Rio de Janeiro, Brazil | 28 July 2026
At a time when the global HIV response is facing one of its most critical moments, the Regional Inter-Agency Task Team on Children and HIV in Eastern and Southern Africa (RIATT-ESA) brought the realities of the region to the global stage at the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, Brazil.
Under the theme “At the Crossroads: Human Rights, Funding Cuts and the Future of HIV Programmes in East and Southern Africa,” RIATT-ESA made a presentation on 28 July 2026, represented by Ms. Lizzie Otaye from East African Health Platform.
The presentation came at a particularly significant moment. AIDS 2026, held from 26–31 July under the theme “Rethink. Rebuild. Rise.”, brought together researchers, policymakers, communities, healthcare professionals, funders and people living with and affected by HIV against the backdrop of an unprecedented funding crisis and major reductions in HIV programme financing.
A Region at a Critical Crossroads
Eastern and Southern Africa has made remarkable progress in the HIV response over the past four decades. Expanded access to HIV testing, antiretroviral therapy, prevention services and community-led interventions has transformed millions of lives.
However, these gains cannot be taken for granted.
The presentation by RIATT-ESA examined the growing consequences of funding reductions for HIV programmes across the region and what these changes mean for vulnerable populations, particularly children, adolescents, young people and communities facing structural barriers to accessing HIV services.
The discussion highlighted an uncomfortable reality: funding cuts are not simply financial decisions. They can translate into reduced services, weakened community systems, loss of skilled personnel, disruptions in prevention programmes and fewer opportunities for advocacy and accountability.
For countries and programmes that have relied heavily on external financing, the current funding environment raises fundamental questions about sustainability, country ownership and the future architecture of the HIV response.
Human Rights Cannot Be Separated from the HIV Response
A central message from the RIATT-ESA presentation was that human rights must remain at the heart of the HIV response.
HIV programmes cannot succeed when people are afraid to seek services because of stigma, discrimination, criminalisation, violence or exclusion.
This is particularly important for populations that already experience multiple vulnerabilities. Children and adolescents, people living with HIV, key populations, young women and girls, and other marginalised communities can face intersecting barriers that prevent them from accessing prevention, treatment, care and support.
The current funding crisis therefore risks more than programme reductions. It could also weaken the human rights infrastructure that enables communities to demand services, challenge discrimination and hold governments and other duty bearers accountable.
The global conversation at AIDS 2026 reinforced this concern. The International AIDS Society described the conference as taking place at a critical turning point, with shifting geopolitical dynamics and funding uncertainties threatening decades of progress.
What Do Funding Cuts Mean for Communities?
Behind every budget line is a person.
A reduction in funding for community-based HIV services can mean fewer outreach activities. A reduction in support for adolescent programmes can mean fewer safe spaces and fewer opportunities for young people to access accurate information and services. Reduced support for civil society can weaken the very organisations that connect communities to health systems and advocate for those who are most often left behind.
The impact can be especially significant in Eastern and Southern Africa, where HIV remains a major public health and development concern.
The crisis is already reflected in global funding trends. According to the IAS, funding for the global HIV response fell sharply in 2025, driven by a steep decline in US support, placing decades of progress at risk.
This situation demands urgent reflection on how HIV programmes are financed, designed and sustained.
Reimagining the Future of HIV Programmes
RIATT-ESA’s participation at AIDS 2026 was not only about highlighting the challenges. It was also about contributing to the conversation on what comes next.
The current crisis provides an opportunity for governments, communities, development partners and regional institutions to rethink the sustainability of HIV programmes.
This includes strengthening domestic financing for health, improving efficiency and coordination, investing in community-led responses, strengthening regional cooperation and ensuring that HIV programmes remain integrated with broader health, social protection, SRHR and child protection systems.
It also requires meaningful participation by communities in decisions that affect them.
As international financing becomes increasingly uncertain, countries in Eastern and Southern Africa will need stronger mechanisms for domestic resource mobilisation and sustainable health financing. However, the transition towards greater domestic ownership must not come at the expense of marginalised communities or essential community-led services.
Keeping Children and Adolescents at the Centre
For RIATT-ESA, the future of the HIV response must remain firmly connected to the rights and wellbeing of children and adolescents.
Funding reductions that affect HIV prevention, treatment, psychosocial support, social protection, SRHR and community services can have consequences that extend far beyond the immediate programme cycle.
Children and adolescents need comprehensive, age-appropriate and rights-based services that respond to the realities of their lives.
This means investing not only in commodities and clinical services, but also in the systems around children—including families, schools, communities, social workers, healthcare providers and youth-led organisations.
From Crossroads to Collective Action
The RIATT-ESA presentation at AIDS 2026 served as a reminder that the region is at a crossroads—but a crossroads also presents an opportunity to choose a different direction.
The HIV response has demonstrated what is possible when science, political commitment, community leadership and international solidarity come together. The progress achieved must not be reversed because of short-term funding decisions or changing geopolitical priorities.
As the global community looks towards the 2030 HIV targets, the question is no longer whether the world has the knowledge and tools to respond to HIV. It is whether there is sufficient political will, financing, solidarity and commitment to human rights to ensure that those tools reach everyone who needs them.
For RIATT-ESA, the message from Rio is clear:
We cannot end AIDS while leaving communities behind. We cannot sustain HIV programmes without protecting human rights. And we cannot allow funding cuts to erase decades of progress.
The future of the HIV response in Eastern and Southern Africa will depend on our ability to rethink, rebuild and rise together, with communities at the centre and human rights as the foundation.
RIATT-ESA remains committed to advancing evidence, regional collaboration, policy dialogue and advocacy to ensure that children, adolescents and communities across Eastern and Southern Africa are not left behind in the changing HIV financing landscape.
