Presented by International Monetary Fund
African health leaders say the fight against HIV and AIDS starts at home, as they prepare for the day when U.S. cash dries up.
Also in today’s edition: More detail emerges on U.K. aid cuts, and how to successfully freelance in the global development world.
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Africa is the continent that suffers the most HIV infections and deaths, yet its fightback relies on flaky financing from a wavering American political system. To fix that, according to a diverse group of experts from across Africa, the continent needs a homegrown strategy to combat the disease, focusing far beyond money allocated for health commodities to better incorporate prevention, governance, integrated supply chains, sustainability, and community response.
“We want to see more Africans on the forefront,” explains Dr. Magda Robalo, president and co-founder of the Institute for Global Health and Development of Guinea-Bissau, in conversation with Sara Jerving, Devex’s senior global health reporter. Robalo adds that the response must be “driven by the continent.”
A new African-led HIV Control Working Group, co-chaired by Robalo, is mulling over domestic financing options and new strategies that look at people holistically.
Africa’s “precarious position” in the fight against HIV was underlined by the U.S. Congress’ decision this year to extend the $120 billion U.S. President’s Emergency Plan for AIDS Relief to next March only, rather than the standard five-year reauthorization, leaving what happens next up in the air. About half of PEPFAR-supported countries are in Africa.
Yesterday, Dec. 1, was World AIDS Day, a day to recognize that 39.9 million people globally live with the disease and that 1.3 million new infections were reported in 2023 — far exceeding the 2025 target of fewer than 370,000, on a road meant to lead to eradication by 2030.
Read: ‘The time has come’ — crafting a sustainable, African-led HIV response
The HIV and AIDS response has made remarkable progress over the last four decades, with treatments and infection prevention tools now available. But persistent stigma and discrimination are posing challenges to ending the AIDS epidemic by the end of this decade.
“That global solidarity that characterized the HIV response 20 years ago has waned because people don't see HIV the way they saw it 20 years ago or 25 years ago,” says Dr. John Nkengasong, head of PEPFAR. “We need to really continue to message very clearly that HIV is not a disease of yesterday. It is a disease and a serious threat for today.”
But longtime AIDS activist Asia Russell, executive director of Health GAP, tells my colleague Jenny Lei Ravelo that discussing sustainability in the HIV response needs to be “grounded in the reality that most African countries’ health budgets are currently outstripped by the size of their commercial debt owed to China.” There is nothing “sustainable” in a response that is given over to governments that criminalize and persecute the very communities that are in the greatest need of support, she tells Jenny, calling for governments to end their “racist, colonial era laws and policies” as the “first step toward real sustainability.”
Read our special report: The evolution of the HIV and AIDS response
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It’s no mean task to calculate how much aid each country in the Middle East and North Africa region receives, from which sources, and for what purpose — but Devex Senior Development Analyst Miguel Antonio Tamonan has you covered. After many hours poring over the Organisation for Economic Co-operation and Development’s creditor reporting system and country development finance data from the International Aid Transparency Initiative, he has a rundown of the funding funneled to Algeria, Egypt, Iran, Iraq, Jordan, Lebanon, Libya, Morocco, the occupied Palestinian territories, Syria, Tunisia, and Yemen.
Discover whether the amount disbursed by the OECD’s Development Assistance Committee donors in 2022 was up or down on the previous year, and how the region’s biggest sources of development aid – in alphabetical order, Canada, France, Germany, Japan, the United Kingdom, and the United States – rank in their generosity.
Miguel uncovered that Syria received the largest amount of ODA flowing to the region, about 14% of the total, and that education was the priority sector in MENA — which appears to make sense when one considers around 55% of its people are under 30, much higher than the OECD average of 36%.
Read: How much aid goes to the Middle East and North Africa? (Pro)
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The United Kingdom has revealed the size of cuts to its overseas aid programs in the current financial year, and they are significant — but nowhere near the scale feared during fierce debates over the last few months.
And there is a glimmer of hope with the promise of a £450 million ($571 million) increase in 2025-26. However, that is dependent on successfully cutting the huge sums diverted to other departments to pay the bills for hosting asylum-seekers, when the number of arrivals is still rising.
In October, the Labour government rebuffed calls to top up its aid budget, raising the prospect of a £700 million-plus cut to frontline spending by the Foreign, Commonwealth & Development Office in 2024-25. That drop will now be around £300 million, because higher gross national income has dragged up the 0.5% share of GNI the U.K. now allocates to aid.
Development Minister Anneliese Dodds told members of the U.K. Parliament that FCDO ministers “expect” a £450 million rise in 2025-26 to a budget of £9.24 billion, but admitted it relies on “measures to reduce the asylum backlog and end the use of expensive hotel accommodation” succeeding.
It is still unclear whether the immediate £300 million-odd reduction will require cuts to longstanding bilateral aid pledges — because, extraordinarily, allocations have yet to be announced with less than four months of the financial year to run.
ICYMI: UK aid on track to stay at 0.5% for rest of the decade
So you think becoming a freelance consultant in global development or humanitarian work is a straightforward and exciting way to pay the bills and build a career without compromising one’s values, lifestyle or ambitions? If you do, Jennifer Bangoura is here to tell you it’s a bit more complicated than that.
“It's not always glamorous and it's not always easy,” the careers expert — who says it took her “over a decade” to achieve a full freelancing life — told a recent Devex event audience. She unveiled four informed tips to smoothen the process, including that getting started doesn’t require a “six-month gig or contract.”
Read: 4 common misconceptions about succeeding as a development freelancer (Career)
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Outgoing U.S. President Joe Biden will be in Angola until Wednesday, where he will discuss his country’s investments in the region, including a railway project funded by the U.S. and the European Union. [France24]
The U.N. has suspended delivery of aid in Gaza via the Kerem Shalom crossing due to security concerns following the looting of convoys by armed gangs in recent weeks. [BBC]
Participants at the fifth U.N. Intergovernmental Negotiating Committee meeting in Busan, South Korea, have failed to reach an agreement on the scope of the global plastic treaty. [ABC News]
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