As donor funding declines and becomes less predictable, countries face a pressing question: how can HIV prevention be financed sustainably while ensuring equity and impact? Without careful planning, programmes risk disruptions, leaving the most vulnerable populations without critical services.

The answer lies in sustainable financing — embedding HIV prevention into national health and community systems, coordinating partners, and using resources efficiently. It’s about building a resilient financing ecosystem that can withstand shocks, ensure continuity, and reach the people who need it most.

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What Sustainable Financing Looks Like

Sustainable HIV prevention financing goes beyond replacing external funds. It ensures that services continue reliably, even when funding streams fluctuate, and that resources are allocated equitably. 

Countries are taking practical steps:

• Sustainability planning and financing transition: Preparing to move from donor-dependent programmes to domestic and pooled funding solutions.
• Costing, budgeting, and integration with national financial systems: Aligning HIV prevention with broader health budgets and public financial management processes.
• Efficiency and integration-oriented financing: Using strategic purchasing and results-based approaches while embedding prevention into wider health services.
• Equity protection through pooled and community financing: Making sure resources reach key populations and the most vulnerable groups.

One country shared how pooling donor, government, and community funds allowed them to maintain critical HIV prevention services during a period of funding uncertainty, ensuring that no populations were left behind.

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Turning Principles into Practice

The South-to-South HIV Prevention Learning Network helps countries translate financing principles into action. Peer learning exchanges and workshops provide opportunities to share experiences and explore solutions. Guidance and tools support:

• Designing resilient financing systems that can withstand funding fluctuations.
• Integrating HIV prevention into national health and community systems, so services are continuous and sustainable.
• Pooling resources across donors, government, and community mechanisms to protect equity.
• Using data and evidence to allocate resources efficiently and effectively.

Countries are also leveraging strategic guidance on domestic resource mobilisation and evidence-based tools for integrated, efficient, and sustainable financing to ensure programs continue even in uncertain funding landscapes.

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‍Why Sustainable Financing Matters

Strong, sustainable financing is the backbone of HIV prevention. It ensures programmes are resilient, integrated, and equitable, protecting services for key populations while making the most of limited resources. Without it, even well-designed interventions can fail to reach those who need them most.

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Actionable Steps for Country Teams

• Develop a financing transition plan from donor to domestic and pooled resources.
• Integrate HIV prevention into national health budgets and systems.
• Use strategic purchasing and results-based approaches to maximise efficiency.
• Pool resources across donors, government, and communities to ensure equity.
• Apply data-driven approaches to allocate funds effectively and track impact.
• Complete the relevant tab of the Pan-PSAT to identify prevention strengths and gaps in sustainable financing. 

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Takeaway: By embedding HIV prevention into national systems, coordinating partners, and planning for sustainable funding, countries can protect programmes, ensure equity, and secure long-term impact — even in a changing funding environment.

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