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Review Article
Country ownership and sustainable programming of the HIV response in South Africa: A scoping review
Submitted: 09 June 2023 | Published: 30 November 2023
About the author(s)
Refilwe N. Phaswana-Mafuya, South African Medical Research Council/University of Johannesburg (SAMRC/UJ) Pan African Centre for Epidemics Research (PACER) Extramural Unit, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa; and, Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South AfricaEdith Phalane, South African Medical Research Council/University of Johannesburg (SAMRC/UJ) Pan African Centre for Epidemics Research (PACER) Extramural Unit, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
Haley Sisel, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America
Lifutso Motsieloa, South African National AIDS Council, Pretoria, South Africa
Katherine Journeay, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America
Vuyiseka Dubula, Centre for Civil Society, School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa
Jabulile Sibeko, South African National AIDS Council, Pretoria, South Africa
Pholokgolo Ramothwala, South African National AIDS Council, Pretoria, South Africa
Abstract
Background: Concerns have arisen regarding the extent to which South Africa’s HIV response can be country-owned and sustainable given substantial foreign investment and technical support.
Objectives: To assess the extent to which South Africa’s national HIV response is country-owned.
Method: We conducted a scoping review of South African literature using the Global Health Initiative Framework for country ownership.
Results: South Africa has clear aspirations for what should be accomplished and strategies are aligned with national and international priorities. Although South Africa has leveraged community-based strategies to reach key populations (KPs), most are supported by international donors, which poses a sustainability challenge. Despite robust capacity strengthening and training programmes, South Africa continues to face healthcare worker shortages. While it is commendable that South Africa funds nearly 70% of the national HIV response, the funds mainly support HIV treatment. This may create dependency on international partners.
Conclusion: South Africa appears to be progressing well along the spectrum of country ownership, but sustained efforts are required to combat HIV. Greater ownership over KP programming and prevention services are especially needed to achieve greater impact.
Keywords
Sustainable Development Goal
Metrics
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