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Africa: Countries Must Urgently Step Up to Transform their HIV Responses Amid An International Funding Crisis That Risks Millions of Lives

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GENEVA/JOHANNESBURG – UNAIDS today launched its 2025 Global AIDS Update, AIDS, Crisis and the Power to Transform, which shows that a historic funding crisis is threatening to unravel decades of progress unless countries can make radical shifts to HIV programming and funding.
The report highlights the impact that the sudden, large-scale funding cuts from international donors are having on countries most affected by HIV. Yet it also showcases some inspiring examples of resilience, with countries and communities stepping up in the face of adversity to protect the gains made and drive the HIV response forward.
Some 25 of the 60 low and middle-income countries included in the report have indicated increases in domestic budgets for their HIV responses in 2026. The estimated collective rise among the 25 countries amounts to 8% over current levels, translating to approximately USD 180 million in additional domestic resources. This is promising, but not sufficient to replace the scale of international funding in countries that are heavily reliant.
A global emergency: massive cuts and weakening of aid consensus threaten to reverse progress
Despite marked progress in the HIV response in 2024, the weakening aid consensus and significant and abrupt funding shortfalls in the HIV response in 2025 have triggered widespread disruption across health systems and cuts to frontline health workers—halting HIV prevention programmes and jeopardizing HIV treatment services.
In Mozambique alone, over 30 000 health personnel were affected. In Nigeria, pre-exposure prophylaxis (PrEP) initiation has plummeted from 40 000 to 6000 people per month. If US-supported HIV treatment and prevention services collapse entirely, UNAIDS estimates that an additional 6 million new HIV infections, and 4 million additional AIDS-related deaths could occur between 2025 and 2029.
“This is not just a funding gap—it’s a ticking time bomb,” said UNAIDS Executive Director Winnie Byanyima. “We have seen services vanish overnight. Health workers have been sent home. And people—especially children and key populations—are being pushed out of care.”
Even before the large-scale service disruptions, the reported data for 2024 shows that 9.2 million people living with HIV were still not accessing life-saving treatment services last year. Among those were 620 000 children aged 0—14 years living with HIV but not on treatment which contributed to 75 000 AIDS-related deaths among children in 2024.
In 2024, 630 000 people died from AIDS-related causes, 61% of them in sub-Saharan Africa. Over 210 000 adolescent girls and young women aged 15—24 acquired HIV in 2024—an average of 570 new infections every day.
HIV prevention services are severely disrupted. Community-led services, which are vital to reaching marginalized populations, are being defunded at alarming rates. In early 2025, over 60% of women-led HIV organizations surveyed had lost funding or were forced to suspend services. The United States President’s Emergency Plan for AIDS Relief (PEPFAR) reached 2.3 million adolescent girls and young women with comprehensive HIV prevention services in 2024 and enabled 2.5 million people to use HIV PrEP—many of these programmes have now stopped completely.
Meanwhile, the rise in punitive laws criminalizing same-sex relationships, gender identity, and drug use is amplifying the crisis, making HIV services inaccessible. Countries like Uganda, Mali and Trinidad and Tobago have seen recent harmful and discriminatory changes to their criminal laws targeting key populations, pushing them further from care and dramatically raising their risk of acquiring HIV.
A beacon of hope: countries and communities are stepping up to protect essential HIV treatment gains and progress is being made
South Africa currently funds 77% of its AIDS response and its 2025 budget review includes a 5.9% annual increase in health expenditure over the next three years, including a 3.3% annual increase for HIV and tuberculosis programmes. The government intends to finance the development of a patient information system, a centralized chronic medicine dispensing and distribution system, and a facility medicine stock surveillance system.
As of December 2024, seven countries—Botswana, Eswatini, Lesotho, Namibia, Rwanda, Zambia, and Zimbabwe—had achieved the 95-95-95 targets: 95% of people living with HIV know their status, 95% of those are on treatment, and 95% of those on treatment are virally suppressed. These successes must be maintained and further scaled up.
The report also highlights the emergence of unprecedented, highly effective new prevention tools like long-acting injectable PrEP, including Lenacapavir, which has shown near-complete efficacy in clinical trials—though affordability and access remain key challenges.
“There is still time to transform this crisis into an opportunity,” said Ms. Byanyima. “Countries are stepping up with domestic funding. Communities are showing what works. We now need global solidarity to match their courage and resilience.”
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A call for solidarity 
The 2025 Global AIDS Update concludes with an urgent call: the global HIV response cannot rely on domestic resources alone. The international community must come together to bridge the financing gap, support countries to close the remaining gaps in HIV prevention and treatment services, remove legal and social barriers, and empower communities to lead the way forward.
UNAIDS emphasizes that every dollar invested in the HIV response not only saves lives but strengthens health systems and promotes broader development goals. Since the start of the epidemic, 26.9 million deaths have been averted through treatment, and 4.4 million children protected from HIV infection through vertical transmission prevention.
“In a time of crisis, the world must choose transformation over retreat,” said Ms Byanyima. “Together, we can still end AIDS as a public health threat by 2030—if we act with urgency, unity, and unwavering commitment.”
UNAIDS report is being launched ahead of the Scientific AIDS Conference IAS 2025 taking place in Kigali, Rwanda, from 13-17 July 2025.
 
Read the original article on UNAIDS.
HIV Deaths and New Infections Decline, But Not Fast Enough to Meet 2030 Targets
Treasury Hands HIV Response a Lifeline, but It’s Probably Too Little
AllAfrica publishes around 600 reports a day from more than 110 news organizations and over 500 other institutions and individuals, representing a diversity of positions on every topic. We publish news and views ranging from vigorous opponents of governments to government publications and spokespersons. Publishers named above each report are responsible for their own content, which AllAfrica does not have the legal right to edit or correct.
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Southern Africa: Becoming Human in Southern Africa – What Ancient Hunter-Gatherer Genomes Reveal

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New genetic research is shedding light on some of the earliest chapters of our human history. In one of the largest studies of its kind, scientists analysed DNA from 28 individuals who lived in southern Africa between 10,200 and a few hundred years ago. The study provides more evidence that hunter-gatherers from southern Africa were some of the earliest modern human groups, with a genetic ancestry tracing back to about 300,000 years ago. Marlize Lombard, an archaeologist whose research focuses on the development of the human mind, breaks down the key findings.
Why did you study the DNA of ancient hunter-gatherers in southern Africa?
According to the genetic, palaeo-anthropological and archaeological evidence, modern humans – Homo sapiens – originated in Africa hundreds of thousands of years ago and then spread around the world. But the evolutionary process of exactly how, where and when this happened is debated.
Africa has the greatest human genetic diversity and the hunter-gatherers of southern Africa represent some of the oldest known genetic lineages. They can therefore reveal more about where and when we originated as a species.
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After thousands of years of migration, modern African populations have a mixed genetic heritage. So their genomes are not very helpful for understanding our deep evolutionary history. For that, we need to look at genetic variation among individuals living before large-scale population movements on the continent.
In southern Africa, it means going back to before about 1,400-2,000 years ago. It also means that such rare ancient hunter-gatherer DNA can provide valuable information, not available in the DNA of living people.
What we specifically wanted to learn from the ancient southern African DNA was to which extent the biological and behavioural patterns we observe in the fossil and archaeological records were continuous and particular to the region.
For example, at a South African fossil-bearing site called Florisbad, we have a human skull dating to about 260,000 years ago that shows a possible transition from Homo heidelbergensis into Homo sapiens. And from about 100,000 years ago there was a rapid increase in technological innovations such as paint-making, glue-making and long-range weapon use.
We sequenced the DNA of 28 ancient individuals from what is now South Africa, all dating to the Holocene epoch that started about 11,700 years ago. DNA sequencing “reads” the order of the chemical base-pairs that make up an individual’s DNA. This helps us to reconstruct a person’s genome, or their complete set of genetic information. Among other things, it can tell us something about the individual’s biological and behavioural characteristics.
Eight of the individuals used to live near the coast at Matjes River, in today’s Western Cape province. Several others lived at inland sites across South Africa. We dated their remains with radiocarbon dating, finding that the oldest died about 10,200 years ago at Matjes River and the most recent died just 280 years ago in the Free State. (All DNA from archaeological contexts is scientifically known as ancient DNA.)
What did the DNA reveal?
Our study shows that the genetic makeup of the southern African hunter-gatherer population didn’t change much for 9,000 years across the whole of South Africa, not only in the southern Cape, even though their technologies and lifeways may have changed or differed during this time.
All ancient southern Africans dated to more than 1,400 years ago had some unique Homo sapiens genetic variations. The ancient DNA had genes associated with UV-light protection, skin diseases, and skin pigmentation. These could have been essential to life on southern Africa’s grasslands and fynbos. Among the genetic variants that were common to ancient and modern humans were genes related to kidney function (potentially connected to improved water-retention) and immune-system related genes.
About 40% of the ancient southern African genes are associated with neurons, brain growth and the way that human brains process information today. Some of these gene variants may have been involved in the evolution of how humans pay attention today. Attention is a cognitive or mental trait that seems to have evolved differently in African Homo sapiens compared to the now extinct Neanderthals and Denisovans from Eurasia. It may have played a role in the successful spread of Homo sapiens out of Africa after about 60,000 years ago.
What does this tell us about human evolution and population migration?
Our work shows that some biological adaptations for becoming modern humans were unique to southern African hunter-gatherers who lived in a relatively large, stable population for many thousands of years south of the Limpopo River.
Co-author and geneticist from Uppsala University in Sweden, Carina Schlebusch, commented that
Because we now have more unadmixed ancient genomes from southern Africa, we are gaining better population-level insights, and a much clearer foundation for understanding how modern humans evolved across Africa.
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Our findings contrast with linguistic, archaeological and some early genetic studies pointing to a shared ancestry or long-term interaction between different regions of Africa. Instead, it seems that southern Africa may have offered humans a climate and landscape refuge where hunter-gatherers thrived, adapting to a place rich in plant and animal resources for 200,000 years or more. During this time, we see no genetic evidence for incoming populations. Instead, sometime after about 100,000-70,000 years ago, small groups of southern African hunter-gatherers may have wandered northwards, carrying with them some of their genetic and technological characteristics.
According to population geneticist Mattias Jakobsson at Uppsala University,
these ancient genomes tell us that southern Africa played a key role in the human journey, perhaps ‘the’ key role.
Up to now, humans seemed to have developed their modern anatomical (physical) form before they developed modern behaviour and thinking. Learning more about ancient genes could help to close this gap, especially once more becomes known from genetic studies of other ancient African forager groups, and indigenous peoples elsewhere on the globe.
Marlize Lombard, Professor with Research Focus in Stone Age Archaeology, Palaeo-Research Institute, University of Johannesburg
This article is republished from The Conversation Africa under a Creative Commons license. Read the original article.
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Africa: America Welcomes a New G20

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Washington, DC — Next year, the United States will host the world’s 20 largest economies for the first time since 2009. Coinciding with America’s 250th anniversary, the 2026 G20 will be a chance to recognize the values of innovation, entrepreneurship, and perseverance that made America great, and which provide a roadmap to prosperity for the entire world. We’ll showcase these values and more when we host the G20 Leaders’ Summit in December 2026 in one of America’s greatest cities, Miami, Florida.
Response to U.S. Secretary Rubio’s Substack post
by Ronald Lamola, South African Minister of International Relations and Cooperation
Under President Trump’s leadership, the G20 will use four working groups to achieve progress on three key themes: removing regulatory burdens, unlocking affordable and secure energy supply chains, and pioneering new technologies and innovation. The first Sherpa and Finance Track meetings will be held in Washington, DC, on December 15-16, followed by a series of meetings throughout 2026. As the global economy confronts the changes driven by technologies such as Artificial Intelligence, and shakes off ideological preoccupations around green energy, the President is prepared to lead the way.
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We will be inviting friends, neighbors, and partners to the American G20. We will welcome the world’s largest economies, as well as burgeoning partners and allies, to America’s table. In particular, Poland, a nation that was once trapped behind the Iron Curtain but now ranks among the world’s 20 largest economies, will be joining us to assume its rightful place in the G20. Poland’s success is proof that a focus on the future is a better path than one on grievances. It shows how partnership with the United States and American companies can promote mutual prosperity and growth.
The contrast with South Africa, host of this year’s G20, is stark.
South Africa entered the post-Cold War era with strong institutions, excellent infrastructure, and global goodwill. It possessed many of the world’s most valuable resources, some of the best agricultural land on the planet, and was located around one of the world’s key trading routes. And in Nelson Mandela, South Africa had a leader who understood that reconciliation and private sector driven economic growth were the only path to a nation where every citizen could prosper.
Sadly, Mandela’s successors have replaced reconciliation with redistributionist policies that discouraged investment and drove South Africa’s most talented citizens abroad. Racial quotas have crippled the private sector, while corruption bankrupts the state.
The numbers speak for themselves. As South Africa’s economy has stagnated under its burdensome regulatory regime driven by racial grievance, and it falls firmly outside the group of the 20 largest industrialized economies.
Rather than take responsibility for its failings, the radical ANC-led South African government has sought to scapegoat its own citizens and the United States. As President Trump has rightly highlighted, the South African government’s appetite for racism and tolerance for violence against its Afrikaner citizens have become embedded as core domestic policies. It seems intent on enriching itself while the country’s economy limps along, all while South Africans are subject to violence, discrimination, and land confiscation without compensation. Its former Ambassador to the United States was openly hostile to America. Its relationships with Iran, its entertainment of Hamas sympathizers, and cozying to America’s greatest adversaries move it from the family of nations we once called close.
The politics of grievance carried over to South Africa’s Presidency of the G20 this month, which was an exercise in spite, division, and radical agendas that have nothing to do with economic growth. South Africa focused on climate change, diversity and inclusion, and aid dependency as central tenets of its working groups. It routinely ignored U.S. objections to consensus communiques and statements. It blocked the U.S. and other countries’ inputs into negotiations. It actively ignored our reasonable faith efforts to negotiate. It doxed U.S. officials working on these negotiations. It fundamentally tarnished the G20’s reputation.
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For these reasons, President Trump and the United States will not be extending an invitation to the South African government to participate in the G20 during our presidency. There is a place for good faith disagreement, but not dishonesty or sabotage.
The United States supports the people of South Africa, but not its radical ANC-led government, and will not tolerate its continued behavior. When South Africa decides it has made the tough decisions needed to fix its broken system and is ready to rejoin the family of prosperous and free nations, the United States will have a seat for it at our table. Until then, America will be forging ahead with a new G20.
Marco Rubio was sworn in as the 72nd secretary of state on January 21, 2025. The secretary is creating a Department of State that puts America First.
Read the original article on State Department.
AllAfrica publishes around 600 reports a day from more than 110 news organizations and over 500 other institutions and individuals, representing a diversity of positions on every topic. We publish news and views ranging from vigorous opponents of governments to government publications and spokespersons. Publishers named above each report are responsible for their own content, which AllAfrica does not have the legal right to edit or correct.
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Africa: On Paper, It Was Africa's G20

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The G20 Leaders’ Summit Declaration in Johannesburg stressed Africa’s interests – but will it survive Trump?
On paper, South Africa’s G20, which climaxed with the Leaders’ Summit in Johannesburg on 22 and 23 November, was a triumph for Africa.
This was the first G20 held on African soil, and Africa’s interests dominated the 30-page Leaders’ Declaration adopted at the summit. Until the last moment it was doubtful that President Cyril Ramaphosa and his team would pull off any declaration at all. It looked more likely that they would have to settle for a weaker ‘Chair’s Statement’ in which South Africa would merely describe what had been agreed and what had not.
The main threat to a full and more powerful declaration adopted by consensus was United States (US) President Donald Trump’s extraordinary hostility towards South Africa’s G20 developmental themes of solidarity, equality and sustainability – and towards the country itself.
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Trump had earlier announced that he would not attend the summit, and would instead send Vice President JD Vance, because South Africa was massacring white Afrikaners and other fictions. Then before the event he went further and declared that no US official would attend.
In the absence of the US, though, the right-wing Argentine government acted as its proxy and tried to block consensus on important issues like gender equality and the Sustainable Development Goals (SDGs). Meanwhile Saudi Arabia did its best to frustrate agreement on renewable energy.
Ramaphosa salvaged his declaration by some deft – some might say crafty – diplomacy. The highlight was getting the Leaders’ Declaration adopted at the start rather than the more logical end of the event, thereby pre-empting an expected Argentine rejection of the declaration. (Which in fact came, but only after it had been adopted without objection.)
So the Leaders’ Declaration remains on the scoreboard as it were, including South Africa’s four G20 priorities – strengthening disaster resilience and response; taking action to ensure debt sustainability for low-income countries; mobilising finance for a Just Energy Transition; and harnessing critical minerals for inclusive growth and sustainable development.
All of these are important for Africa in particular – even though some diplomats told ISS Today that the two African nations invited to the G20 as guests, Nigeria and Egypt, did not play a great role. Perhaps the most important priority of the four for Africa was ensuring debt sustainability, since the African Union (AU) says 21 of its members are in debt distress or at risk of it. Other estimates run higher.
Among other measures, the leaders agreed to further strengthen implementation of the G20 Common Framework for debt treatments which was first launched during the COVID-19 crisis to forgive and restructure the debts of countries overwhelmed by debt servicing costs.
The summit leaders also received a report on African debt by an expert panel chaired by South Africa’s former finance minister Trevor Manuel. Its many recommendations included launching a new G20 debt refinancing initiative and increasing the regulation of credit rating agencies, which many Africans criticise for unfairly pushing up the cost of capital to Africa by overrating the credit risks of its countries.
South Africa’s other G20 priorities also focused on Africa. For instance, the proposed measures to finance Just Energy Transitions noted that over 600 million Africans lacked access to electricity.
And the leaders endorsed several existing international measures to finance disaster prevention and response, underscoring the need to accelerate progress in the implementation of these frameworks, ‘particularly in Africa.’
Likewise measures proposed to ensure that countries benefitted from domestic processing of their own critical minerals stressed the importance of Africa, which perhaps owns more critical minerals than any other continent.
The declaration also reiterated strong support for the G20 Partnership for Africa, with the G20 Compact with Africa as its core. Launched by Germany during its G20 presidency in 2017, the compact focuses on business-led development for the continent, by helping its countries create investor-friendly environments.
The second phase of the compact, for 2025-2033, supported by the establishment of a World Bank Group multi-donor fund, was launched at the Johannesburg summit by Ramaphosa and German Chancellor Friedrich Merz.
Focusing on boosting economic growth through investment rather than development aid was certainly in tune with the zeitgeist, when foreign aid budgets are shrinking and being diverted to defence, and when the ideological compass needle is swinging against development aid anyway.
But a big question remained: would this promising rhetorical emphasis on Africa translate into action? This is of course a perennial question of all G20 summits, as the G20 makes no binding decisions. It’s a ‘ginger group’ as one diplomat put it, intended to energise the adoption of actionable decisions at other fora such as the United Nations, World Trade Organization, etc.
Trump’s hostility, however, aggravated the usual problem of implementation; compounded by the unfortunate coincidence of the US taking over as the next presidency of the forum in 2026. And it didn’t help that Trump announced after the Johannesburg event that he would not invite South Africa to his G20 Summit in Miami next December.
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This is an unprecedented breach of G20 protocol as membership should be decided by consensus. In 2022, for example, Western members were unable to expel Russia for its invasion of Ukraine precisely because some other G20 members were opposed.
All this meant Trump was even more likely to trash South Africa’s hard-fought and comprehensive development-oriented agenda. And indeed this week the Trump administration announced it would focus its G20 very differently, on ‘unleashing economic prosperity by limiting regulatory burdens, unlocking affordable and secure energy supply chains and pioneering new technologies and innovations.’
That all sounded ominously like open season for business, without regard for climate change or any other restraint.
South Africa appears to have resigned itself to sitting out the 2026 G20 season and returning to the club in 2027 when the United Kingdom takes over the presidency and welcomes it back, hopefully reviving at least the high points of South Africa’s agenda.
Peter Fabricius, Consultant, ISS Pretoria
Read the original article on ISS.
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