Climate Change vs. Global AIDS Cuts: We Cannot Afford to Choose

By Brandy Lesline

There is a particular kind of cruelty embedded in the way global crises compete for attention and funding. Not the cruelty of indifference , most people, given the full picture, would want to address all of it. But the cruelty of scarcity, of budget lines and political will that stretch only so far, forcing the question of which emergency gets treated as more urgent than another. Right now, that tension is playing out in a way that deserves far more public conversation than it is getting: as wealthy nations pour billions into climate commitments, funding for global HIV and AIDS programs is being quietly and dangerously cut.

Let me be clear about what those cuts actually mean, because it is easy to speak about them in the abstract and much harder to sit with the reality. Global AIDS funding supports antiretroviral treatment programs that keep millions of people alive , not comfortable, not thriving, but alive. In sub-Saharan Africa, where the epidemic remains most concentrated, these programs are not supplements to functioning national health systems. In many cases, they are the health system. When donor contributions shrink or stall, clinics close, drug supplies run short, and people who had been living stable lives with HIV begin to deteriorate. Children born HIV-positive lose access to the treatment they need to simply reach adulthood. These are not projections. They are patterns that health workers on the ground are already documenting.

Meanwhile, climate change is accelerating, and the urgency of addressing it is real and well-founded. The science is unambiguous, the window for meaningful action is closing, and the consequences of continued inaction will be catastrophic on a scale that dwarfs most other challenges humanity faces. No reasonable person wants to argue against climate investment. But there is a version of climate advocacy that is beginning to absorb so much political and financial oxygen that other life-or-death crises are suffocating in its shadow , and that should trouble anyone who believes that urgency is not the exclusive property of one kind of suffering.

What makes this particularly difficult to stomach is the geography of it all. The countries most responsible for climate change are largely not the countries bearing the worst of the AIDS epidemic. When a wealthy government redirects overseas aid toward green energy transitions at home or climate adaptation in politically strategic regions, and in doing so allows HIV treatment funding to lapse in Zambia or Uganda or Mozambique, it is making a trade-off that it will never be forced to experience personally. The people absorbing the consequences of that decision had the least hand in creating either crisis.

There are those who will argue that this is a false dilemma , that with better prioritization and political will, we could fund both adequately. They are right, and that argument deserves to be made loudly and repeatedly to the governments holding the purse strings. The combined cost of fully funding global HIV treatment programs is a fraction of what major economies spend on climate pledges annually. This is not a question of financial impossibility. It is a question of moral imagination and political courage , specifically, the courage to insist that preventing the deaths of millions of people from a treatable disease is not a lesser priority simply because those people are far away and politically inconvenient to consider.

There is also a longer-term logic here that even the most pragmatic policymaker should be able to follow. A world ravaged by resurgent HIV , where drug-resistant strains spread through underfunded health systems, where whole generations in affected regions are thinned by preventable death, where health infrastructure collapses under the weight of a crisis we once had largely under control , will be a far less stable and less resilient world when it comes time to manage the social upheaval that climate change will bring. These crises are not rivals. They are feeding each other.

We are living in an era that demands we hold multiple emergencies in mind at once, and that is genuinely hard. But hard is not the same as impossible. The question of climate change versus global AIDS cuts is ultimately a question about whose lives we count as urgent, and whose suffering we allow ourselves to look past because it does not fit neatly into the crisis we have decided to prioritize this decade. That is a question every one of us and every government that claims to act in our name , should be made to answer.