Evidence map›Paper›PMID 40959184›Full record

ArticleHealth science reports2025

A Wake-Up Call: Can Africa Sustain HIV/AIDS Programs Without Foreign Aid?

Olivier Uwishema, Jud Ahmed Chakik, Boluwatife Samuel Fatokun, Subham Roy

Abstract read
In one paragraph

Article in Health science reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Olivier UwishemaDepartment of Research and Education Oli Health Magazine Organization Kigali Rwanda.ORCID https://orcid.org/0000-0002-0692-9027
Jud Ahmed ChakikDepartment of Research and Education Oli Health Magazine Organization Kigali Rwanda.
Boluwatife Samuel FatokunDepartment of Research and Education Oli Health Magazine Organization Kigali Rwanda.ORCID https://orcid.org/0009-0000-3344-2209
Subham RoyDepartment of Research and Education Oli Health Magazine Organization Kigali Rwanda.ORCID https://orcid.org/0009-0006-0384-4155

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: Africa's HIV/AIDS response has historically depended on substantial foreign aid from initiatives such as PEPFAR, the Global Fund, and USAID. These programs have dramatically expanded access to antiretroviral therapy (ART), reducing mortality and transmission rates. However, with increasing uncertainty in global funding, the continent faces a pressing question: Can Africa sustain HIV/AIDS programs independently? This study investigates the implications of foreign aid withdrawal and explores sustainable strategies for the future of HIV/AIDS care on the continent. Methods: This study involved a critical review and synthesis of peer-reviewed literature, global health databases (WHO, UNAIDS), and policy documents focusing on foreign aid's role in African HIV/AIDS programs. We conducted a comparative case analysis, using Botswana as a model for successful domestic financing, and evaluated potential fiscal strategies and integration into Universal Health Coverage (UHC). Results: Evidence shows that sudden foreign aid reductions have disrupted ART access, increased viral load and transmission rates, and reversed decades of health gains. Donor-dependent nations reported fragmented care systems and decreased resilience. Conversely, Botswana's model-marked by diversified revenue sources, strong governance, and UHC integration-demonstrated resilience to funding fluctuations. Innovative fiscal measures such as sin taxes, private-sector partnerships, and integrated national financing frameworks emerged as viable tools for sustainability. However, challenges persist, including political instability, weak governance, and economic fragility. Conclusion: Foreign aid remains a critical lifeline, but Africa must urgently shift toward self-reliant HIV/AIDS programs. Strengthening domestic financing, enhancing governance, leveraging public-private partnerships, and embedding HIV care into UHC are key pillars for sustainability. African governments must act decisively to future-proof health systems against donor volatility and ensure uninterrupted access to life-saving treatment for millions.

Indexed as

AfricaAfrican leadersforeign aidhealthcareHIV/AIDS

Identifiers

PMID40959184
PMCPMC12434170

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.