A global pullback on commitments to fund and fight AIDS is resulting in restrictions on the number of people being enrolled into treatment programmes, more frequent drug shortages, and reduced national AIDS budgets, says a new report.

An estimated four million people in the developing world have begun HIV treatment, thanks largely to programmes such as the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria, says the report from the International Treatment Preparedness Coalition, which campaigns to improve access to treatment. But resources are insufficient to provide treatment to another six million people who should be getting it.

The second figure would rise by an additional three to five million people if …