UNAIDS urges stronger political pact for HIV prevention in SADC
The fight against HIV in Southern Africa has reached a defining moment.
As experts and policymakers convene in Lusaka for the SADC Meeting of National AIDS Commission Directors and Sexual and Reproductive Health Programme Managers, the message ringing across the conference halls is clear“Act now, act together, and act sustainably.”
The joint meeting, running under the theme “Accelerating HIV Prevention and Access to Integrated Sexual and Reproductive Health Services: Tackling Inequalities and Securing a Sustainable Response,” seeks to evaluate progress toward the 2025 HIV/TB and SRHR integration targets while setting a new course for sustainable health financing across the region.
Its outcomes will later be presented to the SADC Ministers of Health and Ministers Responsible for HIV and AIDS in November.
Setting the tone for the meeting, UNAIDS Regional Director for Eastern and Southern Africa, Dr. Anne Githuku-Shongwe, has issued a rallying call for what she described as “a renewed SADC commitment to HIV prevention and sustainability a political pact that signals our collective resolve to protect the next generation.”
Dr. Shongwe has called on Member States to increase domestic financing for HIV prevention by at least 30% within three years, integrate HIV prevention into primary health care and national insurance schemes, and establish regional pooled procurement to secure essential commodities like condoms, family planning products, and sanitary pads.
“The SADC region has always been a trailblazer,” she said. “From expanding access to treatment, to advancing gender equality, to leading continental health coordination we have never shied away from bold action. Now is the time to invest smarter, act faster, and partner wider.”
She has cited inspiring examples from the region Malawi’s multi-sectoral approach that cut HIV infections among adolescent girls, Botswana’s domestic funding of 70% of its HIV response, and Rwanda’s legal reform allowing adolescents to access family planning services without parental consent.
“These are not just policies,” she emphasized. “They are lifelines. Every young African girl deserves more than survival she deserves the chance to thrive.”
Despite remarkable progress, Dr. Shongwe has sounded the alarm over the region’s heavy dependence on external donors.
In 2024, HIV prevention in countries like Malawi (88.5%), Zimbabwe (82.7%), and Mozambique (81.8%) relied almost entirely on PEPFAR funding.
“More than half of HIV prevention budgets in Eswatini, Uganda, Lesotho, Botswana, Rwanda, Ethiopia, and South Africa came from external sources,” she noted. “But with global aid shrinking, this is a moment for serious reflection. Sustainability must mean self-reliance.”
UNAIDS, she added, is now transitioning responsibilities to governments and communities urging SADC to build locally driven, financially sustainable systems through health levies, insurance schemes, and local production of essential supplies.
“When our youth access affordable, locally made products through African systems,” she said, “we build resilience and regional solidarity.”
“Let us lead with unity, courage, and conviction,” Simelane concluded. “Let us invest in HIV prevention as the foundation of our future. If we act together, we can make history and be the generation that ends AIDS as a public health threat.”
She commended the region’s achievements, noting that six SADC member states Botswana, Eswatini, Lesotho, Malawi, Zambia, and Zimbabwe have already met the UNAIDS 95–95–95 targets ahead of schedule, with Namibia and Tanzania close behind.
But she has also cautioned that adolescent girls, young women, and key populations remain disproportionately affected.
“These are not just statistics,” Simelane stressed. “There are women and girls behind these numbers young lives at risk when pregnancies occur too early, and futures lost when girls drop out of school due to poverty or lack of support.”
She has welcomed the re-admission policies now adopted by several countries, allowing girls who have given birth to return to school a step toward breaking cycles of poverty and vulnerability.
According to the SADC SRHR Scorecards (2021 & 2023), maternal mortality has declined from 104 to 79.7 per 100,000 live births, a significant milestone. However, neonatal mortality and adolescent birth rates have both risen slightly and this, Ms. Simelane said, “calls for urgent rethinking of adolescent health interventions.”
Condom use among young people has improved from 51% to nearly 66%, showing positive behavioural change.
Ms. Simelane has also celebrated the recent price reduction of lenacapavir, a breakthrough HIV prevention drug, while warning that a changing funding landscape demands homegrown innovation.
“We must embrace integration not just as a good idea, but as a strategic imperative,” he said. “Integrating HIV and SRHR services delivers comprehensive, client-centered care — ensuring no one is left behind.”
Ms. Simelane has underscored the importance of investing in the region’s youth, noting that over 75% of SADC’s population is under 35 and that integrating SRHR, HIV, gender, and socio-economic development initiatives could unlock Africa’s demographic dividend.
“If a girl stays in school longer, she is more likely to get a good education, become economically productive, and contribute to national development,” she said. “That’s the future we want one where no young person is trapped in poverty.”
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