By Linda Naa Deide Aryeetey
Rio de Janeiro, July 31, GNA – African governments are increasing domestic financing and reforming health systems to sustain HIV services following reductions in funding from the United States President’s Emergency Plan for AIDS Relief (PEPFAR).
The funding reductions have prompted countries to prioritise treatment services, integrate HIV programmes into national health systems and review long-term financing strategies amid fiscal pressures.
Dr Joseph Phaahla, South Africa’s Deputy Minister of Health, said this during a panel discussion on Africa’s response to PEPFAR funding reductions at the 26th International AIDS Society Conference on HIV Science in Rio de Janeiro, Brazil.
He said African governments had long anticipated a gradual transition from donor financing but were compelled to accelerate their response because of the pace of the funding reductions.
“The commitment to increase domestic funding was already there, but the speed of the disruption changed everything,” he said.
Dr Phaahla said high public debt, inflation and rising fuel prices had limited governments’ ability to replace donor funding immediately.
He said countries were integrating HIV services into national health systems, strengthening political leadership and aligning remaining donor resources with national priorities to improve programme sustainability.
“Now is the time for Africa to expanded local manufacturing of HIV medicines and other health commodities, to reduce dependence on imported products, secure production licences and build pharmaceutical capacity,” he said.
Ms Florence Riaki Anam, Co-Director of the Global Network of People Living with HIV (GNP+), said the funding reductions initially created uncertainty after some donor-supported facilities reduced or suspended services.
She said governments had introduced emergency budget reallocations, established new partnerships and accelerated policy reforms to maintain HIV treatment services.
“We do not say this enough, African governments stepped up very quickly with what they had,” she said.
Ms Anam said HIV prevention, community-based services, testing and programmes for vulnerable populations continued to face resource constraints.
“A recent data shows declines in HIV testing, pre-exposure prophylaxis (PrEP) uptake and viral load monitoring, warning that interruptions in prevention services could reverse years of progress if not addressed,” she said.
Dr Lloyd Mulenga, Director of Infectious Diseases at Zambia’s Ministry of Health, said Zambia had maintained supplies of antiretroviral medicines while increasing domestic expenditure on selected HIV commodities, including prevention medicines and laboratory services.
He said community HIV testing, voluntary medical male circumcision, youth-friendly centres and some outreach programmes had been reduced as resources were redirected to preserve essential treatment.
“The first thing that suffers is community support, when community services are reduced, prevention also suffers,” he said.
Dr Mulenga said future transitions from donor support should be government-led and phased to minimise disruption to health services.
Dr Mike Reid, former Chief Science Officer of PEPFAR, said advances in long-acting HIV prevention technologies could reduce new infections but would require resilient health systems, HIV testing services and sustained community engagement for effective implementation.
He said discussions on increasing national ownership of PEPFAR-supported programmes had preceded the recent funding reductions, but the pace of the transition had exceeded the preparedness of many countries.
“The transition needed to happen, but it needed to be deliberate, transparent and carefully managed,” he said.
Dr Reid said the funding reductions had prompted governments to place greater emphasis on domestic leadership, public health systems, regional cooperation and local manufacturing in planning future HIV programmes.
GNA
Edited by Kenneth Sackey
Reporter: Linda Naa Deide Aryeetey
Email: [email protected]
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