SADC Urged to Strengthen Self-Reliance in HIV Response as Donor Funding Declines

South Africa's National Sustainability Framework was highlighted as an example of how countries can prepare for a more self-reliant HIV response.

South Africa's Deputy Minister of Health, Dr Joe Phaahla, has called on Southern African countries to accelerate efforts towards financial and institutional self-reliance to protect decades of progress in the fight against HIV as international donor funding continues to decline.

Speaking at a Southern African Development Community (SADC) Secretariat session during the 26th International AIDS Conference in Rio de Janeiro, Brazil, Phaahla said countries must build sustainable health systems that can continue delivering HIV services beyond 2030 despite changing global funding patterns.

Building sustainable HIV programmes

The session, held under the theme "Sustaining the HIV Response in Southern Africa Beyond 2030," focused on the growing financial pressures facing HIV programmes, including the withdrawal of funding from the United States Agency for International Development (USAID).

Phaahla said sustainability can no longer be viewed simply as replacing lost donor funding. Instead, he argued that countries must strengthen institutions, financing systems, healthcare workforces, governance structures and partnerships that allow HIV programmes to remain effective for future generations.

He stressed that lasting progress depends on countries developing strong national systems capable of maintaining HIV prevention, treatment and care regardless of external funding levels.

Health sovereignty at the centre

Phaahla described health sovereignty as a key pillar of the SADC's long-term strategy, saying countries should take greater ownership of their health priorities by mobilising domestic resources, strengthening public health systems and building national expertise.

He said health sovereignty does not mean working in isolation but rather entering international partnerships from a position of leadership, ownership and shared accountability.

South Africa's National Sustainability Framework was highlighted as an example of how countries can prepare for a more self-reliant HIV response. The framework identifies six interconnected priorities: epidemic control, financial sustainability, service delivery, governance and accountability, stronger community support systems, and resilient health systems.

According to Phaahla, these areas must work together to ensure HIV programmes remain effective through domestic leadership while continuing to benefit from predictable international support.

Regional cooperation remains essential

While encouraging greater national ownership, Phaahla emphasised that regional cooperation remains vital because public health challenges extend beyond national borders.

He said stronger collaboration among SADC countries can improve continuity of HIV services for people moving across borders, support joint procurement of medicines and medical supplies, encourage knowledge sharing and innovation, and strengthen efforts to mobilise both domestic and international resources.

Regional partnerships, he added, also improve preparedness for future public health emergencies that require coordinated responses.

Vision for an African-led response

Phaahla said SADC should work towards HIV programmes that are community-driven, financially sustainable, integrated into primary healthcare and Universal Health Coverage, and resilient enough to withstand future shocks.

He concluded that Africa's future HIV response will be shaped not only by the amount of external funding available but by the strength of national health systems, regional partnerships and local leadership.

According to the Deputy Minister, by investing in sustainability, health sovereignty and regional solidarity, Southern Africa has an opportunity to build a lasting African-led model for tackling HIV while strengthening public health for future generations.