Sub-Saharan Africa remains the region most affected by HIV and AIDS representing 69% of the global prevalence. Dramatic investments in the formal health sector over the past decade made possible scaled access to HIV prevention and management services across high-prevalence countries resulting in 56% of ART-eligible people on treatment, a 32% decline in AIDS-related deaths and 25% of new infections averted. Even with this progress, each year new infections outnumber those who access treatment.

1. “Collaborative Partnerships for Sustainable HIV responses in
a Funding-Constrained Environment: Blood: Water Model”
Nadia Kist, Blood: Water, Regional Partner Manager, Nairobi, Kenya; B.Bruerd Blood: Water, Director of Programs,
Nashville, United States: R.Klopp:Blood: Water, Vice President Africa Partnerships, Nashville, United States
A.Samir, Blood: Water, Senior Program Advisor, Nashville, United States: J.Nardella Blood: Water, Founder and
Chief Strategy Officer, Nashville, United States
Introduction: Sub-Saharan Africa remains the region most affected by HIV and
AIDS representing 69% of the global prevalence. Dramatic investments in the formal
health sector over the past decade made possible scaled access to HIV prevention
and management services across high-prevalence countries resulting in 56% of
ART-eligible people on treatment, a 32% decline in AIDS-related deaths and 25% of
new infections averted. Even with this progress, each year new infections
outnumber those who access treatment 2:1.
Background: As funding for HIV/AIDS is increasingly restrained globally, bio-
medical services emerge as the priority for bilateral commitments. However,
structural interventions are increasingly recognized as gatekeepers to accelerated
prevention achievements. Declining support for community-based programs cuts
critical interventions that mobilize service demand, supports retention, reinforces
adherence and mitigates barriers to health facilities.
Objectives/Methodologies: In response, a framework was developed that
complements bilateral strategies by leveraging private philanthropy to address gaps
and opportunities for structural community interventions and system
strengthening. This model targets African civil society organizations (CSO) with
multi-year community-focused grants paired with organizational strengthening: As
CSOs remain best placed to sustain the continuum of ongoing HIV-care and support.
Lessons Learned: This approach demonstrates the feasibility of partner-driven
funding with unrestricted grant mechanisms that are flexible, responsive and
contextually relevant. Central to the design of this framework is the principle of
sustainability. When applied deliberately in the context of national health strategies,
the anticipated outcome is a strengthened and resourced African civil society that
implements complementary need-based programs, enhances the efficacy of clinical
models and champions for their communities with government.
Way Forward: The momentum achieved over the past decade casts a greater
vision: Zero new infections by 2030. To achieve this, structural drivers that
marginalize and perpetuate vulnerability must be disarmed at the grassroots.
Private philanthropic organizations must build collective consensus around
strategic frameworks of engagement that enhance large-scale clinical priorities with
implementation of structural prevention at the community level. These synergies
will more efficiently resource comprehensive coverage of African-led and locally
sustained responses against HIV/AIDS.