disruptions of the last year, it has real limitations for understanding where things stand today. The most recently available data covers only one quarter (July through September 2025), making it difficult to assess current trends. Looking ahead, even as new PEPFAR data becomes available, it will continue to only capture PEPFAR-supported services rather than the full national HIV response. Also, as health systems shift toward integrated service delivery, HIV-specific metrics will become increasingly difficult to track and report through PEPFAR channels. In the table below, CHAI compared annual totals for calendar year 2024 to those from calendar year 2025, in which the aid disruptions happened. Indicator Percent change 2024 to 2025 Table 1. Changes in Key HIV Service Indicators Across Reporting Countries, 2024–2025 | Prevention | Testing | Adults on Treatment | | Pediatrics on Treatment | | Monitoring | Advanced
Care | | --- | --- | --- | --- | --- | --- | --- | --- | | Number of
Oral PrEP
initiations | Number of
Tests run

FAQs

What market changes does CHAI examine in the 2026 memo?

CHAI analyzes declining donor allocations from the U.S. Government and the Global Fund, increased co-financing requirements, and supply chain risks related to the GHSC-PSM transition, supported by country-level HIV metrics through Q1 2026.

How do key HIV service indicators change in the national-level data?

National-level data show declines across most key indicators, including a reported 42% fall in PrEP initiations, a 12% testing decline, a 28% drop in new HIV-positive diagnoses, and a 21% decrease in viral load testing, with little to no recovery.

Why does CHAI highlight pediatric treatment gaps?

The memo reports that new pediatric ART initiations dropped 15% and total children on ART fell 11%, resulting in about 26,000 fewer children on treatment across nine countries.

Sep 11, 2026

Upload by James