Local Thunder Bay organizations feeling impact of global cuts to HIV funding

Researchers and support workers who focus on HIV prevention and education in Thunder Bay are worried about the potential consequences here in Canada as cuts, particularly from the US, take hold. 

A majority of the major cuts to funding have come from the US government severing its ties with UNAIDS in February. The move paused funding for the President's Emergency Plan for AIDS relief (PEPFAR), a program responsible for roughly seventy percent of financing for HIV research and support services worldwide since 2003.

Pauline Sameshima is a member of Lakehead University's faculty of education, and a member of the international HIV Obstruction by Programmed Epigenetics (HOPE) Collaboratory, whose research focuses on finding a cure for HIV.

HOPE brings in researchers from around the world to develop a strategy of blocking HIV reactivation, while locking it in in a dormant state and making it permanently defective through gene editing therapies and techniques. The research program received a five-year, $26.5 million grant from the U.S. National Institutes of Health in 2021.

Funding cuts have Sameshima worried if funding for HOPE will continue into the fifth year of the grant.
The Lakehead University professor is a part of the collaboratory's community engagement team.

"I lead the CAIR program, which is community arts, integrated research and education portion and the goal is to advance HIV cure research through community engagement," Sameshima said, noting that much of her work involves engaging with 2SLGBTQ+ and minority groups.

However, given the U.S. government's recent cuts toward universities over their Equity, Diversity and Inclusion (EDI) polices, Sameshima says that funding for the community engagement team on the HOPE collaboratory has been cancelled.

"All community engagement work has been cut because it's all to do with EDI connections," Sameshima said, adding that 2SLGBTQ+ groups, including transgender populations, are one of the largest populations that have been part of HIV research.

For local support workers, community engagement research continues to inform their own approaches to ensuring people of all backgrounds have equitable access to care specific to their needs.

Global decisions on a local level

"That community engagement part is extremely important because evidence or research in a lab, standalone, doesn't really address the gaps that we're seeing in equity to access to care and all of those things,"  said Kandace Belanger, who manages Thunder Bay District Health Unit (TBDHU)'s street outreach, harm reduction and sexual health programs.

Belanger knows first-hand how important the knowledge is of up-to-date knowledge of up-to-date HIV medication strategies and medications. In 2019, TBDHU declared an HIV outbreak, after the region reported eight new cases within the first half of the year.

"Our outbreak response really focused on efforts to increase access to prevention. That includes harm reduction and things like condoms and injection supplies, along with the education and information that helps support that use," Belanger said. Her team works closely with those diagnosed with HIV to provide support testing and referrals to treatment providers.

Growing cases of HIV are already a concern in Canada, with 2024 seeing a 35% increase in new HIV cases compared to the year before. Compared to its G7 counterparts, the country ranks lowest in preventing the spread of new HIV infections.

Canada has, however, stepped up efforts as of late to increase HIV research and support funding. In 2022, the country increased its contributions to the Global Fund to fight AIDS by 30 percent, pledging $1.21 billion between 2023 and 2025.

Domestically, the government invested $99.5 million over the past year in funding to address sexually transmitted and blood-borne infections, according to a statement from Health Canada.

Canada is also steadily working toward UNAIDS's 95-95-95 target. The target means that 95 percent of HIV patients know they have the disease, are diagnosed with antiretroviral treatment, and are able to achieve viral suppression — factors which could end AIDS as an epidemic. 

By 2022, 89 percent of people living with HIV had been diagnosed and only 85% were on treatment, according to the Public Health Agency of Canada.

Still, Belanger said she is worried that if Canada does not step up further in its funding, both domestically and internationally, we could see these percentages start to decline, amounting to a greater strain on our healthcare system.

Sameshima said in order for countries like Canada to be able to meet the 95-95-95 threshold, more funding needs to be put forward for community engagement work in particular, as research teams like the HOPE collaboratory continue to face cuts when it comes to community-based research.

The engagement part is really crucial to HIV research because a lot of the reason why we've not been able to reach a threshold is there needs to be funding to get there, Sameshima said. "All of this progress to reach the 95 [percent threshold] is about education, helping people to get access so they can know their status, access antiretroviral treatment and then also know if they are virally suppressed."

When it comes to the global picture, the 2025 UNAIDS report reported that the number of new cases of HIV discovered in 2024 was 40 percent lower than in 2010. UNAIDS estimates that continued cuts to PEPFAR could mean an additional four million AIDS-related deaths and at least six million new HIV infections globally by 2030.

The stark decrease in international funding for HIV research cannot be attributed to the U.S. alone, as the report also noted there was a 77 percent decrease in funding from bilateral donors, not including the United States, since 2010.