Africa’s HIV Response at a Turning Point: What Will It Take to Sustain Decades of Progress?

For more than four decades, Africa has been at the center of global HIV response. The continent has carried one of the world’s largest HIV burdens, but it has also demonstrated one of the greatest public health turnarounds of our time. Millions of lives have been saved, access to lifesaving treatment has expanded dramatically, and new infections have declined. Countries that once carried some of the highest HIV burdens globally are now demonstrating what sustained political commitment, community leadership and global partnerships can achieve.[1], [2]

Several African countries, including Botswana, Eswatini, Lesotho, Namibia, Rwanda, Zambia and Zimbabwe, have reached the ambitious 95-95-95 HIV treatment targets, marking a significant milestone in the global effort to end AIDS as a public health threat.[2]

However, in 2026, the HIV response is entering a different phase. The ambition to end AIDS as a public health threat remains, but emerging financing uncertainties have raised concerns about the sustainability of the progress achieved. This has brought renewed attention to strengthening the systems behind the response and ensuring continuity of prevention, treatment and care for people living with and affected by HIV.[1], [2]

A Turning Point Defined by Progress and Change

The first half of 2026 has brought renewed attention to the future of HIV response. From the United Nations High-Level Meeting on HIV/AIDS to the 26th International AIDS Conference held in Rio de Janeiro, global leaders, researchers, communities and policymakers have been reflecting on both the progress achieved and the challenges ahead.[2], [3]

Scientific progress has been remarkable, with advances in treatment continuing to improve the quality of life for millions of people living with HIV, while new prevention interventions are creating new possibilities for how HIV prevention can be delivered. Among these advances, long-acting prevention options, including injectable PrEP, have generated significant attention as potential interventions to expand prevention choices and address some of the barriers associated with daily medication.[3], [4]

At the same time, this progress is unfolding alongside a changing global health financing landscape. For decades, international investment has played a critical role in supporting HIV programs across Africa, enabling countries to expand prevention, testing, treatment and community-led services. As global funding priorities evolve and resources become increasingly constrained, the sustainability of these programs has come under renewed scrutiny.[1], [2]

For Africa, where many HIV programs have benefited from decades of global solidarity, this moment reinforces the importance of building more resilient financing models. The conversation is increasingly shifting towards domestic resource mobilization, stronger national ownership, and a more sustainable balance between domestic investment and strategic international partnerships.

This is not about replacing global solidarity, which has been fundamental to the progress achieved. It is ensuring that the systems, partnerships, and financing models that underpin the HIV response are strong enough to sustain progress through a changing global health landscape.

A New Chapter for Africa’s HIV Response

The success of Africa’s HIV response has never been driven by medicines alone. Behind every treatment success, every person reached with prevention services and every reduction in new infections has been a network of health workers, community organizations, advocates and policymakers working together.

Community-led organizations, in particular, have played a critical role in reaching populations often underserved by traditional health systems. They have supported prevention efforts, expanded testing, improved treatment literacy, and helped reduce stigma associated with HIV. However, these same organizations have often been among the first affected when funding becomes uncertain.

As Africa moves into the next phase of the HIV response, maintaining these delivery systems will be as important as introducing new interventions. The challenge is not only developing better tools, but ensuring that the systems, financing and partnerships required to deliver them remain resilient.

The UNAIDS Global AIDS Strategy 2026–2031 reflects this changing reality: sustaining progress will require stronger country leadership, greater equity in access, and continued community engagement.[1] For Africa, this translates into three key priorities.

• Building sustainable and country-owned responses. As global health financing evolves, countries will need to strengthen domestic resource mobilization while ensuring HIV services are integrated within broader health systems.
• Ensuring equitable access to prevention, testing, treatment, and care. New innovations will only deliver impact if they are affordable, accessible, and supported by systems that can reach the people who need them most.
• Protecting community leadership. Communities have been central to Africa’s HIV response and must remain active partners in shaping and delivering the next phase of HIV programs.

Across the continent, countries are already exploring pathways towards more sustainable and resilient HIV responses. South Africa provides an important example of strengthening national ownership, with domestic resources accounting for approximately 74% of its HIV response, alongside continued investments to sustain essential HIV and tuberculosis programs.[2] Kenya also demonstrates this shift, with the government increasing its pledge to the Global Fund’s Seventh Replenishment to US$10 million for 2023–2025, reflecting a growing commitment to strengthen domestic ownership while maintaining strategic global partnerships.[5]

Together, these examples highlight that the next phase of Africa’s HIV response will require not only continued access to innovations, but also stronger financing models, resilient systems and country-led approaches to sustain the progress achieved.

The blueprint for the next era of Africa’s HIV response is before us. The question before us is whether we can sustain the progress achieved, strengthen the systems that have enabled it, and build the financing models and partnerships required to translate this moment of innovation into lasting health impact for the continent.

At AHAC, we believe the path forward lies in bringing together like-minded partners driven by the common goal of shaping health systems that are resilient, sustainable and ready for the future. We welcome collaboration with those committed to advancing this conversation and building the next chapter of Africa’s HIV response.