NEW YORK - UNAIDS chief Winnie Byanyima called on Tuesday for "radical change" following global aid cuts, telling AFP that African governments must re-prioritise their own health spending.
Last year, US President Donald Trump's administration dismantled the world's largest aid agency, the United States Agency for International Development (USAID), cutting off funding for programmes across the world.
Other Western countries, including France, Germany and the UK have also slashed foreign assistance, leaving humanitarian organisations reeling and severely affecting efforts to combat diseases such as HIV.
The UN's top body on combating HIV and AIDS lost about 25 percent of its total financial aid last year, Byanyima told AFP.
"So there is a need for Africa to quickly adapt its systems for health in order to keep its people alive and to work towards health sovereignty," she said.
"We don't have time to lose. This is a moment of radical change," Byanyima said in an interview on the sidelines of an African Union health summit in the Ghanaian capital, Accra.
The continent carries the most HIV infections in the world.
Sixty-four percent of people living with HIV worldwide reside in sub-Saharan Africa.
Last year, 60 percent of new infections occurred in Africa.
Local drug production
"Every country must make financial decisions, structural decisions to protect its people's health," Byanyima said.
She said Africa needed to finance more projects itself, re-allocate existing funds and use scarce money more efficiently.
"We must re-prioritise. We must spend differently if the health of our people is to be protected," she said.
"It's a critical moment to make financial decisions but to also integrate and move towards production of our own medicines.
"We have to begin local production.
"If we do not do that, for sure we will halt our progress," Byanyima said.
Stigma and discrimination
Beyond financing concerns, Byanyima also lamented the "serious pushback on human rights" for those with HIV, which was "pushing people underground" and away from receiving testing, prevention and treatment.
People who are "sexually different, gendered differently" suffer "discrimination" and "stigma".
"And sadly, what people don't want to accept is that they are part of our communities and transmission is across the groups," she said.
A string of African countries, including Ghana, have increased penalties on same-sex relations, further eroding LGBTQ rights on a continent where in many countries they were already tenuous.
Of Africa's 54 countries, only about 20 do not currently criminalise same-sex relations.
Byanyima also lauded the new "innovations" in the treatment and prevention of HIV, which she said help reduce infections to almost "zero".
Lenacapavir, developed by the US pharmaceutical company Gilead, is a long-acting injectable which both treats and prevents HIV and only needs to be administered twice a year.
Over 6,000 people were receiving the drug across five African countries by the end of March 2026, according to a UNAIDS report.
But Byanyima has called this "a drop in the ocean" compared to what is needed, calling for 20 million people to receive the drug.
She was optimistic that the goal of ending AIDS as a public health threat is achievable even without a cure or vaccine.
"We can reduce the deaths, because we have all the science we need for prevention. We have even new tools now, we now have an injectable that gives almost perfect protection.
"We can roll that out, we need to get that company, Gilead to get us out of a slow track, give us licences, get us to produce for the whole region," she said.
In a major step forward for medical sovereignty, international health agency Unitaid earlier this year announced that a South African laboratory will produce the generic version of Lenacapavir.
Studies show that Lenacapavir reduces the risk of HIV transmission by 99.9 percent.
- AFP