The Joint United Nations Programme on HIV and AIDS (UNAIDS) has announced plans to reduce international assistance to Rwanda’s heralded HIV/AIDS programme, citing the country’s own significant achievements in managing the epidemic.
The decision comes as Rwanda has reached the “95-95-95” targets set by UNAIDS for HIV/AIDS progress.
Those targets signify that 95% of people living with HIV know their status, 95% of those diagnosed receive sustained antiretroviral therapy, and 95% of those on treatment achieve viral suppression.
Speaking during an event to observe World AIDS Day on Thursday, November 30, Hind Hassan, UNAIDS Representative to Rwanda, said donors are reprioritising their funding to focus on countries with more need.
“Because Rwanda and other countries have achieved so much progress, donors are reallocating their resources to other countries where they are much more needed,” she noted.
“So, we do have to look at domestic resource financing and mobilisation, and for that, we have to look at who is not on the discussion table right now; an example is the private sector. How can we mobilise for the engagement of the private sector to generate resources for the response?” she added.
With around 220,000 people living with HIV in the country, experts warn that losing external aid could undermine Rwanda’s progress. Currently, donors cover approximately 80% of the nation’s AIDS response budget.
However, Hassan asserted that Rwanda’s ability to reach the three 95s is proof that HIV investments here have paid off. She encouraged the government to step up domestic funding and build resilience against reductions in foreign assistance.
Rwanda’s epidemic control approach has been hailed globally as a public health success story. Health officials say sustained efforts are still necessary, but a shift in funding priorities away from models like Rwanda points to complex resource allocation dilemmas confronting global AIDS programming.
Delegates pose for a group photo as Rwanda marks World AIDS Day in Kigali, November 30.
The antiretroviral medication is manufactured in foreign countries and provided to Rwanda via an arrangement that is mainly financed through the Global Fund or the US President’s Emergency Plan for AIDS Relief (PEPFAR).
Sylvie Muneza, the Chairperson of Rwanda Network of People Living with HIV/AIDS, also expressed concerns regarding reduced donor aid.
“The aid is continuing to reduce. We hope more donors come up so that we can reach the targets we set,” she said.
The Rwanda Biomedical Centre (RBC) has a plan to close the resource gap, making it a priority that there is sustainable financing for the national HIV response.
Basile Ikuzo, the Director of the HIV Prevention Unit at RBC, told the media that it is true that there are some concerns regarding aid, but said that the government continues to take alternative measures to counter the changes that are coming up.
Minister of Health Dr Sabin Nsanzimana addresses participants during the World AIDS Day event in Kigali on Thursday, November 30.
According to the government’s HIV response plan, there is a need to explore strategies to minimise costs, increase efficiency gains within the sector, and plan a long-term strategy to increase domestic funding for the HIV programme.
Among the things that the country is doing is bringing on board the private sector and increasing its involvement in HIV response by investing in health.
Dr Sabin Nsanzimana, the Minister of Health, said in a speech he gave at an event to mark World AIDS Day that the disease is not yet finished.
“There are people who are dying of AIDS as we speak, and unfortunately, there are young people who are getting infected as we speak,” he noted, adding that when young people get tested and start treatment, their compliance with treatment is low.
Dr Sabin Nsanzimana, the Minister of Health, interacts with UN Resident Coordinator Ozonnia Ojielo (with red beret) at the event.
There are an estimated 5,400 new cases of HIV annually among adults in Rwanda, according to the Rwanda Population-Based HIV Impact Assessment (RPHIA), a national household-based survey that was conducted between October 2018 and March 2019.
According to the Rwanda Population-Based HIV Impact Assessment (RPHIA), a national household-based survey conducted between October 2018 and March, the prevalence of HIV among adults in Rwanda was 3.0 per cent.
