12th SA AIDS Conference: Unite for Change – Empower Communities
- Karabo Makgato
The Deputy President of the Republic of South Africa, His Excellency Paul Mashatile, in his capacity as Chairperson of the South African National AIDS Council (SANAC), officially opened the 12th South African AIDS Conference on Monday, 08 September 2025, at Emperor’s Palace in the Gauteng Province.
This year’s conference, hosted under the theme “Unite for Change – Empower Communities and Redefine Priorities for HIV/AIDS,” brought together leaders, researchers, policy makers, academics, implementing partners, civil society organisations, and advocates from across South Africa, the continent, and the globe over four days to reflect on progress and chart the way forward in ending HIV and AIDS as a public health threat.
In his keynote address, Deputy President Mashatile emphasised the importance of shifting from a top-down approach to one that places communities at the centre of the HIV response. “To empower communities and redefine priorities for HIV/AIDS, our strategies must prioritise giving power and resources to those who are most affected,” he said, underscoring the need for community ownership, accountability, and inclusive service delivery.
The Deputy President acknowledged South Africa’s progress towards the UNAIDS 95-95-95 targets but noted challenges in the “second 95,” ensuring that people living with HIV remain on treatment. South Africa currently sits at 96-78-97. To address this gap, the Close the Gap – Start and Stay on HIV Treatment campaign was launched earlier this year, aiming to find 1.1 million people living with HIV who are not yet on treatment. He also highlighted SANAC’s recently developed HIV Prevention Roadmap 2025–2028, which aligns with the National Strategic Plan (NSP) 2023–2028 and prioritises evidence-based, community-led approaches.
Speaking at the opening plenary session, Dr Kate Rees and Dr Candice Chetty-Makkan, Co-Chairs of the 12th SA AIDS Conference, cautioned: “South Africa needs to be realistic about the HIV/AIDS situation it faces. Efforts to eradicate the epidemic must be more inclusive and transparent. One of the most pressing issues highlighted at this year’s Conference is the risk to South Africa’s world-leading HIV/AIDS programme, the largest globally, due to the sharp reduction in support from PEPFAR. While the programme previously relied on around R7.5 billion annually, the Treasury’s pledge of R753 million in bridging funds remains insufficient to sustain epidemic control.”
On day two of the conference, SANAC CEO, Dr Thembisile Xulu, joined a high-level plenary panel titled Re-imagining South Africa’s HIV Programme, alongside Dr Sandile Buthelezi, Director General of the National Department of Health, and Dr Linda-Gail Bekker, CEO of the Desmond Tutu Health Foundation, moderated by renowned health journalist Mia Malan. Responding to some of the reasons why countries affected by Funding Cuts, the SANAC CEO shared with the delegates that she was the Chairperson of the HIV Leadership Forum which is made up of CEO’s of National AIDS Councils (NACs) of over 40 countries in Africa, Asia, and Latin America. She highlighted that many countries had become overly reliant on donor-driven systems that operated parallel to national structures.
“These systems, designed mainly to meet donor requirements, often duplicate efforts and weaken opportunities to strengthen existing national health, social, and economic systems. Countries also fail to effectively engage the private sector, whose technology, innovation, and expertise could support more sustainable HIV programmes,” said Dr. Xulu.
Civil society’s pivotal role in HIV response was reaffirmed at the Closing Plenary on Thursday, 11 September, where SANAC Civil Society Forum (CSF) Chairperson, Mr Solly Nduku, presented CSF priorities towards 2028. These include expanding access to HIV primary prevention tools, scaling up youth-led programmes, advancing legal and policy reforms to decriminalise sex work, and strengthening community-led monitoring to improve service delivery. “Service provision, at its core, is about our people. The beneficiaries are not abstract numbers; they are the mothers, fathers, young people, workers, and leaders who depend on accessible and quality health services to live healthy lives. We therefore make a clear and urgent call for increased financial support and consideration for full implementation of our programmes as Civil Society Forum,” Mr Nduku urged.
The 12th SA AIDS Conference underscored both progress made and critical challenges ahead. Four key reflections emerged as guiding priorities for the next phase of South Africa’s HIV response:
- Improving surveillance to guide interventions– Delegates emphasised the need for accurate, granular, and timely data that reflects the true status of the epidemic, especially as 2030 approaches.
- Integrating service delivery models– There was strong consensus on rethinking health systems to cut costs and maximise efficiencies, particularly considering reduced financial support such as cuts in PEPFAR funding.
- Building community capacity– Greater investment in peer-to-peer education and mobilisation is essential to increase uptake of prevention tools like PrEP and PEP. With innovations such as Lenacapavir on the horizon, the persistent challenge of low uptake must be addressed.
- Advancing the triple elimination agenda– Opportunities and challenges for eliminating HIV, Syphilis, and Hepatitis B transmission from mother to child were discussed, reinforcing the global goal of ensuring that future generations are born free of these infections.
The conference reaffirmed that while challenges remain particularly funding gaps and persistent barriers to treatment, South Africa’s path forward lies in unity, resilience, and empowering communities to lead the response.