African Nations Urged to Enhance Domestic Funding for HIV Initiatives

At the 13th International AIDS Society Conference on HIV Science (IAS 2025) held in Kigali, Rwanda, global leaders in HIV advocacy have called upon African nations to take greater ownership of their HIV response strategies and urgently invest in community-led health systems. This appeal comes as a critical reminder that two decades of progress in the fight against the virus are at risk without sustained investments and localized interventions.

Dr. Yogan Pillay, the Director of HIV and TB Delivery at the Bill and Melinda Gates Foundation, emphasized the necessity of constructing national programs from the ground up. He cited the Blantyre model in Malawi, where local health authorities have successfully tailored HIV responses to meet community-specific needs. "Taking a detailed, ground-up approach is essential as it means co-developing, co-publishing, and building programs alongside local leaders from the very start," Dr. Pillay remarked during his address on July 13, 2025. He stressed the detrimental effects of disjointed funding strategies, warning that competing programs from various donors could undermine local efforts.

Dr. Ingrid Katz, representing the President's Emergency Plan for AIDS Relief (PEPFAR), echoed these sentiments by highlighting the program's 20-year history of fostering robust national health systems. "This is about sustainability; our role is to invest in what works and support countries as they shape their own HIV responses within broader health systems," Dr. Katz stated. She pointed to the sustainability roadmaps developed since 2023 as vital tools to assist nations in navigating this transition.

UNAIDS Deputy Executive Director Christine Stegling also contributed to the discourse, spotlighting the risks involved in excluding community input from HIV responses. She noted, "Where we've seen the worst impact of the current funding crisis is in community systems and prevention; that is where it hits first." Stegling highlighted the importance of institutionalizing funding for community networks, arguing that it is both efficient and equitable. Despite 80% of countries allowing networks of individuals living with HIV to operate, she pointed out that only half support networks for key populations, such as sex workers and LGBTQ+ individuals.

The conference was a pivotal moment in addressing the challenges faced by African nations in sustaining their HIV initiatives, with speakers advocating for innovative financing solutions that can operate effectively even in politically volatile environments. Dr. Pillay also underscored the role of self-care and artificial intelligence in shaping future HIV strategies, asserting that self-care is central to both prevention and sustainability.

As the global community reflects on its commitment to the fight against HIV, the need for African governments to prioritize domestic funding and local engagement in health systems has never been more apparent. The success of HIV responses hinges not only on international support but also on the empowerment of local communities to lead these efforts sustainably. If African nations heed this call, they could safeguard the progress achieved over the last two decades and continue to advance the health and well-being of their populations.