The pace of reducing new HIV infections is slowing and progress in accessing treatment is decreasing, putting UN targets to end the Aids epidemic by 2030 in doubt.

The UNAids report, published on Tuesday, showed mixed progress, with certain countries making solid gains but others experiencing rises in both new infections and Aids-related deaths.

The UN is calling for greater urgency and more resources to protect global gains made in recent years.

The report showed that the gap between funding required and resources available is growing. For the first time, money available for HIV and Aids has reduced globally by almost a billion dollars, as donors have given less and domestic investments have not grown adequately to offset inflation. By 2018, $19bn (£15bn) was available for the Aids response, $7.2bn short of the estimated $26.2bn that needs to be raised by 2020.

The UN is calling on donors to replenish the Global Fund to Fight Aids, TB and Malaria with at least $14bn in October, and to boost bilateral and domestic resources for HIV and Aids.

Speaking at the launch of the report in Eshowe, South Africa, Gunilla Carlsson, UNAids acting executive director, said: “We urgently need increased political leadership to end Aids. This starts with investing adequately and smartly and by looking at what’s making some countries so successful.”

StopAids’ director, Mike Podmore, said: “This report confirms that we are way off where we need to be to meet global HIV and Aids targets and that unless governments around the world reprioritise the HIV response politically and financially, progress will continue to slide.

“We have the tools and the knowledge we need to meet our goals but neither are being equitably distributed. This means that while we are seeing positive and welcome progress in some places, which we should definitely celebrate, in other places marginalised and criminalised populations continue to be left behind and progress is either stalling or reversing.”

Christine Stegling, executive director of Frontline Aids, added: “Far from getting back on track on HIV, we are witnessing a prevention crisis that is disproportionately affecting those with the least power in societies. Marginalised people face a daily toll of stigma, discrimination and criminalisation. They are often denied access to HIV prevention, treatment and care simply because of who they are.

“This report is a wakeup call to invest more in marginalised people and adolescent girls and young women if we want to avoid sleepwalking into a further crisis fuelled by the denial of human rights and gender justice.”

The report found that greater community involvement in HIV treatment led to a stronger uptake of services in countries like Botswana, Namibia and Malawi, which are making good progress, as well as reducing stigma and discrimination.

Sthandwa Buthelezi, founder of Shine, an organisation that tackles stigma and discrimination in the community, said: “I’ve been on treatment for 16 years, am virally suppressed and doing well. But stigma and discrimination are still widespread, particularly in healthcare. I encourage everyone, including community leaders, to talk openly about HIV so that people can live positively and shine.”

The report found that in 2018, 79% of people living with HIV knew their HIV status, 78% who knew their HIV status were accessing treatment, and 86% of people living with HIV and accessing treatment were virally suppressed, meaning they are both well and not transmitting the virus to others.

Aids-related deaths have continued to decline – down by 33% since 2010 to 770,000 in 2018 – as access to treatment grows and progress is made on delivering HIV/tuberculosis services.

Progress still varies regionally. Overall reductions in Aids-related deaths are mainly due to progress in eastern and southern Africa. Yet since 2010, Aids-related deaths have actually increased by 5% in eastern Europe and central Asia, and 9% in the Middle East and north Africa.

“Ending Aids is possible if we focus on people, not diseases, create road maps for the people and locations being left behind, and take a human rights-based approach to reaching people most affected by HIV,” said Carlsson.