This marks the 20th annual resource tracking publication from Funders Concerned About AIDS (FCAA) on philanthropic support to address HIV and AIDS. The report relies on grants lists submitted directly by 72 funders (representing 92% of the total HIV-related philanthropic funding tracked by FCAA), as well as publicly sourced grants information from funder websites, grants databases, annual reports, U.S. Internal Revenue Service (IRS) Form 990 returns, and Candid’s Foundation Maps grants database (representing the remaining 8% of funding in the report). This report specifically captures HIV-related funding from philanthropic organizations around the world; it excludes any government funding to address HIV and AIDS, including domestic government, bilateral, and multilateral support.

HIV-related giving among philanthropic organizations totaled $692 million in 2021, representing a $9 million (1%) decrease from 2020. As in previous years, fluctuations in funding are predominantly driven by a handful of funders who control the majority of the resources.

For FCAA’s analysis of these main findings, please read the Foreword.

HIV-related philanthropic disbursements totaled $692 million in 2021, a 1% decrease from 2020.

In 2021, the top 20 HIV-related funders—out of 187 total funders tracked—disbursed $659 million in grants for HIV-related responses. This accounted for 92% of the total HIV-related philanthropic support for that year. As in previous years, this concentration of funding at the top is further illustrated by the fact that the top two funders alone accounted for 66% of all HIV-related philanthropy in 2021.

In 2021 the top 20 funder list saw three new funders join the ranks: Silicon Valley Community Foundation (SVCF), American Jewish World Service, and UHAI-EASHRI, an East-African participatory grantmaker who saw a more than 100% increase in their funding from the previous year.

Ten of the top 20 funders increased giving, while the other 10 decreased their giving. Overall decreases outpaced increases by about $12 million; however, these data are heavily influenced by two key factors. The first was a $43 million decrease from Gilead Sciences, Inc., an expected drop in funding, after a large disbursement-related increase in 2020. The other was a $31 million increase from SVCF due to two large grants from a donor-advised fund. Although we have tracked funding from SVCF in the past, most recently in 2019 totaling just $200,000, we suspect this level of giving to be an anomaly, given the nature and origin of the funds, and that it likely will not be recurring at this level in future years.

Prevention, treatment, and research have long been the pillars for tackling the HIV pandemic. They’re at the core of UNAIDS’ strategy and the Ending the HIV Epidemic in the U.S. Initiative: Get people tested, treat people who test positive, and connect people who test negative with varying modes of prevention, including condoms, sexual and reproductive health education, syringe service programs, PrEP, and other education and awareness programs. Research, of course, has been pivotal all along in developing treatment and prevention options that have saved lives. Philanthropy has been a key player in all these ventures since the early days of the epidemic, even before government funding began to flow more freely, and has made invaluable contributions to research and the HIV response over the years. Prevention, treatment, and research continue to be the top three strategies funded by philanthropy.

One of the transformational roles philanthropy plays, however, is in its capacity to respond quickly, strategically, and with great flexibility, and to give voice and decision-making power to the communities it serves. In 2021, HIV-related philanthropy for advocacy and human rights increased by $20 million (15%), reaching an all-time high of $150 million.

In 2021, UNAIDS estimated there were 38.4 million people living with HIV globally. 1.7 million of them were children under the age of 15, and 54% of all people living with HIV were cisgender women and girls.*

Funding for women and girls and youth (15-24) both saw dramatic increases, upwards of $30 million (~60%) from 2020. These were both in large part due to sizeable research grants for prevention tools targeting cisgender adolescent girls and young women. However, philanthropy reaching children (0-14) and families both saw declines in the same period. Due to two large grants disbursed in 2021, funding for pregnant women/ mothers and babies increased by $33 million (almost 400%). On the other end of the spectrum, funding for Older Adults (over 50) saw a dramatic increase as well, of $19 million.

Collectively, sex workers and their clients, gay men and MSM, people who use drugs, and transgender people and their sexual partners accounted for 70% of HIV infections globally and 94% of HIV infections outside of sub-Saharan Africa. Funding for these heavily impacted and often criminalized populations— often referred to as “key populations”—is represented in bold in the accompanying chart.

In 2021, a total of 187 philanthropic funders made more than 5,600 HIV-related grants to over 2,800 grantees, totaling $692 million. To better elucidate the discrepancies in funding for certain regions, we overlaid recent UNAIDS data with the 2021 HIV-related philanthropy totals for comparable regions. This visual shows that funding does not closely align with the highest-burden regions; the Global North receives the bulk of funding despite its lower prevalence, and higher-burden regions, including Eastern and Southern Africa, receive significantly less funding. For additional detail, please reference the regional profiles.