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UNAIDS estimates that globally, low and middle-income countries will need investments of US$ 29 billion annually to meet targets of ending AIDS as a public health threat by 2030. In 2021, only US$ 21.4 billion was spent on HIV responses low and middle-income countries. 

In order to advance urgent and collaborative action to keep HIV high on political agendas and re-prioritize funding for health and HIV, African ministers of finance joined international partners on the side-lines of the World Bank / International Monetary Fund Spring meetings in Washington DC to explore ways to ensure financial sustainability of domestic HIV responses.

During the event, Ministers of Finance and senior representatives from Angola, Burundi, Democratic Republic of the Congo, Eswatini, Kenya, Lesotho, Nigeria, Mozambique, Rwanda, South Sudan, Tanzania and Uganda, and the Minister of Health of Côte d’Ivoire came together with global partners, including PEPFAR, the US Department of the Treasury, UNAIDS and the Global Fund to Fight AIDS, TB and Malaria.

Participants explored co-creating country-led paths towards the sustainability of the HIV response within broader health financing challenges. In the dialogue with Ministers of Finance, several issues were explored, among those, the need to overcome financing bottlenecks for HIV, expand local production of medicines and health technologies, or strengthen health systems and pandemics preparedness, while considering the relevance of developing joint HIV financial sustainability road-maps. 

The event, ‘Investing in Sustainable HIV Responses for Broader Health Security and Economic Resilience in Africa’, was moderated by Donald Kaberuka, Chair of the Board of the Global Fund to Fight AIDS, Tuberculosis, and Malaria and the African Union’s High Representative for Financing, the Peace Fund and COVID-19 response. The event included remarks by;

  • Alexia Latortue, Assistant Secretary for International Trade and Development, US Department of the Treasury,
  • Dr. John N. Nkengasong, US Global AIDS Coordinator and Special Representative for Global Health Diplomacy, PEPFAR, US Department of State,
  • Winnie Byanyima, Executive Director, UNAIDS, and  
  • Symerre Grey Johnson, Head of Regional Integration Infrastructure and Trade, New Partnership for Africa's Development (AU/NEPAD)

Participants also reflected on the finding of the recently released report by the Economist Impact, supported by UNAIDS, titled A Triple Dividend: The health, social and economic gains from financing the HIV response in Africa. The report provided evidence showing that fully financing the HIV response to get back on track to achieve the 2030 goals will produce substantial health, social and economic gains in 13 countries in sub-Saharan Africa. 

This meeting was the first in-person discussion among ministers of finance and international partners around the sustainability of the HIV response held since COVID-19 travel restrictions were lifted. The meeting will be followed by a series of regional and in-country engagements to advance the financial, political and programmatic sustainability of the HIV response in preparation for the African Union’s Assembly of Heads of State Extraordinary Session on Ending AIDS by 2030.

The meeting follows a February meeting where African leaders and partners joined together at a high-level event on the side-lines of the 36th Session of the African Union to commit to a set of actions to boost progress towards ending AIDS. The event, Health Financing and Sustaining Action to End AIDS and Related Communicable and Non-Communicable Diseases, was co-hosted by the African Union, NEPAD, UNAIDS and PEPFAR.

During the event, heads of state and government adopted a declaration which includes commitments to take personal responsibility and provide active leadership in the AIDS response, champion science and mobilize domestic political and financial support.

African Union Development Agency – (AUDA-NEPAD) Chief Executive Officer Nardos Bekele-Thomas gave the opening remarks, stating that this was the right time to reflect on previous commitments, implementations, and what has worked and what has not. “The COVID-19 pandemic presented essential lessons that we should use to shape the future of our health systems, the African Continent spearheaded collective actions to respond better. Furthermore, we saw the private sector coming together to work with the Governments to provide services to the people that needed them.”

The commitments come at a critical time because despite unprecedented progress, AIDS in Africa is far from over. The massive impacts of the twin pandemics of COVID-19 and HIV have exposed huge weaknesses in health systems across Africa and the continent is not on track to achieve an AIDS-free Africa by 2030.

“The coming into force of the African Medicines Agency (AMA) Treaty is an important milestone for the Continent. Aligned and coordinated regulatory systems will open up the continental market for pharmaceuticals and enable our manufacturers to leverage the advantages of the ACFTA. The AUDA-NEPAD will continue taking technical leadership in the operationalisation of the AMA which will bring us a step closer in our fight against AIDS” said Nardos Bekele-Thomas.

Africa has been disproportionately affected by the AIDS pandemic with 67% of people living with HIV living on the African continent. The spread of the disease has affected every dimension of African society.