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突破障碍,改变范式:非洲实现艾滋病可持续发展的激进议程。

Breaking barriers, changing paradigms: Africa's radical agenda for HIV sustainability.

作者信息

Chola Mumbi, Robalo Magda, Buse Kent, Oduro-Bonsrah Pokuaa, Ozoemene Jekwu, Dieng Abdoul, Akulu Ruth, Madzima Bernard, Coll-Seck Awa Marie, Sheneberger Robb, Nene Sesupo Makakole, Sikazwe Izukanji, Sidibe Michel

机构信息

Adult HIV Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.

Institute for Global Health and Development (IGHD), Bissau, Guinea-Bissau.

出版信息

Front Reprod Health. 2025 Aug 7;7:1612902. doi: 10.3389/frph.2025.1612902. eCollection 2025.

Abstract

Despite significant progress in the HIV response, the sustainability of this journey is threatened by over-reliance on external support and imported and often inappropriate models. The recent sudden shifts in the United States Government's foreign aid policy have heightened the urgency for independence. Africa is at a critical point, which presents an opportunity to move from dependency on external assistance to establishing itself as a self-sustaining center of innovation and sustainable growth. Africa must reshape its approach to the HIV response by addressing the continent's over-reliance on external funding and shift towards self-sustainability and inclusiveness. For Africa to sustain its HIV response, it is critical to have African voices and leadership in the HIV response, adopt African-centric approaches in moving from silos to the integration of programme governance, ensure renewed governance and accountability frameworks, Africanizing research and development and also ensure African medicines security and sovereignty. Africa must leverage Ubuntu approaches to empowering communities, women, youth, and key and vulnerable populations, and work with community networks for service delivery. There must also be sustained HIV Programmes in Fragile and Post-conflict Settings. It is also critical to secure domestic financing through a continental approach to financing health and well-being. For Africa to realize the vision of a sustainable, African-led, and owned HIV response and health agenda, collective action is imperative. African stakeholders must fully support this agenda and claim it as their own in the spirit of Ubuntu, within the context of continental plans for transformation and revitalization. Together, we can realize the vision of the "Africa we want."

摘要

尽管在应对艾滋病毒方面取得了重大进展,但过度依赖外部支持以及采用进口且往往不适用的模式,正威胁着这一进程的可持续性。美国政府近期对外援助政策的突然转变,加剧了实现独立的紧迫性。非洲正处于关键节点,这为从依赖外部援助转向成为一个自我维持的创新与可持续增长中心提供了契机。非洲必须通过解决对外部资金的过度依赖问题,重塑其应对艾滋病毒的方式,转向自我可持续性和包容性。为使非洲维持其艾滋病毒应对工作,关键在于让非洲声音和领导力在艾滋病毒应对中发挥作用,在从各自为政转向项目治理整合的过程中采用以非洲为中心的方法,确保更新治理和问责框架,使研发本土化,并确保非洲药品安全和主权。非洲必须利用乌班图理念来增强社区、妇女、青年以及关键和弱势群体的权能,并与社区网络合作提供服务。在脆弱和冲突后环境中也必须持续开展艾滋病毒防治项目。通过采取大陆性的健康与福祉融资方法来确保国内融资也至关重要。为使非洲实现可持续、由非洲主导并自主的艾滋病毒应对及健康议程的愿景,集体行动势在必行。非洲利益相关者必须全力支持这一议程,并本着乌班图精神将其视为己任,这是在大陆转型与振兴计划的背景下。我们携手共进,就能实现“我们想要的非洲”这一愿景。

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