Africa’s HIV response shifts as donor funding tightens, Roche executive says

Africa’s fight against HIV is entering a new phase as uncertainty in global donor funding pushes governments to strengthen locally led, diagnostics-driven health systems, a senior Roche Diagnostics executive said.

Allan Pamba, the company’s Africa executive vice president, said progress over the past two decades, marked by wider access to testing and treatment and stronger community engagement — has left the continent at an “inflection point” that requires bolder reforms.

“You can never cross the ocean until you dare to lose sight of the shore,” Pamba wrote in an opinion article marking World AIDS Day, arguing Africa must move beyond reliance on traditional, donor-heavy disease programs toward more integrated health systems.

For years, HIV programs across the continent have been supported by a mix of domestic funding and large-scale external aid. That model is under strain as budgets tighten and donor priorities expand to include a broader set of global health threats.

While past contributions remain vital, Pamba said sustaining progress now depends on reinforcing the systems that underpin care — particularly diagnostics.

“For essential health services to continue, grow and maintain the gains we have achieved thus far, Africa must reinforce the systems that sustain them; particularly diagnostics, and do so proactively, in haste,” he wrote.

Health ministries are increasingly pursuing integrated testing platforms that allow screening for HIV, tuberculosis, hepatitis and human papillomavirus using shared infrastructure, staff and logistics instead of parallel disease-specific systems. The strategy aims to stretch limited budgets, reduce duplication and preserve frontline services.

South Africa provides an example, Pamba noted, where national laboratory networks used shared infrastructure and high-volume platforms to rapidly expand viral-load testing across multiple diseases. The consolidation lowered costs, boosted capacity and shortened turnaround times, strengthening system resilience.

The World Health Organization is also advocating for locally manufactured, quality-assured medicines and diagnostics to boost supply-chain security and regional self-reliance, working with African governments, manufacturers, the Global Fund and Unitaid.

Pamba said the shift toward integrated, locally financed systems supports Africa’s broader ambition for universal health coverage. “Protecting HIV testing within integrated programmes for TB, HPV and other diseases … is the next stage of our journey,” he wrote.

The goal, he said, is not to replace international assistance but to reduce dependence on it by building durable partnerships between governments, healthcare workers, donors and industry, ensuring Africa’s HIV response remains resilient even as global funding patterns change.

Wasiu Alli

Wasiu Alli is a business and economics journalist with more than two years experience covering macro trends, government policies, corporate earnings and comparative economics analysis. Alli turns raw data into trends that not only tells compelling stories but nudges investors to make valued and informed decisions. An alumnus of Lagos State University and trained at Lagos Business School, he heads the Companies and Markets desk at BusinessDay where he writes and supervises the production of well researched articles on earnings updates, corporate sectoral comparisons, market intelligence as well as interviews with C-suite executives.