Nearly 40 million people were living with the HIV virus that causes AIDS last year, over 9 million weren’t getting any treatment, and the result was that every minute someone died of AIDS-related causes, the U.N. said in a new report launched Monday.

While advances are being made to end the global AIDS pandemic, the report said progress has slowed, funding is shrinking, and new infections are rising in three regions: the Middle East and North Africa, Eastern Europe and Central Asia, and Latin America.

In 2023, around 630,000 people died from AIDS-related illnesses, a significant decline from the 2.1 million deaths in 2004. But the latest figure is more than double the target for 2025 of fewer than 250,000 deaths, according to the report by UNAIDS, the U.N. agency leading the global effort to end the pandemic.

Gender inequality is exacerbating the risks for girls and women, the report said, citing the extraordinarily high incidence of HIV among adolescents and young women in parts of Africa.

The proportion of new infections globally among marginalized communities that face stigma and discrimination – sex workers, men who have sex with men, and people who inject drugs also increased to 55% in 2023 from 45% in 2010, it said.

UNAIDS Executive Director Winnie Byanyima said: “World leaders pledged to end the AIDS pandemic as a public health threat by 2030, and they can uphold their promise, but only if they ensure that the HIV response has the resources it needs, and that the human rights of everyone are protected.”

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As part of that pledge, leaders vowed to reduce annual new HIV infections to below 370,000 by 2025, but the report said in 2023 new infections were more than three times higher at 1.3 million.

Last year, among the 39.9 million people globally living with HIV, 86% knew they were infected, 77% were accessing treatment, and for 72% the virus was suppressed, the report said

Cesar Nunez, director of the UNAIDS New York office, told a news conference there has been progress in HIV treatments — injections that can stay in the body for six months, but the two doses cost $40,000 yearly, out of reach for all but the richest people with the virus.

He said UNAIDS has been asking the manufacturer to make it available at lower cost to low and middle-income countries.

Nunez said there have also been seven cases where people with HIV who were treated for leukemia emerged with no sign of the HIV virus in their system.

He said injections and the seven cases will be discussed at the 25th International AIDS Conference which began Monday in Munich.

At present, he said, daily treatment with pills costs about $75 per person per year. It has allowed many countries to increase the number of people with HIV to receive treatment.

Nunez said UNAIDS will continue advocating for a vaccine to prevent AIDS.