34 AFRICAN COUNTRIES SPEND MORE ON DEBT THAN HEALTHCARE. Winnie Byanyima, Executive Director of UNAIDS reports.

If Africa cannot take ownership of the HIV responses in the face of cuts, our continent could return to the darkest days of AIDS.

The cost of inaction? Lives lost.

We are seeing a humanitarian disaster unfold simultaneously at breakneck speed and in slow motion.

In 2023, 3,500 people acquired HIV every day. According to our latest estimates, if the US President's Emergency Plan for AIDS Relief (PEPFAR) is not reinstated, and nothing comes in its place, that figure will grow to 5,800.

The world will see 4 million more AIDS-related illnesses and 6 million more HIV infections by 2029.

We cannot address the aid crisis if we do not address the debt crisis.
First, the poorest countries in greatest need should have their debts cancelled. These are low-income countries in or close to debt distress, many facing default.

Fragile public services are already barely able to keep people alive, but debt obligations could force governments to gut what remains.

The world has a moral duty to act in solidarity.

Second, lower-middle income countries that have faced multiple shocks need breathing space to recover and invest in their economies.

African countries are facing debt interest payments up to nine times higher than those paid by wealthy countries. For these countries, debt restructuring is needed to curb interest rates and reschedule payments into realistic timelines.

Third, African governments must ramp up efforts to increase revenues through progressive taxation. Africa loses $89 billion every year to illicit financial flows, mostly aggressive tax planning enabled by tax incentives, exemptions, and loopholes. Health levies on tobacco, alcohol, and sugary beverages pose an opportunity to generate short-term revenue, while helping to curb unhealthy behaviours.

But the richest should shoulder the greatest burden, and that can only be achieved through taxing wealth, corporate profits, inheritance, and capital gains.

If Africa cannot take ownership of the HIV responses in the face of cuts, our continent could return to the darkest days of AIDS.

African leaders are rising to meet this critical moment with action. But the scale of the challenge means that we cannot simply reallocate existing budgets – we need more money in government coffers.

Ultimately, tackling debt and taxation head-on is the only path forward.