BERLIN — A top UNAIDS official told delegates at the World Health Summit this week that it would be “very difficult” to envision shutting down the agency by the end of 2026, pushing back against a controversial proposal from UN Secretary-General António Guterres that has triggered an outcry from civil society groups and member states.

“I know the [Secretary-General’s] proposal is formulated in a way that strikes people as if it’s already a decision, but it is a proposal,” Christine Stegling, deputy executive director of UNAIDS, said at the summit. “There’s pressure on all of us to rethink ourselves and to think how we can maybe accelerate the timeline, but I personally find it very difficult to think about how we could do that by the end of 2026.”

Her comments come weeks after Guterres released his UN80 reform plan in September, a sweeping 45-page blueprint for restructuring the UN system that included a single sentence stating: “We plan to sunset UNAIDS by the end of 2026.”

The proposal caught the agency’s own governing board off guard, as well as donor governments and the civil society organizations that hold a unique seat at the table in UNAIDS governance.

UNAIDS was already implementing its own board-approved transformation plan, which includes a 54% reduction in secretariat staffing and consolidation of country offices from 85 to 54.

That plan, informed by a high-level panel that worked from October 2024 to March 2025, envisions a gradual two-phase process that would propose to the board in mid-2027 to “further transform, consolidate, integrate, with a view to eventually closing down the UNAIDS Secretariat in its current form”—a timeline measured in years, not the 14 months the UN80 plan allows.

“We heard very powerful voices in our board meeting in June from communities telling us, look, sunsetting can be good if you stand in a beautiful sunset,” Stegling said. “And it can be terrifying if you’re standing by yourself, and it just all of a sudden gets dark.”

‘I’m seeing death’

The fight over the programme’s future unfolds as the global HIV response faces what UNAIDS has called a “historic funding crisis.”

There were 1.3 million new HIV infections in 2024, virtually unchanged from the previous year and far short of targets needed to end AIDS as a public health threat by 2030, according to the agency’s 2025 Global AIDS Update released in July.

The sudden withdrawal of US funding in early 2025, which had previously accounted for 73% of international HIV/AIDS financing, has disrupted treatment and prevention programmes worldwide. UNAIDS modelling suggests the funding collapse could lead to an additional 6.6 million new HIV infections and 4.2 million AIDS-related deaths by 2029.

“This is not just a funding gap – it’s a ticking time bomb,” Byanyima said when the annual report was released. “We have seen services vanish overnight. Health workers have been sent home. And people – especially children and key populations – are being pushed out of care.”

In Mozambique alone, over 30,000 health personnel lost their jobs, while Nigeria has seen monthly initiations of pre-exposure prophylaxis to prevent HIV transmission have plummeted from 40,000 to 6,000.

“I’m seeing death, real people dying because clinics are shutting, because services for the most vulnerable people are closing,” Winnie Byanyima, UNAIDS executive director, told the summit. “That suddenness, that rapid decline, is costing lives. Let’s be clear about that. People are dying.”

Speaking about the abrupt US funding cuts, Stegling drew a parallel to the UN80 proposal: “It was the shock and it was the abruptness, and it was the unpreparedness that hit hardest, with little time to react.”

At an extraordinary UNAIDS board meeting last week, member states expressed strong opposition to the accelerated timeline.

“Member states on our board, and in particular those who are most affected, all speak about a similar issue,” Stegling said, specifically citing the Africa group. “They’re basically saying, look, the ecosystem is collapsing around us. The funding is collapsing around us, and at this particular time, you’re taking away a structure that we have at a country level that helps us to navigate these new realities, and so therefore we can’t support that.”

Donors demand answers

Germany and the Netherlands, the two largest contributors to HIV financing aside from the US, said their delegations would use the next meeting of the UNAIDS Programme Coordinating Board to question UN80’s abrupt departure from the agency’s existing reform trajectory.

“The Secretary-General’s proposal that sunsets UNAIDS already by the end of 2026 came to all of us as a surprise,” said Paul Zubeil of Germany’s Ministry of Health, adding that the proposals outlined in the UNAIDS-led reforms were “very balanced.”

“It’s an easy pitch to close a very small, not even UN agency, but a small joint programme, to integrate it,” Zubeil continued. “This would probably show the world ‘we’re doing something, we’re integrating UN agencies into each other,’ but it’s not really what does the trick. We don’t talk about WFP or about FAO or any others, the big ships.”

“I don’t know what’s on [Guterres’] mind, but again, I think we should monitor this. We should take it very seriously. But there’s no reason for panic upfront when the storm has not hit us yet.”

Peter Derrek Hof of the Netherlands Ministry of Foreign Affairs said his government had prepared questions about “why not follow the transition plan that was well thought out, was well prepared.”

While supporting the broader UN reform process, he added: “It doesn’t mean that on specific issues we won’t raise issues, and we will ask questions – this will be one of them.”

Civil society outcry

The UN proposal has generated fierce resistance from civil society organizations who sit on the UNAIDS Programme Coordinating Board – the only governance structure in the UN with direct civil society representation.

More than 1,000 civil society organisations have signed a letter expressing “deepest alarm” at the sunsetting proposal, noting their seat at the table had been effectively stepped over by the Secretary-General, who did not consult UNAIDS or its board before publishing the UN80 agenda.

“UNAIDS must remain until new HIV infections are halted, until lifesaving HIV treatment reaches all who need it, and until the human rights of all people living with and affected by HIV are fully safeguarded,” the letter states.

“Preserving UNAIDS is about saving lives, and to propose sunsetting it now is profoundly dangerous and a betrayal of the global goal to end AIDS by 2030,” the groups said. “Any restructuring must strengthen – not weaken – the HIV response, human rights, community leadership, and accountability.”

The exclusion of civil society from the UN80 process carries particular sting, given the history of the AIDS crisis. When governments worldwide ignored the epidemic in the 1980s as it killed millions, dismissing it as a “gay plague”, it was grassroots activists who forced the issue onto the political agenda, staged “die-ins” at pharmaceutical companies to demand treatment access, and ultimately shaped the unprecedented global response that created institutions like UNAIDS and the Global Fund.

“I come from that time where we took to the streets, where we threw red paint on politicians, where we went into parliament with coffins,” said Erika Castellanos, a civil society representative. “And because of that action with the global community, the international community ended up with institutions like the Global Fund and UNAIDS.”

“We need to have an institution at the highest level, at the UN level, where the participation and engagement of community is preserved to the level it is now,” Castellanos said. “Whatever we create or redesign needs to keep communities in decision-making seats with equal power. Otherwise, representation goes back to tokenistic.”

The move also reflects a broader trend across the UN system, where civil society access has been shrinking in both Geneva and New York. The recent plastics treaty negotiations saw civil society representatives largely stonewalled, while Brazil’s COP30 climate summit is expected to draw record-low civil society participation – a retreat from the open multilateralism that defined earlier UN processes.

Calling out the euphemistic language of the proposal, Clemens Gros, another civil society representative, compared “sunsetting” to SpaceX’s description of a rocket explosion as “rapid unscheduled disassembly.”

“Sun setting the organization would effectively mean it will not be there anymore once it’s beyond the horizon,” he said.

UN80: Response to ‘severe pressure’

The UNAIDS proposal sits within a wider UN80 reform initiative launched by Guterres in March as the body marks its 80th anniversary.

The “Shifting Paradigms: United to Deliver” report, released on 18 September at the General Assembly in New York, proposes numerous mergers and consolidations across the UN system.

Among the proposals: merging the UN Population Fund and UN Women “to create a unified voice and platform on gender equality and women’s rights.”

The reforms are widely seen as a response to severe funding pressures—particularly US aid cuts under the Trump administration—though Guterres has denied this.

Informal discussions have also circulated about potentially merging the two largest non-UN health agencies, Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria, though the agencies themselves have emphasized closer collaboration over outright merger.

For now, member states and agency leadership are left navigating between two competing visions: the gradual, community-informed transformation UNAIDS had charted for itself, and the abrupt 2026 closure proposed in the UN80 plan.

“We went from street rioters to policy makers because we were forced to take that role,” Castellanos said. “We finally arrive at a place where we have a seat at the table, and often the privilege and honor to lead that table.”

“This hasn’t come easily. It’s with a lot of pain and suffering, and a lot of people who have done a lot of amazing work before us. So I find it a little bit irresponsible and a little bit too naive, perhaps, to think that we can shift gears suddenly without a planned process.”

Image Credits: https://www.flickr.com/photos/22539273@N00/50637583117, Patrick Gruban.